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What is lymphedema?

Lymphedema is swelling in your body, caused by an abnormal buildup of lymphatic fluid. This protein-rich fluid normally flows throughout the body, but if the lymphatic system is damaged, then the fluid will start to build up and cause swelling.

If not treated, lymphedema can progress and lead to fibrosis (hardened tissues), skin changes, and cause difficulty with your function and mobility. Common causes of lymphedema include cancer and cancer treatment, injuries or trauma to the lymphatic system, infections, and obesity. It most often develops in the arms and legs, but it can also occur in the head, neck, and torso.

Signs and symptoms of lymphedema that can be experienced in the affected body part:

• Decreased joint range of motion
• Heaviness and aching
• Limited mobility and function
• Pitting, or when a mark is left on the skin after applying pressure
• Swelling
• Tight-fitting jewelry or clothing

What does lymphedema treatment involve?

Complete decongestive therapy, or CDT, is considered the gold standard in the treatment of lymphedema. This treatment is carried out by a specially trained certified lymphedema therapist (CLT) and is composed of four primary interventions:

1. Compression: This can include both compression wrapping, which is performed in the office by your physical therapist and uses short-stretch bandages, and compression garments, which you are fitted for toward the end of your treatment. Compression is needed lifelong for those living with lymphedema.
2. Exercise: Staying active and moving your joints and muscles helps to move the fluid out of the affected body part. Your physical therapist may recommend using compression while exercising to help reduce the lymphatic fluid or decrease the risk of swelling.
3. Manual Lymphatic Drainage (MLD): This is a specialized hands-on technique that moves the lymphatic fluid away from the affected body part. Your physical therapist will teach you how to perform MLD, and may recommend an intermittent pneumatic compression device (pump machine) for home use.
4. Self-care: These are everyday tasks and skin care that you can do to reduce the risk of lymphedema. Your physical therapist will review these tips with you.

It’s important that all four interventions are used to effectively treat lymphedema. At ÂÜÀòÉç Jacksonville, your CLT physical therapist is trained to implement these interventions tailored to your lymphedema presentation and goals.

What should you expect at your evaluation and follow-up visits?

Your physical therapist will ask about your medical and surgical history and your lymphedema symptoms. You’ll discuss any prior treatments, as well as your goals for physical therapy.

At your follow-up appointments, your physical therapist will implement CDT interventions. This includes specific exercises, teaching you how to perform MLD, compression wrapping, and educating you on the condition and how to best care for your skin.

As the swelling reduces, your physical therapist will assist you with transitioning to compression garments, like compression sleeves or stockings, to continue wearing to manage lymphedema.

It’s never too early or late to address lymphedema. We have CLTs at ÂÜÀòÉç Rehabilitation – Emerson, ÂÜÀòÉç Rehabilitation – Jacksonville, and ÂÜÀòÉç Rehabilitation – North.

Call 904.427.8900 for more information or to schedule an appointment.

About the author

Alexandra Hill earned her doctorate of physical therapy at the University of Florida and completed a women’s health physical therapy residency at Duke University. Alexandra is a dual board-certified clinical specialist in women's health and oncologic physical therapy, as well as a LANA-certified lymphedema therapist. She specializes in pelvic health, lymphedema, and oncology rehabilitation for all genders, and works at ÂÜÀòÉç Rehabilitation – Emerson.