From the Guidelines
Impaired circulation and lymph drainage can be effectively managed with compression therapy, which is the cornerstone of treatment, as it reduces venous stasis, improves lymphatic drainage, and enhances microcirculation.
Treatment Options
The treatment options for impaired circulation and lymph drainage include:
- Compression therapy with graduated compression stockings (20-30 mmHg for mild cases, 30-40 mmHg for more severe cases) worn daily from morning until bedtime, as recommended by the study published in the Journal of the American College of Radiology 1
- Complete decongestive therapy, which combines manual lymphatic drainage massage, compression bandaging, exercise, and meticulous skin care, is considered the gold standard for lymphedema
- Regular physical activity, such as walking 30 minutes daily, improves both circulation and lymph flow
- Elevation of affected limbs above heart level when resting helps reduce swelling
- Weight management is crucial as excess weight puts additional pressure on the circulatory and lymphatic systems
- For severe cases, surgical interventions like lymphovenous anastomosis or vascular bypass procedures may be considered
Key Considerations
When using compression therapy, it is essential to:
- Use a minimum pressure of 20 to 30 mm Hg, with higher pressures (30-40 mmHg) advised for more severe disease 1
- Apply compression bandages with more force generated at the calf over the distal ankle (negative graduated compression bandage) for improved ejection fraction in refluxing vessels and higher extrinsic pressures
- Ensure proper fitting, education, and detailed instructions to encourage adherence to compression therapy
Additional Therapies
Other therapies that may be considered for improving lymphedema include:
- Low-level laser therapy
- Manual lymphatic drainage
- Compression bandaging, as endorsed by the American Society of Clinical Oncology (ASCO) 1
From the FDA Drug Label
Patients with chronic occlusive arterial disease of the limbs frequently show other manifestations of arteriosclerotic disease Pentoxifylline has been used safely for treatment of peripheral arterial disease in patients with concurrent coronary artery and cerebrovascular diseases
The treatment options for impaired circulation and lymph drainage include pentoxifylline (PO), which has been used safely for the treatment of peripheral arterial disease. However, it is essential to note that the primary use of pentoxifylline is for improving blood flow and reducing symptoms of intermittent claudication.
- Key considerations for treatment with pentoxifylline include:
- Monitoring of anticoagulant activity in patients concomitantly treated with vitamin K antagonists
- Monitoring of prothrombin times in patients on Warfarin
- Periodic examinations for bleeding in patients with risk factors complicated by hemorrhage
- Dosage adjustments may be necessary in patients with hepatic or renal impairment 2 2
From the Research
Treatment Options for Impaired Circulation and Lymph Drainage
Impaired circulation and lymph drainage can lead to various health issues, including lymphedema. The following are some treatment options for impaired circulation and lymph drainage:
- Complete decongestive therapy (CDT) is effective in reducing lymphedema, as shown in a study published in 2013 3.
- Manual lymphatic drainage (MLD) massage is widely accepted as a conservative treatment for lymphedema, with some studies reporting positive effects on volume reduction, quality of life, and symptom-related outcomes 4.
- Compression therapy, including multilayer short-stretch compression bandaging, can be effective in reducing limb volume and improving patient outcomes 5.
- Physiotherapeutic rehabilitation of lymphedema, including approaches such as MLD, lymphedema rehabilitation exercises, and compression therapy, can achieve a 45-70% reduction in lymphedema volume 6.
- Diuretics combined with compression therapy may be a valuable option for refractory cases of limb edema in advanced disease 5.
Conservative Management Approaches
Conservative management approaches for impaired circulation and lymph drainage include:
- Complete decongestive physiotherapy (CDT)
- Manual lymphatic drainage (MLD)
- Compression therapy
- Lymphedema rehabilitation exercises
- Skin care
- Pneumatic compression
- Elevation of the extremities
- Thermal therapy
- Taping
- Aqua lymphatic therapy
Importance of Lymphatic System
The lymphatic system plays a crucial role in maintaining tissue and plasma volume homeostasis, and impaired lymph drainage can have far-reaching effects on cardiovascular disease, immune surveillance, and cancer 7.