The best recommended treatment for stage 0 and 1 lymphedema is decongestive lymphatic therapy (DLT). Surgery is the treatment for stages 2 and 3. There is no cure for lymphedema; The swelling can be controlled by the following methods.
Decongestive Lymphatic Therapy
Intensive Phase – With the Therapist
You may receive daily lymphedema treatment for several weeks to reduce the lymphedema of the part affected by your therapist.
Maintenance Phase – Self Management
The intensive phase is followed by a maintenance phase in which you will be encouraged to maintain lymphedema-reducing status by wearing compression clothing, doing self-massage at home, and continuing the exercise daily. Your doctor will review it every few months to check the progression of treatment.
Components in the treatment of decongestive lymphatic therapy:
Compression Bandages and Clothing
Compression bandages / multilayer bandages are done by a trained therapist. At the end of the intensive phase, compression clothing such as gloves, socks or tights, sleeves, fitted clothes will be measured for you. It helps by moving lymphatic fluid out of the affected limb and further decreases the collection of lymph in the limbs, acting as a counterforce to the muscles. This stimulates more lymphatic drainage. Doing exercises using compression bandages or clothing helps more lymphatic drainage.
Compression clothing can be worn after a massage session to reduce lymphatic fluid recovery. Your doctor will show you how to apply a compression bandage, velcro bandage or clothing properly.
You should give special skin care and maintain healthy skin to reduce the chance of infections such as cellulite. Any cuts, scratches can create a door for organisms to enter your body and this can lead to an infection. Skin infections can damage the lymphatic system and cause lymphedema. Treat cuts, scratches immediately with an antiseptic cream. Moisturize your skin daily with an appropriate cream to keep it healthy. Take precautions to avoid damage to your skin.
The exercises help the lymph flow forward in the lymphatic system, thereby reducing the lymph collection. Walking, cycling, swimming also stimulate lymphatic drainage through muscle movement. There are special exercises you must do to reduce lymphedema. Your doctor will teach you how to do these exercises.
Specialized Massage Techniques
This is known as manual lymphatic drainage (MLD). It is a special massage therapy done by a trained therapist to move the lymph from the swollen areas to the normally functioning lymph nodes. This helps the lymph flow forward and reduces the lymph collection and swelling. During the maintenance phase, your therapist will teach you how to do a self massage, which is called simple lymphatic drainage at home.
Weight management and maintenance
Maintain a normal weight; Lymphedema can get worse with being overweight.
Pneumatic Compression Devices
A pneumatic compression device (PCD) consists of an inflatable arm or leg piece and an electric pneumatic pump that fills the garment with compressed air. This helps lymphatic drainage.
In some people, surgery may be used to treat lymphedema. There are four main types of surgery that can be helpful.
- Vascularized Lymph Node Transfer – Healthy lymph nodes are transferred to affected areas and reconnected to the lymphatic system to reduce swelling.
- Intravenous lymphatic anastomosis – This is done by connecting the lymphatic system to nearby veins. Outpatient procedure with small incision.
- Debulking – Removal of excess sections of skin and underlying tissue
- Liposuction – Fat Removal / Suction Of Affected Limb
We cannot say exactly what the best treatment method for lymphedema is this method because it depends on the stage of lymphedema, its fitness level and other comorbid conditions. Decongestive lymphatic therapy (DLT) is generally recommended for stage 0 and 1 lymphedema. Surgery is recommended for stage 2 and above stages.