What is lymphedema?
Lymphedema is a condition where the accumulation of excessive amounts of protein-rich fluid in the tissue results in swelling of one or more regions of the body. Lymphedema usually affects the limb(s) although it may also involve the trunk, breast, head and neck or genital area.
Lymphedema is due to a failure of the lymphatic system and occurs when
the lymphatic fluid cannot move through the lymphatic circulation efficiently.
The lymphatic system is made up of a network of vessels and nodes throughout the body which transport fluid (lymph) from the body tissues back to the bloodstream. The functions of the lymphatic system are to:
- maintain the volume and protein concentration of extracellular fluid in the body
- to assist the immune system in detecting and destroying pathogens and removing waste products from the tissues.
There are many reasons for a swelling of a body region. Swelling can occur following tissue trauma, wounds, acute infections, cardiac failure, blood vessel issues, thyroid, kidney or liver dysfunction, obesity and can sometimes be linked to medications. In these cases, initial swelling is not caused by dysfunction in the lymphatic system and the condition is often referred to as ‘edema’. However, there may be some impact on the lymphatic system drainage over time. Edema of short duration is called ‘acute’ whereas edema of longer duration (more than 12 weeks) is called ‘chronic’ and then becomes lymphedema.
The established classifications of lymphedema are:
Primary: due to a genetic malformation of the lymphatics. Onset of swelling may not present until adolescence or adulthood
Secondary: to damage or destruction of lymph nodes or lymphatic vessels. This may occur with surgery and/or radiotherapy related to cancer treatment, recurrent cellulitis, or following injury (trauma or surgery to other organs or structures in the body)
Left untreated, lymphedema can lead to progressive swelling over time. However, lymphedema can be reduced and managed with appropriate intervention. The stage, location and severity of the lymphedema, together with individual circumstances of the client, will influence the most appropriate intervention.
Timberlane Physical Therapy Treatment:
Our clinic has extensive training and background in treating swelling from many causes. We use traditional lymphedema treatment such as bandaging and manual lymphatic drainage, and augment these treatments with pneumatic compression, low level light therapy, and a variety of treatments for scarring and fibrosis. We work with our patients to create effective home management programs. The addition of exercise and flexibility are also very helpful in the long term management of lymphedema.
Dr. Lesli Bell graduated with her Bachelor of Science in Physical Therapy in 1984 from California State University at Fresno. She completed her Transitional Doctorate in Physical Therapy at Regis University in Colorado in 2013. She has always worked hard to advance and develop her orthopedic, subspecialties, and manual therapy skills staying current in evidence-based practice and being innovative in the needs of her patients. In 1997 she was introduced to the world of edema and lymphatic disorders and quickly realized the importance of this information in many areas of physical therapy.
Dr. Bell is a leader in the areas of lymphedema (primary and vascular) and edema (orthopedic injuries and post operative swelling) treatment and has devoted much time to studying and solving the complicated problems for this patient population. She has lectured extensively in the US and internationally at academic and clinical conferences and seminars regarding lymphedema, swelling, scarring, fibrosis and breast cancer interventions for PT’s and other medical disciplines over the last 20 years. She has a specific interest in treating the breast cancer population and understanding the challenges that they have following the medical procedures that impair the lymphatic system and create scarring, fibrosis and other functional limitations. She has been very involved with the American Physical Therapy Association both in Vermont and Nationally since 1988, including serving as the Lymphedema Special Interest Group Chair for the Academy of Oncologic Physical Therapy from 2004 to 2021. In 2001 she co-developed the Bellisse Compressure Comfort Bra to meet the needs of breast cancer patients with trunk and breast edema. This product is now available world-wide and is distributed by Jobst Essity Corporation, a leader in medical product development and distribution around the world. Dr. Bell loves solving the easy and complex problems and making the management of lymphedema something her patients can live with and manage.