Physiotherapy Treatment in Lymphedema

Definition: It is the collection of lymph in the subcutaneous tissues due to abnormality in the lymphatic system

Physiotherapy Management

1. Elevation of the affected limb

2. Application of anti-embolic stockings and pressure bandage, lymphedema sleeves

3. Faradism under pressure if the joins are unable to move due to severe accumulation of fluid and pain

4. Pneumatic compression machine:  Intermittent mode and Sequential mode

·         It helps to give compression to the limb from distal to proximal

5. Soft tissue manipulation:

·         Massage

·         Kneading, stroking, efflurage

·         Ultrasound (micromassage)

·         Pulsed electromagnetic energy

6. Exercises:

·         Distal joint mobilization

·         Active movements of involved joints in elevated position

·         It helps in mobilization of fluid from the subcutaneous tissues

·         It can be done 4-5 times/day

·         Ankle/toe movements, wrist fingers flexion, extension

7. Advise to the patient:

·         Prevent prolonged standing or walking or in dependent position

·         Keep the affected limb in elevated position

·         Prevent any injury over the affected limb due to high chances of infection

·         Do not take hot baths

·         Do not wear tight bands, ankles, rings or jewelry on the swollen limb

·         Wear appropriate foot wear with elastic stockings