Riverside Medical Supply Lymphedema Therapy


What is Lymphedema?


Lymphedema is an accumulation of lymphatic fluid that causes swelling in the extremities (arms and legs).  This accumulation of protein-rich fluid in the interstitium is caused by an impairment of the lymph transport system.  It is generally a lifelong condition, and is chronic and progressive.



What causes Lymphedema?

Lymphedema is a mechanical breakdown of the lymphatic system which prevents the removal of lymph from a section of the body, causing it to swell and harden over time.

'Primary' Lymphedema is congenital or hereditary, and may manifest at birth 'Milroy's', or around puberty 'Praecox', or later in life 'Tarda' 

Primary lymphedema is rare--most patients that we have treated here at Riverside have Secondary Lymphedema, which is acquired, and generally caused by some event that disrupts or traumatizes the lymphatic system:

  • Chronic Venous Insufficiency
  • Post-Mastectomy Lymph Node removal or dissection
  • Surgical Damage to the Lymph Nodes
  • Radiation Therapy
  • Injury/Trauma
  • Morbid Obesity
What Complications Arise from Lymphedema?
  • Cellulitis – increased susceptibility of infection
  • Non-healing wounds/ulcerations
  • Pain/discomfort
  • Fibrosis
  • Loss of function in limbs

How Does Compression Therapy Treat Lymphedema?
Lymphedema is most effectively treated by compression. Compression must be applied to the limbs to reduce the swelling. Medical-grade compression stockings or sleeves can apply the firm but gentle pressures that encourages the lymph fluid to move back into the bloodstream.  

Pneumatic Compression Pumps are increasingly being recognized as the most effective long-term treatment for lymphedema.  The compression pump system consists of an air pump and a garment that fits over the affected extremity. 

Air pressure is applied to the garment, which in turn applies pressure to the extremity. A non-calibrated pump applies uniform pressure over the entire extremity. This system consist of a pump and garment with 4 or 8 Chambers that apply sequential pressure along the extremity, distally to proximally (from the hand or foot toward the torso).

Since lymphatic pressure is greater distally (in the hand or foot) than it is proximally (near the torso), the Gold Standard method of pneumatic compression therapy mimics the gradient pressures that are a normal part of a healthy lymphatic system. This is accomplished by means of a calibrated pump that applies gradient pressure to the segmented appliance, putting more pressure on the hand or foot and less pressure near the torso.

This type of system creates a gentle massaging action, moving the accumulated fluid from the affected extremities back into the body, where it can be naturally eliminated. Pressure and the subsequent effectiveness of the treatment can be gradually increased as the patient becomes more tolerant.






Further Reading: Studies on the Use of Pneumatic Compression Pumps to Treat Lymphedema

By, Marzanna Zaleska, Waldemar L. Olszewski, Marta Cakala, Jaroslaw Cwikla and Tadeusz Budlewski., 2015

By, Mariusz Kaczmarek, PhD, Waldemar L. Olszewski, MD, PhD, Joanna Nowak, MSc, and Maranna Zaleska, MB., 2014

 

By, Marzanna Zaleska, Waldemar L. Olszewski & Marek Durlik., 2014

 

By, Cheri Hoskins, CLT, CCT, 2014

 

By, Marzanna Zaleska, Waldemar L. Olsewski, Pradeep Jain, Sashi Gogia, Arun Rekha, Samsita Mishra, and Marek Durlik., 2013

 

By, Cheri Hoskins, CLT, CCT, 2013

 

By, Oscar M. Alvarez, PhD, Martin Wendelken, DPM, RN, Lee Markowitz, DPM, Rachelle Parker, MD & Christopher Comfort, MD., 2012

 

By, W.L. Olszewski, J. Cwikla, M. Zaleska, A. Domaszewska-Szostek, T. Gradalski, S. Szopinska., 2011

 

By, Waldemar L. Olszewski, M.D., PhD, Pradeep Jain, M.D., Ph.D, Govinda Ambujam, M.D., Ph.D, Marzanna Zaleska, M.B., Marta Cakala, M.B., and Tomasz Gradalski, M.D. Ph.D., 2011

 

By, Waldemar L. Olszewski, Pradeep Jain, Govinda Ambujam, Marzanna Zaleska, Marta Cakala., 2010

 

By, Dr. Waldemar L. Olszewski, 2009

 

By, Andrzej Szuba, MD., PhD,  Radha Achalu, MD, & Stanley G. Rockson, MD., 2002.

 

By, Renee Robinson, Lisa A. Massa, PT, CLT, Jennifer Maddox, PT, Nancy Guillett, LMT, CLT-LANA, Katherine Arsenault, MPT, CLT-LANA, Deborah Daugherty, MOT, CLT-LANA, Cheri Hoskins, Stephen Morgan, Ann Hafner and Tony Reid MD, PhD. 2005