What is Lymphedema and How is it Treated?
Lymphedema is chronic swelling due to a build-up of lymphatic fluid in the body. If the complex lymphatic channels are blocked or damaged, fluid cannot be normally processed and eliminated. Lymphedema usually presents as edema in the extremities however edema can manifest in any area of the body. Symptoms of lymphedema include edema and swelling in either upper or lower extremities, heaviness and tightness in a specific limb, decreased range of motion related to increased edema, aching of effective limb and hardening/thickening of skin causing fibrosis.
Functional limitations of edema include declines with self-care skills, declines with functional mobility, reduced skin integrity and depression and/or isolation. Lymphedema can be hereditary (primary lymphedema) causing edema across generations. Lymphedema can also be a result of trauma, infection, cancer treatment or surgery, known as secondary lymphedema.
Treatment of lymphedema requires a combination of multiple interventions including manual lymphatic drainage (MLD), complete decongestive therapy (CDT), elevation of the effected limb(s), compression garments, self-care skills for skin integrity, lymphatic pumps and diet/exercise. Duration and treatment course is specific to the patient. Some patients need to be seen daily for MLD/CDT and others can tolerate wrapping weekly.
Courses are available to become a Certified Lymphatic Therapist. Lymphatic certification is a rewarding experience to further enhance your patient’s treatment progress. Any OT or PT including COTA/Ls and PTAs can become lymphatic certified, however, an OT or PT must complete the patient’s evaluation. Lymphatic treatment in a long-term care setting allows residents to have increased independence with self-care and safe mobility to return to their prior level of function. Lymphatic treatment outcomes include reduction of edema, reduced fibrosis and hyperkeratosis, increased mobility and increased independence with self-care skills.
To become a Certified Lymphatic Therapist, one must attend a certification course. It usually runs 10 days and costs approximately $4000. The certification course requires a completed hands-on practical exam and a written exam. You are required to complete at least 40 hours of coursework prior to the class and pass all competencies. The actual classroom learning is an intensive 10 consecutive days.
Written by Jenn Neely-Aurandt, OTR/L, CLT and Director of Rehab. Jenn has been a Certified Lymphatic Therapist since 2019. She reports that it has truly enhanced her treatment approach with her residents. Jenn received her certification through Klose Training, which she believes is the gold standard for lymphatic education.