Unfortunately, there is no known cure for lymphedema at this time. But the condition can be managed through a wide range of non-surgical and surgical treatments.
A referral from a primary care doctor, or some other type of health care provider, is required for lymphedema treatment.
Non-surgical treatments
Lymphedema therapy
Manual lymphatic drainage:
A light, hands-on massage technique done to move fluid to healthy parts of the body to train
Compression therapy:
Wrapping the affected body part in multiple layers of cloth, or wearing compression garments to control the swelling.
Your lymphedema therapist will discuss compression garments or garment alternatives that are best suited to your needs and abilities to help you make the best choice about long term lymphedema management.
Exercise:
Your physical therapist will have you focus on exercises that increase your range of motion, mobility, strength and deep breathing.
Skin care:
Your physical therapist will help you develop a skin care routine that protects your skin from infection, reduces scarring and helps to heal any wounds.
Pneumatic pumps:
A pneumatic pump is a large garment applied to a swollen leg or arm. It has air-filled chambers that systematically fill and shrink as the pressure moves down and then back up the arm or leg.
Pneumatic pumps can help you can more mobility in your limb impacted my lymphedema, and ultimately drain your swelling.
Pneumatic pumps mimic (but don’t replace) manual lymphatic drainage. We may use them during your initial treatment, but most often, they recommend them as an at-home treatment option.
Surgical treatments
Surgical treatments are done in addition to non-surgical treatments. They are not a replacement for non-surgical treatments. Surgery can often improve your quality of life.
There is a wide range of surgical treatments available, including:
Lymphovenous bypass
During lymphovenous bypass surgery, the surgeon will create a new pathway for lymphatic fluid to enter your blood stream. Your lymphatic vessels are joined to a vein using a super-microscope and a very fine stitch. Stitches are also used to close the skin, and will be removed two weeks after surgery.
The surgery lasts between three and six hours, and most people only need acetaminophen or ibuprofen for a day or two after surgery.
If you still have fluid shifting in your arms are legs, and still have lymphatic vessels, you may be a good candidate for lymphovenous bypass.
Nebraska Medicine is the only health system in our region that performs this procedure.
Vascularized lymph node transplant
During vascularized lymph node transplant surgery, the surgeon creates a new pathway for your lymphatic fluid to enter the blood stream.
This is done by taking lymph nodes from one part of your body and moving them to the swollen arm or leg.
If you still have fluid shifting in the arm or leg but don’t have lymphatic vessels, you may be a good candidate for vascularized lymph node transplant.
Liposuction
During liposuction, the surgeon uses a tube to remove fatty tissue from the swollen arm or leg.
Strict compression after surgery is very important to keep the arm or leg from swelling again.
If you do not have a lot of fluid shifting, and have healthy skin, you may be a good candidate for liposuction.
Excisional surgery
Excisional surgery is a broad term. It’s basically a surgical procedure that removes skin and fat from the swollen arm or leg.
If your lymphedema is severely debilitating, or you’re experiencing severe skin changes, you may be a good candidate for excisional surgery.