Lymphedema: Questions and Answers

By Matt Humphrey, OTR/L, CLT, CAPS

The lymph system is a network of lymph vessels, tissues, and organs that carry lymph throughout the body. We have lymph nodes throughout our body with primary areas in our neck, sternum, abdomen, and groin. Anatomically, not everyone’s lymph system is the same; some people have more lymph nodes than others in certain parts of their body.

What is lymphedema and how does a person get it?

Lymphedema is the build-up of fluid in soft body tissues when the lymph system is damaged or blocked, and lymph is unable to flow through the body the way it should. Lymphedema usually occurs in an arm or leg but can also occur in the face, neck, and trunk areas of the body when lymphatic channels are blocked or damaged. The most common causes of lymphedema include:

• Cancer. If cancer cells block lymph vessels, lymphedema may result. A tumor may block lymph nodes as it grows and cause a backup of fluid in parts of the body.

• Radiation treatment for cancer. Although procedures have improved with new technology and preciseness of radiation treatments, radiation can cause scarring and inflammation of lymph nodes or lymph vessels.

• Surgery. In cancer surgery, lymph nodes are often removed to see if the disease has spread. However, new techniques and education have limited lymph node removal en masse although lymphedema can still occur. Lymphedema also can take place after undergoing other surgical procedures that compromise the lymphatic system.

• Parasites. In developing countries and in the tropics, the most common cause of lymphedema is infection with threadlike worms that clog the lymph nodes. This is also called elephantiasis.

If I have lymphedema, what can I do?

Lymphedema can’t be cured, but the swelling can be controlled and kept from getting worse. The key is management. Through massage, diet, compression, and exercise, the damaged lymphatic system can be addressed. Staying healthy and understanding the condition of lymphedema will allow you to live an active lifestyle. Certified lymphedema therapists (CLTs) can also help manage the condition through education, manual lymphatic drainage techniques, and compression so that you can remain active and functional.

What happens if lymphedema goes untreated?

Left untreated, lymphedema can worsen and cause severe swelling and permanent changes to the tissues under the skin, such as thickening and scarring. Patients can have weeping edema that can lead to infections or cellulitis. In severe cases, untreated lymphedema can result in papillomas, which are bumps or nodules on the skin. Severe cases can hamper the ability to move the affected limb, increase the risks of skin infections and sepsis, and lead to skin changes and breakdown. Some extreme cases may require surgery, performed by a vascular surgeon, to remove swollen tissue or to create new drainage routes.

What are the best treatment options for lymphedema?

CLTs can teach you techniques and provide equipment that will help reduce the swelling caused by lymphedema. These include:

• Exercises. Gentle contraction of the muscles in the arm or leg can help move the excess fluid out of the swollen limb. Elevated pumping exercises are emphasized after a manual lymphatic drainage treatment from a therapist.

• Manual lymph drainage. Therapists trained in this massage-like technique use very light pressure to move the trapped fluid in the swollen limb toward an area with working lymph vessels. Patients should avoid manual lymph drainage if they have a skin infection (such as cellulitis), blood clots, or active cancer in the affected limb.

• Compression bandages. Using low-stretch bandages to wrap the entire limb encourages lymph fluid to flow back toward the trunk of the body.

• Compression garments. Close-fitting elastic sleeves or stockings can compress the arm or leg to encourage lymph fluid drainage. These garments often require a prescription to ensure that the proper amount of compression is used. You may need to be measured by a professional to ensure proper fit.

• Sequential pumping. A sleeve worn over the affected arm or leg connects to a pump that intermittently inflates the sleeve, putting pressure on the limb and moving lymph fluid away from the fingers or toes.

Although lymphedema is a chronic disease, it can be managed and treated so that those living with this illness can lead vital and active lives.

For more information about lymphedema treatments or to schedule an appointment with a certified lymphedema therapist (CLT), call Unity Health & Wellness at 435-703-6600, or visit their website at unityhealthutah.com.

About the Author

Matt Humphrey is an occupational therapist who grew up in Houston, Texas. He graduated from the University of Texas Medical Branch in Galveston, where he and his wife of twenty-eight years, Kerry Ann, also an occupational therapist, met. He has worked in southern Utah as an occupational therapist for twenty-eight years. He has coached many youth and club sports teams. Matt loves golfing and running, even in the extreme heat of southern Utah. He and Kerry Ann recently opened their own wellness clinic, Unity Health and Wellness, in Hurricane, Utah, that offers aerial yoga.

Matt and Kerry Ann Humphrey