Treatments
Most HelpfulTreatments in this category include:
Complete decongestive therapy is a two-phase, comprehensive, multipronged approach that includes skin care, manual lymph drainage (MLD), compression bandaging, and movement therapy to decrease swelling and pain, as well as increase a limb's range of motion. Compression bandaging during the intensive phase (or phase one) consists of wrapping with special inelastic, low-stretch bandages after MLD. They are worn daily between MLD sessions. At the end of the intensive phase, the patient is fitted with an elastic-type garment that may include a gauntlet for arm lymphedema. This is the start of the maintenance phase (or phase two), when the patient wears a prescribed compression garment by day, and at night performs simple lymph drainage followed by compression bandages. Not every patient will need all of these components, and the earlier treatment is initiated, the less burdensome the therapy.
The goal of complete decongestive therapy is to stimulate the lymphatic system to drain the lymph out of blocked areas so that it can re-enter the lymph system. Moving the lymph is vital to preventing fibrosis and helps prevent infections. Certain bacteria thrive on the protein buildup in congested tissues.
Because lymphedema can predispose you to getting an infection, prompt treatment with antibiotics is crucial when symptoms first appear. Early symptoms of localized infection can include swelling and heat where lymph nodes have been removed, as well as fever and a general sense of "ill-being" (called malaise).
Likely to Be HelpfulMaintaining a healthy weight according to the BMI (body mass index) can reduce swelling and make your lymphedema more manageable. If your BMI score is higher than 30, you may have a higher risk for lymphedema. Women who develop lymphedema after breast cancer treatment should be particularly careful to watch their weight.
Manual lymph drainage is a component of complete decongestive drainage. Manual lymph drainage is an advanced, specialized type of massage that moves lymph away from the swollen area so that it can drain normally. This type of massage can be administered only by a trained therapist.
Skin care is crucial when you have lymphedema because your skin is your first line of defense against bacterial and fungal infections. When lymph doesn't move properly, it can't filter out microorganisms that are able to get through your skin barrier-through seemingly harmless things such as a cut, hangnail, or ingrown toenail. Good skin care should include all of the following.
May or May Not Be HelpfulExercise is a good way to get lymph moving because muscle contractions (from walking or any other exercise) help propel lymph through your lymph vessels. Consult your physician before starting an exercise program. Stop exercising immediately and call your physician if you notice increased swelling or pain.
If you have lymphedema and have had several infections in the past, you may be prescribed antibiotics as a preventive measure. This is not needed universally, but it is important to have antibiotics with you when you travel. Click here for more details on travel tips.
Not Enough EvidenceHyperbaric oxygen forces oxygen into your skin at a pressure higher than atmospheric pressure. This painless procedure involves lying in a closed chamber for a preset period of time. Hyperbaric oxygen has been used with success to treat a wide variety of health problems.
If you develop ulcers as a result of lymphedema, nanocrystalline silver ointment has been used with success in treating such ulcers. Silver is a natural antibiotic.
A pneumatic compression pump can be used to help lymph drainage. The principle is similar to that of a compression garment, but the pump applies intermittent pressure to the area. This is not helpful in all cases of lymphedema; other medical conditions might preclude your physician from prescribing this.
Simple lymph drainage is a self-administered form of manual lymph drainage. The goal is to massage the skin lightly away from a clogged area to a place where the lymph can drain.
Surgery is considered a last resort in treating lymphedema. Surgical procedures may include bypassing lymphatic obstructions, linking lymph vessels to veins to help drainage, liposuction, removing selected fatty tissue ("debulking"), and lymphatic grafting. The safety and benefits of such surgical procedures are unclear.
Low-level laser therapy (LLLT) uses a laser that emits infrared light, which can penetrate deep into tissue. This has been used with success on patients undergoing mastectomy. Using LLLT on other areas of the body where lymph nodes have been removed has not yet been studied. Benefits can include the following: decreased volume of fluid in the area; softening of hardened tissue; decreased pain, stiffness, and heaviness in the arm; improved arm mobility, and improved skin integrity. LLLT may also stimulate your immune system.
Diuretics control how much water the body retains. Diuretics are not helpful with lymphedema because proteins are being displaced-not water.
Benzopyrenes are a group of compounds with wide-ranging effects. Some benzopyrenes possess anti-inflammatory properties; others act as antioxidants. To date, treatment with benzopyrenes has produced small effects, but they may be transient. Some benzopyrenes can damage your liver.
Other medical conditions:
If you have chronic, nonpitting lymphedema, deep vein thrombosis or pulmonary embolus, congestive heart failure, active cellulitis, severe peripheral neuropathy, active metastatic disease affecting the limb, or other select conditions, you should not use a pneumatic compression pump. Your physician will know whether this option is right for you.
