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Lymphedema: Causes, Symptoms, Physical Therapy Treatment

What is Lymphedema?

Lymphedema is a condition in which the lymphatic system of the body is unable to properly transport lymph fluid from the tissue spaces back to the blood stream, leading to swelling in the limbs, trunk, genitalia, head, neck, or anywhere there is lymphatic tissue. Protein-rich lymphatic fluid is different than typical edema or swelling and can only be drained by the lymphatic vessels.  Because lymphedema is often mechanical in nature (meaning the structure of the lymphatic system is compromised), lymphedema is a life-long condition.  Finding and addressing lymphedema early helps ensure faster, more successful outcomes.  However, individuals with chronic lymphedema can also benefit significantly from physical therapy interventions.  There is no cure, but the condition can be managed successfully.

 

What causes lymphedema?

Lymphedema has a variety of causes including but not limited to: trauma, surgical intervention (ex: lymph node removal during surgery for breast or other cancers), heredity, infection, radiation treatment, or late effects of cardiovascular disease. Surgical removal of lymph nodes near the axilla (armpit) due to breast cancer is the most common cause of lymphedema in the United States; undergoing radiation after this surgery increases the likelihood of developing lymphedema.

 

What are the symptoms of lymphedema?

Swelling is the main symptom of lymphedema, which is often localized to one body region or limb.  Swelling may also be caused by other organ systems (especially the heart and kidneys) or musculoskeletal injury.  A detailed examination performed by a healthcare provider will determine the cause of the swelling and the appropriate treatment.  Other symptoms of lymphedema include recurrent infections, pain, heaviness or hardening of the affected limb, and swollen lymph nodes.

 

How can physical therapy help?

Physical therapists who are specially trained can help individuals with lymphedema regain function and movement.  Treatment includes manual lymphatic drainage, compression bandaging, and movement.  Guidance on compression garments, exercise and skin care for management at home in also provided for when therapy is discontinued. 

 

Who should be referred to a lymphedema-trained physical therapist for lymphedema therapy?

 

Those with:

  • Swelling in the arm or leg after treatment for cancer

  • Trouble getting jewelry on (rings, watches, bracelets) or having sleeve garments fit correctly

  • Lack of knowledge about the condition and prevention of lymphedema

  • “Pitting” in the tissues (where an indentation is made by a finger or pressure to the area which then takes time to ‘fill in’ after the pressure is removed)

Looking for a Physical Therapist that specializes in lymphedema?

Visit our PT Locator that will allow you to find PTs by zip code and specialty including lymphedema. Visit ptl.womenshealthapta.org.

Section on Women's Health
Section on Women's Health
Section on Women’s Health-American Physical Therapy Association (SoWH) is a professional association of more than 3,000 physical therapists. Members provide the latest evidence-based physical therapy services to everyone from childbearing women to peri-menopausal mothers, young athletes to men with incontinence or other pelvic health complications. To learn more, visit www.womenshealthpata.org.

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