Lymphedema Treatments

Lymphedema is not a curable condition. But there are various surgical and non-surgical lymphedema treatments that focus on managing symptoms, keeping flare-ups under control, and keeping the lymphedema from getting worse. Your lymphedema specialist can advise you on a treatment plan based on the lymphedema’s stage and severity.

There are several non-invasive treatments that help reduce symptoms of early-stage lymphedema. Your doctor or lymphedema specialist may recommend one or more of the following procedures.

Keep your arm elevated to let gravity help drain any accumulated fluid. Follow your lymphedema specialist’s instructions on how to position your arm (usually above heart level). Ask your lymphedema specialist how long you should keep your arm elevated and how often you should elevate it throughout the day.

There are various styles and types of compression sleeves and garments, including fingerless gloves or gauntlets, support bras, and vests. Compression garments are made of stretchy fabric and apply pressure to the arm, hand, or trunk to help lymph flow and stop it from accumulating. 

Learn more about compression sleeves and garments for lymphedema.

Similar to compression sleeves and garments, compression wraps and bandages also apply pressure to the affected area to help drain lymph. Depending on your lymphedema treatment plan, you may have to bandage up the affected area every day for a few weeks. 

Learn more about compression wraps and bandages for lymphedema.

Some lymphedema specialists recommend using foam pads and chip bags together with compression wraps and bandages or compression garments. Foam pads and chip bags apply pressure to the affected area and help to reduce swelling and soften tissue affected by later-stage lymphedema. Your lymphedema specialist can help you pick the right foam pad or chip bag for you and show you how to place these under your bandages or compression garments. 

Manual lymphatic drainage — sometimes called lymphatic drainage massage — is a massage technique that moves excess lymph from a swollen area back into the lymphatic vessels. The specialist uses gentle movements that apply light pressure to the affected area. 

Some people might need manual lymphatic drainage five days a week for an extended period of time, and others might need the treatment three times a week for a few weeks, depending on the lymphedema’s stage and severity. Make sure your lymphedema specialist is experienced in manual lymphatic drainage or can recommend a physical therapist experienced in lymphedema treatments.

Although more research is needed to see whether manual lymphatic drainage is effective, some studies have shown that people up to age 60 benefit from this treatment.

Your lymphedema specialist can show you stretches and exercises that can help improve flexibility and strength and encourage lymph to flow. When you gently contract the muscles of a swollen arm or hand, for example, the accumulated lymph is more likely to flow out of the affected area.

Learn more about lymphedema exercises and tips.

Experts recommend drinking plenty of water and eating foods that are low in salt and trans fats and high in fiber to keep the lymphatic system as healthy as possible. Choose nutritious foods, such as fruits, vegetables, whole grains, and lean proteins, over-processed foods. Eating a healthy diet also helps you maintain a weight that’s right for you.

Complete decongestive therapy (CDT) is an intensive program that combines many different lymphedema treatments, including compression wraps and bandages, compression sleeves, manual lymphatic drainage, and exercise.

Learn more about complete decongestive therapy for lymphedema.

Pneumatic pumps are used to treat lymphedema. Padded, inflatable sleeves, vests, or stockings are attached to an external pneumatic pump that applies intermittent pressure to the affected area to reduce swelling and stimulate lymph flow.

Learn more about pneumatic pumps for lymphedema.

Kinesio tape is a flexible, adhesive tape typically used to support certain muscles and joints that some experts recommend for people with lymphedema. When placed on a swollen area, the Kinesio tape pulls the skin slightly and creates a space between the top layer of skin and the underlying tissues that allows lymph to flow. The effect of Kinesio tape is similar to manual lymphatic drainage, except you get the benefits of drainage for however long you leave the tape on.

Some people might find using Kinesio tape easier than using compression wraps and bandages. But since it’s an adhesive tape, there’s a greater risk of injury to the skin. Make sure your lymphedema specialist has experience working with Kinesio tape and shows you how to use the tape safely before you use it on your own, and don’t tape over skin that is already irritated.

There are laser and surgical treatments that help reduce symptoms of severe, later-stage lymphedema. If you have later-stage lymphedema, ask your doctor or lymphedema specialist if any of the following laser or surgical procedures make sense for you.

Doctors use low-level laser therapy to remove lymph nodes and help improve the range of motion in the affected area and reduce swelling. Infrared lasers penetrate the affected tissue and change the cells that are causing inflammation. The device looks a lot like the otoscope doctors use to look inside the ears during regular checkups. You don’t feel anything as the laser treatment is delivered. Even if you receive this treatment in the hospital, you can go home the same day.

Plastic surgeons specializing in liposuction for lymphedema remove the affected tissue so you can continue receiving non-surgical lymphedema treatments. Not all plastic surgeons who perform liposuction are qualified to perform liposuction for lymphedema.

Microsurgeons replace damaged lymph nodes with healthy lymph nodes taken from other areas in your body and rewire the lymphatic system so lymph can flow normally again. This procedure, which is performed with general anesthesia, takes three hours and usually requires a one- to two-day hospital stay. Follow your doctor’s post-surgical instructions. Your lymphedema specialist can monitor for any signs of lymphedema that might result from surgery.

Microsurgeons connect and reroute lymphatic vessels and veins to let lymph flow freely through the lymphatic system. This procedure, which is performed with general anesthesia, takes about two hours and usually does not require an overnight stay in the hospital.

Your lymphedema specialist may recommend a combination of non-surgical and surgical lymphedema treatments based on a few factors. 

Early-stage lymphedema that causes mild swelling doesn’t need as much treatment as later-stage lymphedema that causes obvious swelling and scarring of the soft tissue under the skin. Although later-stage lymphedema isn’t reversible, a combination of treatments can help ease swelling.

Some people experience lymphedema flare-ups when it’s hot outside, and others experience flare-ups when they use their arms more than usual. Additional factors that can cause lymphedema flare-ups include sunburn, carrying excessive loads, staying in one position for too long, limb constriction because of tight clothing or jewelry, skin infections, insect bites, injections, and injuries to the affected area.

Some people prefer an aggressive treatment plan, and others prefer a modified treatment plan that takes their usual daily routine into account. Depending on the stage of lymphedema, some people might need treatment on and off for the rest of their lives, and others might only need treatment for a few weeks with regular monitoring.

Health insurance plans do not always cover lymphedema treatments. For example, a health plan might cover a certain number of visits with a lymphedema specialist, but might not cover certain types of lymphedema treatments. Call your health insurance company and find out exactly what your particular plan covers, and talk to your doctor if you are concerned about out-of-pocket costs for any lymphedema treatments.

The Lymphedema Treatment Act, which went into effect Jan. 1, 2024, expands Medicare coverage for lymphedema-related compression garments. People covered by other health insurance plans are likely to benefit as well because health insurance companies tend to follow Medicare coverage guidelines.

 

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