Following a diagnosis of lymphedema, multidisciplinary management is put in place in order to best support the patient... It is generally the patient’s own doctor that makes the preliminary diagnosis. He or she then refers the patient to other healthcare professionals and is the starting point for overall management of the condition.
The importance of a multidisciplinary management
Whether in a community or hospital setting, the management of lymphedema needs to be global. In the community medicine setting, patients will mainly see physiotherapists for manual lymphatic drainage and tissue mobilization sessions. Physiotherapists may also teach patients self-draining techniques and, in particular, self-massage. But this management is more effective if there is complementarity and continuity of care between community medicine and hospital treatments. The management of lymphedema is based on complex decongestive physiotherapy, which is performed in two phases:
The first intensive phase aims to reduce the volume of lymphedema using low-elasticity, short-stretch bandages that are changed daily. These are combined with lymphatic drainage, exercises while wearing the bandages and skincare to prevent any potential ports of entry for infection.
The second phase aims to maintain the reduction in lymphedema volume. It is based on daily wear of elastic compression devices during the day and low-elasticity bandages at night. Skin and wound care is also performed, as well as lymphatic drainage. In parallel, it is important to try to have a healthy lifestyle and get regular physical exercise.
Hospital management
The lymphology units set up in some hospitals, generally within vascular medicine departments, have teams made up of angiologists, dermatologists, physiotherapists, nurses and occupational therapists. They are therefore able to provide global, patient-tailored support in terms medical, nutritional and psychological needs. For example, lymphology departments offer a complete lymphatic rehabilitation program. This obviously includes decongestive physiotherapy. But it is supplemented by physical exercises, the provision of comprehensive information to patients about their condition and its possible complications, as well as teaching of relaxation and self-care techniques. The objective is to promote patient autonomy once they return home after the intensive phase. Treatment is intensive and is usually delivered over a short period of time.
If you have any questions, ask your doctor for advice.
ILF : Best Practice for the management of lymphoedema – 2006
Lymphedema should not be a barrier to physical activity. On the contrary, sport has been shown to be beneficial in stimulating lymphatic circulation and improving the quality of life of those affected.
Lymphedema of the arm, also known as ‘big arm’, affects 5 to 20% of women treated for breast cancer. This uncomfortable condition, with a risk of complications, requires compression therapy and drainage of lymph fluid.
