Physiotherapy & Rehabilitation

Lymphedema is oedema produced by an overabundance of lymphatic fluid in the body. Lymph nodes work in the same way as a sink drain does. If the drain is clogged, the liquids cannot drain. It usually happens in the upper limbs after axillary lymph node dissection for breast cancer or in lower limbs after inguinal lymph node dissection for carcinoma penis although it can occur in body parts. Lymph fluid is a part of the lymphatic system that distributes fluid and cells that help the body fight illnesses. This swelling might arise abruptly or gradually over time. Associated Anatomy of Lymphedema It usually affects the legs or arms, although it can also affect the chest wall, belly, neck, and genitals. Lymphedema Causes Cancer or cancer therapy, especially surgery can both induce lymphedema. A malignant tumour might grow large enough to obstruct the lymphatic system. Surgery to remove cancer may also involve the removal of lymph nodes or portions of the vessels that transport lymph fluid. This can cause fluid to accumulate in the surrounding tissues drained by the removed lymph nodes. Radiation therapy can cause lymph vessel damage, resulting in excess tissue lymph fluid accumulation. Lymphedema Symptoms Lymphedema symptoms can appear gradually over time or suddenly. If you are at risk for lymphedema or have a history of lymphedema and suffer an injury or infection, this could precipitate a case. Symptoms of Lymphedema include: Swelling of the arms or legs (or any areas at risk). Heaviness or fullness that is unbearable. Skin tightness when wearing clothing and jewellery. Itching or burning to feel Skin thickening is noticeable. These weaker, earlier symptoms may occur before you notice any swelling: Veins and tendons in your hands and feet are difficult to see or feel. Skin rashes and edema Your arm or leg looks to be somewhat larger in size significant than the other. Joints are stiff and unyielding. A puffy appearance to the skin. After cancer treatment, the patient should contact their healthcare provider if they experience any symptoms. Swelling must be controlled as soon as possible. Lymphedema Stages Stage 1: Lymphatic system abnormal flow. There are no symptoms. Stage 2: Fluid accumulation with oedema reduced with chelation Stage 3: Chronic swelling, which does not improve with elevation. Stage 4: Elephantiasis (giant malformed limb), skin thickness with "wart-like" growth, and severe scarring are all symptoms. Lymphedema Diagnosis If a patient is vulnerable to lymphedema, such as recently undergoing cancer surgery involving lymph node removal, their surgeon may detect lymphedema by observing the clinical manifestations. Lymphedema origins cannot be determined, your surgeon may order imaging tests to know your lymph system. Among the possible tests are: MRI Scan Using a magnet and radio waves, an MRI creates 3D, high-resolution images of the damaged tissue. CT Scan This scan method produces accurate images of the body's anatomy. Ultrasound Sound waves are used in this test to develop images of the body's internal structures. It can discover obstructions in the lymph and vascular systems. Lymphoscintigraphy A dye is injected into the individual and then checked by a system. The dye is visible as it travels through the lymphatic veins, revealing any bottlenecks. Lymphedema Treatment Lymphedema cannot be completely cured. The goal of lymphedema management is to prevent, reduce and avoid complications. Medicines Lymphedema increases the risk for skin infections substantially (cellulitis). Keep antibiotics on hand in case you develop symptoms so that you can start taking them right away. Therapy Lymphedema therapists can show you how to use strategies and equipment to help minimise lymphedema swelling. Here are several examples: Exercises Gentle contractions of the muscles and joint range of motion exercises might help remove extra fluid from the oedema part. Manual Drainage Specialised massage to promote lymph fluid absorption and flow. Compression Bandages Lymph fluid flows back into the body's trunk when the entire limb is wrapped in low-stretch bandages. Compression Garments Lymph fluid outflow can be aided by compressing the upper and lower limbs using close-fitting elastic sleeves or stockings. These garments typically require a prescription to ensure that the optimum compression level is performed. It may be necessary to have your measurements taken by a specialist to provide the best fit. Pneumatic Compression in a Series A pump intermittently inflates a sleeve worn over the affected arm/leg, exerting pressure on the limb and allowing lymph fluid to escape. Note: Therapist will decided the best therapy options on the basis of assessment Surgical and non-surgical procedures Lymphedema surgery may comprise the following procedures: Transplantation of lymph nodes New drainage channels Fibrous tissue removal Risk Factors of Lymphedema These are the risk factors: Older age is one factor that may raise the chance of getting lymphedema. Obesity or excess weight. Psoriatic or rheumatoid arthritis Possible Complications of Lymphedema Cellulitis Sepsis Skin perforation causes leakage The skin changes Cancer. Lymphedema Prevention Primary Prevention Avoid the following if you are at risk for lymphedema: To avoid sunburns, use sunscreen with an SPF of 30 or higher. When going outside, use insect repellent to avoid bites that might lead to illness. Avoid any kind of trauma or harm to the afflicted region. Heavy lifting should be avoided with the afflicted arm. Secondary Prevention Secondary prophylaxis comprises a clinical assessment of the patient and lymphoscintigraphy, which can detect lymphatic stasis in the afflicted limb even before it manifests clinically. Epidemiology of Lymphedema Primary lymphedema is uncommon, affecting one in every 100,000 people. Secondary lymphedema is the most frequent cause of the illness, affecting around one in every 1000 Americans. Expected Prognosis of Lymphedema The five-year outlook for lymphangiosarcoma is less than 10%, with an average survival of 19 months after diagnosis. This malignant degeneration is widespread in individuals with postmastectomy lymphedema, with an estimated prevalence of 0.5 per cent. Natural Progression of Lymphedema Lymphedema can also develop 4 to 6 weeks after surgery or radiotherapy and then resolve independently. The most frequent lymphedema is asymptomatic and can develop gradually 18 to 24 months following surgery. It does not improve without therapy. 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