Treatment Options
There is currently no cure for lymphedema, and if left untreated, the condition can worsen, leading to increased swelling and pain, progressive hardening of the affected tissues (fibrosis), and recurrent infections (cellulitis). The condition can also decrease mobility, dexterity, range of motion and the ability to perform activities of daily living. With effective treatment, however, patients can manage their symptoms, minimize infections, and improve their overall health and quality of life.
Complete Decongestive Therapy: Two-Phased Treatment Intervention for
Lymphedema Management
Professional consensus deems complete decongestive therapy (CDT) as the “Gold Standard” for the treatment of lymphedema. Provided by a trained lymphedema therapist, CDT is a multi-modal treatment approach consisting of intensive in-clinic treatment (Phase I), followed by at-home self-management (Phase II).
Phase I: In-Clinic Decongestive Therapy
Phase I focuses on decongesting affected areas, reducing limb volume and fibrosis, and instructing the patient in self-management of this chronic condition.
Components may include:
- Manual lymphatic drainage (MLD) therapy
- Compression bandaging
- Decongestive exercise
- Meticulous skin and nail care
- Instruction in self-management
Phase II: At-Home Self-Management
In Phase II, the patient assumes responsibility for managing and maintaining the benefits achieved during Phase I. The treatment components may include some or all of those administered in Phase I, but are customized for the patient, based on the individual’s needs, capabilities, lifestyle and responsiveness to treatment.
Components include:
- Compression garments (daytime)
- Compression bandaging or alternative (nighttime)
- Meticulous skin and nail care
- Daily decongestive exercise
- Self-MLD or alternative (such as the Flexitouch system)
- Follow-up visits with lymphedema therapist (as needed)
Manual Lymphatic Drainage (MLD) Therapy: Key Treatment Component
Studies show that in-clinic MLD therapy, a key component of CDT, is a highly effective method for the treatment of lymphedema. Performed by a certified lymphedema therapist, MLD utilizes a sequence of highly specific hand motions consistent with established anatomic and physiologic principles to enhance lymph flow. These techniques utilize the application of slight pressure and stretch against the skin (“working phase”) to promote movement of fluid in the desired drainage direction followed by a release (“relaxation phase”) in which a vacuum caused by the passive distention of the tissue leads to refilling of the lymph vessels. This gentle, systematic, massage-like technique stimulates lymphatic function and re-directs fluid away from congested and swollen areas to functioning, unaffected regions so that the fluid can be properly managed by the body.
Once discharged from in-clinic therapy, patients need to continue daily treatment at home utilizing self-MLD, if they are able, along with any other treatment components recommended by their clinician. Patients with lymphedema, however, often lack the strength, flexibility or other physical skills to perform self-MLD and other treatment components consistently and effectively. As a result, their symptoms can worsen and may lead to increased as swelling and pain, progressive hardening of the skin (fibrosis), and/or recurrent infections (cellulitis).
The Flexitouch system, designed by a certified lymphedema therapist, simulates MLD therapy allowing patients to treat lymphedema at home on a daily basis. The Flexitouch system can be used in place of, or in combination with, self-MLD and other treatment components recommended by a clinician, enabling patients to maintain reductions in limb volume and other symptoms in between clinic follow-up visits. The Flexitouch system minimizes the obstacles to successful at-home treatment by automating self-MLD therapy. Used daily, the Flexitouch system offers patients a way to successfully manage their lymphedema at home and experience a more satisfying quality of life.
For more information, please visit:
The National Lymphedema Network (NLN)
www.lymphnet.org
National Cancer Institute: Lymphedema
www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/patient
Mayo Clinic.com: Lymphedema
http://www.mayoclinic.com/health/lymphedema/DS00609/DSECTION=1