4 Effective Strategies for Helping Patients Manage Lymphedema

Lymphedema is a chronic and often debilitating condition characterized by the abnormal accumulation of lymphatic fluid, leading to swelling in various parts of the body, most commonly in the arms or legs. This condition occurs when the lymphatic system—responsible for draining excess fluids from tissues and maintaining immune function—becomes damaged or blocked, preventing the proper circulation of lymph fluid. As a result, affected areas can experience persistent swelling, discomfort, and a range of associated complications.

While lymphedema can develop as a result of genetic factors, it is more commonly acquired after surgery, radiation therapy, infections, or injury. Despite its potential impact on quality of life, lymphedema can be managed with early diagnosis and appropriate treatment. Let’s take a look at four strategies for helping patients manage this condition.

Utilize Manual Lymphatic Drainage (MLD)

Manual lymphatic drainage (MLD) is a gentle technique utilized to guide lymphatic fluid from swollen, blocked regions toward healthy lymph nodes and vessels. It consists of a working phase (which directs lymphatic fluid in the appropriate direction) and a resting phase (releasing the skin and returning to the starting position). This should not be confused with massage, as massage techniques are generally very different and utilized for different purposes.

MLD creates a suction effect that allows for areas of accumulated lymph fluid to move towards areas with better lymphatic drainage. MLD is also very soothing for most individuals and assists with pain relief. Although MLD is frequently performed on limbs, it can also be performed on head, neck, abdominal region, and back depending on your patient’s needs.

MLD is an appropriate treatment technique for the majority of individuals with lymphedema, although there are some contraindications to keep in mind for MLD in general along with performing certain MLD on certain regions. For example, you wouldn’t want to perform MLD for anyone with cardiac edema, acute infections, malignancies, acute deep vein thrombosis, and/or several other diagnoses.

Include All Aspects of Complete Decongestive Therapy (CDT)

One common mistake I see in lymphedema treatment is not including all aspects of complete decongestive therapy (CDT) in the treatment plan. CDT is the gold-standard treatment for lymphedema and is composed of MLD, compression, skin care, and exercise. MLD and compression tend to get a lot of attention, but skin care and exercise are just as important for best results and long-term success.

Image from MedBridge Patient Education: Lymphedema Compression

The beauty of CDT is that the large majority of patients respond very well to it and start seeing results quickly. This increases overall motivation for therapy sessions for the majority of patients. However, CDT does not cure lymphedema. Because of this, we really need patient involvement throughout the entire therapy process. For your patient’s lymphedema to be properly managed long-term, your patient will need a good understanding of each area of CDT and not just rely on their therapist to “fix” them.

Image from MedBridge Patient Education: CDT for Lymphedema

Manage Expectations

Remember that lymphedema is a chronic, life-long condition that eventually requires the patient to be able to manage their own symptoms. We have a lot of empathy for our patients and want to make their life easier. As a result, I often find therapists (including myself) wanting to “fix” everything. Especially when a large percentage of your patients in this population are undergoing serious medical procedures such as surgery, chemotherapy, radiation, and/or trauma while simultaneously attending therapy sessions. But managing expectations on the therapist role and patient’s goals are important to facilitate patient engagement and self-management of symptoms.

Keep Your Patients Actively Engaged

For long lasting results, it’s important to help your patients be actively involved in the therapy process by providing them with high-quality patient education and home exercises like the ones featured here. To help facilitate this, I recently collaborated with MedBridge to create a comprehensive set of lymphedema resources. Find out how to access over 60 additional patient education resources and home exercises for lymphedema here.

Examples of MedBridge Lymphedema Home Exercises

How to Perform Effleurage in a Distal to Proximal Motion

How to Perform MLD on Cervical Lymph Nodes

How to Perform MLD on Popliteal Fossa