So what exactly is Lymphedema and what is the best treatment. Read on to find out more….
What is Lymphedema ?
Lymphedema is the condition caused when an accumulation of lymphatic fluid builds in a specific area of the body, most commonly the legs, resulting in swelling.
The lymphatic system consists of a network of lymph nodes and lymphatic tissue.
It plays a vital role in the circulatory and immune systems, transporting lymph fluid throughout the body which strengthens the body’s immune function.
Lymphedema occurs due to an impaired lymphatic system or when the body produces too much interstitial fluid for the lymphatic system to handle.
What are the types of lymphedema?
Typically, there are two types of lymphedema.
Primary lymphedema can occur due to genetic abnormalities within the lymphatic system.
Secondary lymphedema occurs when a health lymphatic system is put under a severe amount of stress or is damaged due to ailments such as bodily inflammation, cancer or chemotherapy/radiation.
Signs and symptoms of lymphedema
Lymphedema can be difficult to detect and diagnose.
In some cases when lymphedema is left untreated it can lead to skin infections, cellulitis, lymphangitis, lymphadenitis and skin ulcers.
Lymphedema can also result in low self esteem and poor body image which can cause stress, anxiety and psychological distress.
Early signs of lymphedema include:
- Discomfort and aching, particularly in the limbs
- Reduced range of motion
- A feeling of heaviness or tightness
- Recurrent infections
- Skin thickening or hardening
Stages of lymphedema
After lymphedema has been diagnosed by a doctor, it will be classified into different stages. Globally, there are several different staging systems used, but the most common is the International Society of Lymphology (ISL) Lymphedema staging system.
ISL Lymphedema Stage 0
A subclinical state where swelling is not evident despite impaired lymph transport.
This stage may exist for months or years before edema becomes evident.
ISL Lymphedema Stage I
Early onset of the condition where there is accumulation of tissue fluid that subsides with limb elevation.
However, swelling soon returns when the limb is returned to a normal position.
ISL Lymphedema Stage II
Limb elevation alone rarely reduces swelling. Tissue becomes increasingly firm due to fibrosis.
Fibrosis is the formation of fine, firm structures within the tissues that causes hardening.
ISL Lymphedema Late Stage III
Tissue fibrosis becomes more evident. Skin colour may change, normal skin elasticity is lost and as a result, skin hangs in folds.
ISL Lymphedema Stage IIII
The tissue is hard (fibrotic) and pitting is absent.
Skin changes such as thickening, hyperpigmentation, increased skin folds, fat deposits and warty overgrowths develop.
Treatment for lymphedema
Lymphedema is often a debilitating and chronic condition. Whilst currently there is no cure, there are several ways to treat and manage symptoms.
Lymphedema treatment should focus on optimising interstitial fluid flow, reducing swelling and improving overall skin condition. If you suffer from early stage or mild lymphedema, it can be managed with regular exercise, skin care and Class I compression stockings.
Severe or more advanced lymphedema can require complete decongestive therapy (CDT).
CDT consists of an initial intense reductive phase during which you receive daily care from a lymphedema therapist.
This is followed up with a maintenance phase where you take over your own treatment using the skills and knowledge they have learned.
CDT combines the following treatments:
- Manual lymphatic drainage
- Compression bandaging and Stage II and Stage III compression stocking therapy
- Regular limb movement and exercise
- Skin care protocols
- Patient education
Depending upon the stage of your lymphedema and upon the recommendation of your lymphedema therapist, Bodyment can help find you find the right brands, compression level, and sizing.
The amount of compression is determined in the amount of compression from the ankle to the top in millimeters of mercury (or mmHg).
That calculation is often broken down into classes – Class I, Class II, etc.
The most used compression levels:
- 8-15mmHg – Anti-embolism or “TED”
- 15-20mmHg – Class I or Travel Socks
- 20-30mmHg – Class II
- 30-40mmHg – Class III
Then there is the medical hosiery that is not classified. These garments have all-over compression and are not recommended as they do not push fluids upwards through the legs.
In treating lymphedema, the aim is to use compression therapy to support tissues, veins and muscles and encourage your body to move lymphatic fluid.
Historically, surgery has shown to be largely ineffective and has had disappointing outcomes compared with non-surgical lymphedema therapy.
Whilst lymphedema is a lifelong condition, the right lymphedema specialist, treatment plan and compression therapy garments can help you to regain control back over your life.