From the Guidelines
For lymphedema in the arm, the best option is to use a compression sleeve specifically designed for lymphedema, as it applies graduated pressure to help reduce swelling and improve lymph flow, with manual lymphatic drainage being considered for those who have sensitivity to bandaging 1.
Recommended Management
To manage lymphedema in the arm effectively, consider the following steps:
- Get fitted for a custom compression sleeve by a certified lymphedema therapist.
- Wear the sleeve daily, especially during activities.
- Use a nighttime compression garment while sleeping.
- Perform regular lymphatic drainage exercises as taught by your therapist.
- Keep the affected arm elevated when possible.
- Maintain skin hygiene to prevent infections.
Additional Measures
Additional measures to consider include:
- Avoiding heat, tight clothing, or jewelry on the affected arm
- Staying hydrated and maintaining a healthy weight
- Considering the use of a pneumatic compression pump for 30-60 minutes daily
Rationale
Compression sleeves work by applying external pressure to help move excess fluid out of the arm and back into the lymphatic system, which helps reduce swelling, improves comfort, and prevents further progression of lymphedema 1. Regular use, combined with other management techniques, can significantly improve quality of life for those with arm lymphedema. It's also important to note that obesity is a risk factor for lymphedema, so maintaining a normal weight is crucial, and supervised, slowly progressive resistance training may be safe and effective for breast cancer survivors with regard to lymphedema development 1.
From the Research
Types of Sleeves for Lymphedema Management
- Auto-adjustable nighttime compression sleeves, such as MOBIDERM® Autofit, have been shown to be effective in maintaining lymphedema volume during the maintenance phase of treatment 2, 3
- Sequential pneumatic compression (SPC) is another option for managing lymphedema, with studies suggesting it can reduce arm volume by 7% 4
- Manual lymph drainage (MLD) has also been found to be effective in reducing lymphedema volume, with a 15% reduction in arm volume reported in one study 4
- Novel arm sleeves that provide graduated compression to a wider area of the body may also be beneficial in improving subcutaneous fluid and venous drainage 5
Comparison of Compression Therapies
- Compression bandaging has been compared to compression garments in one study, with results suggesting that bandaging may lead to greater volume reduction but worse upper extremity functional status 6
- Compression garments, on the other hand, may be more comfortable and easier to use than bandaging, but may not be as effective in reducing lymphedema volume 6
Key Considerations
- The choice of sleeve or intervention for lymphedema management should be based on individual patient needs and preferences
- Factors such as comfort, ease of use, and effectiveness should be taken into account when selecting a treatment option
- Further research is needed to fully understand the benefits and limitations of different sleeves and interventions for lymphedema management 2, 4, 3, 5, 6