Lymphedema is an accumulation of protein-rich fluid in the tissue space in the body. This accumulation causes swelling. Lymphedema most often affects the arms and legs. There are two types of lymphedema: primary and secondary.

Primary lymphedema may be due to a congenital malformation or the absence of lymphatics. It can develop in adults without any obvious cause.

Secondary, or acquired lymphedema, is more common. It can occur as a result of surgery, radiation, trauma, or infection.

Many types of cancer require the removal of lymph nodes. Anytime lymph nodes are removed or damaged, patients are at risk for developing lymphedema. Lymphedema may appear days, weeks, or even years after cancer treatment. Other conditions, such as post-surgical edema and congestive heart failure, can also lead to lymphedema if left untreated.

The Treatment Process

Manual lymph drainage/complete decongestive therapy is a noninvasive, highly effective treatment for lymphedema. Generally, treatment is made up of two phases:

Phase I

  • Manual lymph drainage (MLD)
  • Compression bandaging
  • Skin care
  • Decongestive exercises

Treatment is usually done three to five times per week for four to six weeks, depending on severity. Throughout phase I treatment, education plays a major role in helping the patient progress and preparing the patient for home management. The patient and family are taught self MLD, bandaging, limb size monitoring, and compression garment guidelines, all of which are necessary to maintain or improve the results achieved in phase I.

Phase II

  • Self MLD
  • Compression garment daily, bandaging at night as needed
  • Skin care
  • Continued exercises
  • Lifelong management