Treatment of lymphedema
Lymphedema is a chronic disorder. This means that at present we do not have a definitive cure. For this reason, non-surgical treatment, also called conservative treatment, should be carried out daily in a disciplined manner. This treatment is based on:
Manual lymphatic drainage
Lymphatic drainage allows to channel new lymphatic channels and to reduce the amount of fluid in the limb. This treatment must be carried out by a trained physiotherapist. It is recommended to perform this technique on a scheduled basis at regular time intervals. The frequency will depend on the stage and treatment planning. Manual lymphatic drainage should be avoided when there are signs of infection or venous thrombosis.
Compression garments are essential to prevent fluid collections in the limb. They should be used as long as possible. The pressure is important since their use can be harmful if they are not properly adjusted. We recommend changing them every 6 months.
The recommended minimum pressure is 20 mmHg. There are different degrees of compression, and it is usually specified on the label of the garment.
Pneumatic compression is performed with machines that perform compression / decompression cycles. Scientific studies have shown that they are useful for reducing the volume in the limb, although there is no consensus on how long, nor what pressure levels are more efficient.
Exercises should be performed daily. The goal is to strengthen the muscles, mobilize the joints and lymphatic flow. The patient should learn these exercises and perform them daily.
Surgical treatment of the lymphedema should be considered if there is no resolution of the lymphedema after 6 months of conservative treatment. The most advanced techniques to improve lymphedema are based on lymphovenous anastomosis and lymph node transfer.