Lymphoedema
Lymphoedema is a debilitating condition which involves the swelling of a limb or body part. It is often disfiguring and can affect the quality of life of the sufferer.
Causes of Lymphoedema are various and are labelled as primary, secondary, dynamic or combined.
- Primary Lymphoedema is when the lymph system is faulty (i.e. either lymph vessels are lacking or are not structured correctly) causing a compromise of drainage from the tissues. Symptoms can present themselves at birth or during other stages in life such as puberty.
- Secondary Lymphoedemas are when a usually healthy lymph system is subject to body trauma such as cancer, radiotherapy or injury.
- Other oedemas often have multiple complex origins such as Vascularissues, (Venous Insufficiency), Obesity, Lipoedema, Paralysis (DependencyOedema), active Cancer, Trauma, Infection and Scarring. The oedema becomes symptomatic when the lymphatic pathways and functions become compromised.
Lymphoedema management
Treatment for Lymphoedema is multifaceted.
- Manual Lymph Drainage works by softening the tissues and reducing the limb size.
- Skin care is essential for moisturising and creates a protective barrier and so prevents infection.
- Movement is vital to assist lymphatic return
- We know Best Practice dictates the use of Compression where appropriate as a key treatment modality. This works by increasing tissue pressure to accelerate the lymphatic flow to the lymph nodes as well as supporting the venous supply.
- Other proven modalities are Photobiomodulaton (low level laser), Deep Oscillation, Kinesiotape, Pneumatic compression pump.
Multi-layer compression bandaging
Complex Decongestive Therapy or CDT (sometimes called Decongestive Lymphoedema treatment or DLT) is when we do an intensive course of Manual Lymph Drainage with Multi Layer Compression Bandaging. This treatment is vital to bring the oedematous limb or body part down in size. It softens hard fibrotic tissue, prevents lymph leakage (lymphorrhea) and prevents infections such as cellulitis.
Treatment intensity will be decided on patient examination and either short stretch bandaging with padding or Coban 2 bandages will be ordered. Most of these are available on prescription. During this intensive phase skin will be monitored throughout and exercises suggested.
Low Level Laser and Kinesiotape may also be used if appropriate.
Following this intensive phase, the patient will be measured for compression garments and monitored on a regular basis to ensure the lymphoedema is under total control.
