Understanding Lymphedema Therapy

Lymphedema is a chronic condition of localized tissue swelling that can affect the arms, legs, face, neck, torso, and/or the genital region. Common causes of lymphedema include heredity, trauma, surgeries, cancer and cancer-related treatments that include lymph node removal and radiation therapy. Other factors include obesity, diabetes, chronic heart failure, limited mobility, and disease of the veins.

How do you know if you’re at risk?

These are some of the symptoms you could experience with lymphedema that often go under-recognized or under treated by medical professionals:

  • Swelling in the legs or arm that doesn’t go away
  • Heaviness, fullness, and/or achiness in the limb
  • Difficulty wearing shoes or certain clothing because of swelling

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If you think you or someone you know may have symptoms of lymphedema, it is important to be evaluated by a medical professional. A physician, nurse practitioner, or lymphedema therapist can provide a thorough evaluation and a confirmed diagnosis. The standard of care for a patient with lymphedema is a treatment called Complete Decongestive Therapy (CDT). CDT should be performed by a practitioner that has had at least 135 hours of advanced training in lymphedema.

What is CDT?

It is a treatment that requires extensive commitment by both the patient and their therapist, and includes 4 key components: skin care, exercise, manual lymphatic drainage, and compression bandaging. See our recent blog about CDT here. This active phase of therapy is usually 3- 5 times per week for 4 to 12 weeks.

The goal of this therapy is to reduce the swelling in the affected area enough for the patient to transition to self-management, including appropriately fitted and prescribed compression garments and an individually prescribed home care regimen. Because lymphedema is a chronic condition, patients are encouraged to follow up with their lymphedema therapist every 6 months for reassessment and new compression garments.

What happens if lymphedema swelling is ignored and left untreated?

Untreated lymphedema can result in hard, thickened skin, wounds that are difficult to heal, large limbs that make it difficult to move, and increased risk of skin infection, known as cellulitis. Progressed cellulitis can result in infection of the body’s internal organs, leading to severe illness and even death.

March has been designated Lymphedema Awareness month in an effort to bring awareness to this under-recognized and under treated disease. Lymphedema management has never belonged to any particular medical specialty and is presently underfunded by Medicare and most Medicare supplemental insurance plans. Consequently, many patients with this diagnosis are left with the high cost of funding treatment supplies and compression garments in addition to co-payments for treatment.

The lymphedema physical therapists at Penn Therapy & Fitness are committed to helping patients receive optimal treatment for their lymphedema despite the many challenges. Through our outpatient lymphedema program, we work with patients to provide resources for the tools and treatment for long-term management. Our team of experienced lymphedema therapists provide care at several Penn Therapy & Fitness locations across the region.


About the Blogger:

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Erin Fazzari, MPT, CLT, CWS, DWC received her Masters of Physical Therapy from the University of the Sciences in Philadelphia in 2002. She has a well-rounded skill set having worked in a variety of settings including outpatient orthopedics, acute care, skilled nursing, and inpatient rehab. She specializes in the treatment of patients with lymphedema, cancer-related fatigue, and chronic wounds.