From the Guidelines
Lymphedema should be managed through a comprehensive approach, including manual lymphatic drainage, compression therapy, exercise, and meticulous skin care, as these methods have been shown to reduce swelling and prevent complications 1.
Key Components of Lymphedema Management
- Manual lymphatic drainage: a gentle massage technique to move fluid and reduce swelling
- Compression therapy: using bandages or garments like 20-30 mmHg compression stockings to help reduce swelling
- Exercise: to improve lymphatic function and overall mobility
- Meticulous skin care: to prevent infections and skin changes
Daily Management Strategies
- Elevate the affected limb when possible
- Perform prescribed exercises
- Wear compression garments during waking hours
- Practice good skin hygiene
- Avoid heat, tight clothing, blood pressure measurements, or injections in the affected limb
Importance of Weight Management
Weight management is crucial, as obesity can worsen lymphedema symptoms 1.
Role of Physical Therapy
Physical therapy with a lymphedema specialist can be beneficial for developing an individualized treatment plan 1.
Treatment Options
Low-level laser therapy, manual lymphatic drainage, and compression bandaging can be considered for improving lymphedema, although the evidence is graded as C 1.
Avoiding Ineffective Treatments
Diuretics like furosemide are generally not recommended long-term, as they do not address the underlying lymphatic dysfunction and can cause electrolyte imbalances.
From the Research
Lymphedema Treatment
- Complete decongestive therapy (CDT) is effective in reducing lymphedema, as shown in studies 2, 3, 4, 5
- CDT typically includes manual lymphatic drainage (MLD), compression therapy, skincare, and remedial exercises, adapted to the needs of the patient 3, 4, 5
- The standard of care for lymphedema encompasses risk reduction, early detection, Phase-I Complete Decongestive Therapy in a clinical setting, and Phase-II Self Management at home 4
Components of Lymphedema Treatment
- Manual lymphatic drainage (MLD) is a key component of CDT, although its contribution to the overall effectiveness of CDT has not been fully determined 2, 6
- Compression therapy, including bandaging and garments, is an essential part of lymphedema management 3, 4, 6
- Skincare and remedial exercises are also important components of CDT 3, 4, 5
Effectiveness of Lymphedema Treatment
- CDT can achieve a 45-70% reduction in lymphedema volume, as shown in study 5
- Compression bandaging (CB) and physical exercises can be as effective as CDT in reducing edema volume, as demonstrated in study 6
- Treatment of lymphedema with CDT can improve patients' functionality, mobility, and quality of life, as reported in study 5