Lymphedema corresponds to the accumulation of fluids in a certain area of the body, which leads to swelling. This situation can happen after surgery, and it is also common after the removal of lymph nodes affected by malignant cells, due to cancer, for example.
Although rare, lymphedema can also be congenital and manifest in the baby, but it is more common in adults due to infections or complications from cancer. The treatment of lymphedema is done with physical therapy for a few weeks or months, in order to eliminate excess fluid and facilitate the movement of the affected body region.
How to identify
Lymphedema is easily observed with the naked eye and during palpation, and it is not necessary to perform any specific exam for its diagnosis, but it can be useful to check the diameter of the affected limb with a tape measure.
Lymphedema is considered when there is an increase of 2 cm in the circumference of the left arm, when compared to the measurements of the right arm, for example. This measurement must be made on every affected limb every 5 to 10 cm away, and serves as a parameter to verify the effects of the treatment. In areas such as the trunk, genital area or when both limbs are affected, a good solution may be to take photographs to evaluate the results before and after.
In addition to local swelling, the person may experience heaviness, tension, difficulty moving the affected limb.
Is lymphedema curable?
It is not possible to cure lymphedema because the result of the treatment is not definitive, requiring another period of treatment. However, treatment can significantly reduce swelling, and clinical and physical therapy treatment is recommended for approximately 3 to 6 months.
In physiotherapy it is recommended to do 5 sessions per week in the initial phase, until the moment when there is a stabilization of the swelling. After that period it is recommended to do another 8 to 10 weeks of treatment, but this time varies from person to person and the care you maintain in your day-to-day.
How to treat lymphedema
The treatment of lymphedema should be guided by the doctor and the physical therapist and can be done with:
- Remedies: as gamma benzopyrones or flavonoids, under indication and medical monitoring; Physiotherapy: it is indicated to perform manual lymphatic drainage adapted to the reality of the person's body. Lymphatic drainage after lymph node removal is a little different than usual, because it is necessary to direct the lymph to the correct lymph nodes. Otherwise, drainage can be harmful causing even more pain and discomfort; Elastic bandage: this is a type of bandage not too tight, which when properly placed helps to conduct the lymph properly, eliminating swelling. The elastic sleeve should be used, according to the recommendation of the doctor and / or physiotherapist, with compression of 30 to 60 mmHg during the day, and also during the performance of exercises; Bandaging: a tension band should be placed in overlapping layers after draining for the first 7 days, and then 3 times a week, to help eliminate edema. The sleeve is recommended for lymphedema in the arm and elastic compression stocking for swollen legs; Exercises: it is also important to perform exercises under the supervision of the physiotherapist, which can be performed with a stick, for example, but aerobic exercises are also indicated; Skin care: the skin must be kept clean and hydrated, avoiding wearing tight clothing or buttons that may injure the skin, facilitating the entry of microorganisms. Thus, it is preferable to use cotton fabric with velcro or foam; Surgery: can be indicated in case of lymphedema in the genital region, and in lymphedema of legs and feet of primary cause.
In case of excess weight it is important to lose weight and it is also recommended to reduce the consumption of salt and foods that increase fluid retention, such as industrialized and high in sodium, this will not eliminate excess fluids related to lymphedema, but it helps to deflate the body, as a whole.
When the person has had edema for a long time, the presence of fibrosis, which is a hardened tissue in the region, can arise as a complication, in which case specific therapy to eliminate fibrosis must be performed, with manual techniques.
Why lymphedema happens
Lymphedema is the accumulation of lymph, which is a liquid and proteins outside the blood and lymphatic circulation, in the space between cells. Lymphedema can be classified as:
- Primary lymphedema: although it is very rare, it is when it is caused by changes in the development of the lymphatic system, and the baby is born with this condition and the swelling remains throughout life, although it can be treated Secondary lymphedema: when it happens due to some obstruction or change in the lymphatic system due to infectious disease, such as elephantiasis, obstruction caused by cancer or the consequence of its treatment, due to surgery, traumatic injury or inflammatory disease, in which case there is always inflammation of the tissues involved and risk of fibrosis.
Lymphedema is very common after breast cancer, when lymph nodes are removed in tumor removal surgery, because the lymph circulation is impaired, and due to gravity, excess fluid is accumulated in the arm. Learn more about physical therapy after breast cancer.
