Lymphedema Therapy

What is Lymphedema?

Lymphedema is the swelling of soft tissues as a result of the accumulation of protein-rich fluid in the extracellular spaces. It occurs most frequently in an extremity but can be seen in the head, neck, abdomen, and genitalia.

There are two types of lymphedema. Primary lymphedema occurs without any known precipitating cause and is due to inadequate or non-functional lymphatic vessels. Primary lymphedema present at birth is called congenital lymphedema. Lymphedema praecox evolves in adolescence or mid-life. Lymphedema tarda evolves late in life.

Secondary lymphedema is precipitated by an event causing blockage or interruption of the lymphatic vessels. In the United States, the most common causes are surgery involving the lymph nodes, radiation therapy, trauma, and cancer. It is most often seen following surgery for cancer of the breast, pelvic area, and resections for lymphomas and melanomas.

As lymphedema progresses, the involved areas swell more and more. Mobility can be severely impaired as the affected areas increase in girth. Joint movement is restricted and painful, and the skin over the involved areas becomes taut and dry. The subcutaneous tissues can become hard and fibrotic which impairs the flow of blood and oxygen to the area. This unhealthy state often leads to recurrent infections because the high protein lymph fluid is a good growth media for bacteria and fungi. These infections can be life-threatening and may require hospitalization for intravenous antibiotic therapy.