LymphedemaIn Austin, San Antonio, & surrounding cities
Lymphedema is a painful condition resulting in persistent swelling of an arm or leg due to a blockage in your lymphatic system, an important part of your immune and circulatory systems. It is most commonly caused by removal or damage of lymph nodes during cancer treatment.
What is lymphedema?
The lymphatic system is an important part of the body’s immune system and works with the circulatory system to filter fluid and proteins. Lymphedema is a condition in which the lymphatic system is not able to transport fluid efficiently. When transportation is less efficient, the fluid accumulates and becomes congested like a traffic jam. Often times, this congestion looks like persistent swelling of an arm, leg, breast, or other body region. Lymphatic congestion can occur for many reasons, the most common being removal of or damage to lymph nodes during cancer treatments.
While there is currently no cure for lymphedema, it can be managed!
Treatment for Lymphedema
The most effective management of lymphedema includes the following components: education, skin care, manual lymphatic drainage, compression, and exercise. These components are known as complete decongestive therapy (CDT). (Disecco et al. 2024).
Education around the lymphatic system and the importance of de-congestion can reduce the risk of infections and mitigate progression of symptoms. (McNeely et al. 2024).
Skin care is imperative for managing and preventing lymphatic dysfunction. Lymph fluid accumulates underneath the skin. Any break in the skin risks exposure to bacteria and thereby infection.
Manual lymphatic drainage (MLD) is a specialized massage technique which facilitates the movement of lymph fluid.
Compression is achieved by a special wrapping technique and then by a custom garment. The affected area is wrapped with bandages first in order to gradually de-congest the area. Once the area has de-congested, a custom garment is used to maintain limb size and limit disease progression. The bandaging process takes approximately 2-3 weeks. To be effective, the affected area must be wrapped for ~23hr/day. After 2-3 weeks, measurements can be taken for a custom garment.
Exercise provides natural compression and circulation. When muscles work, they pump fluid from the limbs to the heart and abdomen. This component of CDT performed with compression is our most powerful way to manage lymphedema long-term.
Insurance Coverage:
TexPTS will contact your insurance carrier for you during your initial appointment to obtain detailed information about your coverage.
Medicare and most insurance companies cover much of the cost of physical therapy appointments.
There is variable coverage for supplies (such as compression bandages) and compression garments. Your therapist will work with you to coordinate insurance coverage of compression supplies.
References:
DiCecco, S., Davies, C.C., Gilchrist, L. et al. Complete decongestive therapy phase 1: an expert consensus document. Med Oncol 41, 304 (2024). https://doi.org/10.1007/s12032-024-02407-4
McNeely, M.L., Al Onazi, M.M., Bond, M. et al. Essential components of the maintenance phase of complex decongestive therapy. Med Oncol 41, 289 (2024). https://doi.org/10.1007/s12032-024-02442-1
