Lymphedema

What Is Lymphedema?

Lymphedema is swelling that occurs in arms or legs. While there is presently no cure for lymphedema, it can be managed with early diagnosis and diligent care of your affected limb.

Make an appointment with your doctor if you notice persistent swelling in your arm or leg. If you already have the diagnosis of lymphedema of a limb, see your doctor if there is a sudden dramatic increase in the size of the involved limb, as it may suggest a new process is occurring.

What Is the Cause?

Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment, especially to the upper extremities.

Lower extremity lymphedema may be related to prior surgery, radiation treatment, trauma, or infection. It is also common to see lower extremity lymphedema be related to chronic venous insufficiency/varicose vein disease, known as “phlebolymphedema.”

The interaction between the lymphatic system and problematic lower extremity superficial venous issues is gaining wider recognition worldwide.

For some patients with phlebolymphedema, addressing underlying venous issues may help with controlling lower extremity swelling.

The lymphatic system, which is also part of your immune system, relies on a small caliber network of vessels to convey fluid out of the space between the body’s cells known as the “interstitium.” Damage or blockage of these vessels prevents lymph fluid from draining well, and the fluid buildup leads to swelling.

Persistent lymphatic fluid accumulation the lower extremities may also lead to chronic thickening of the skin and accumulation of adipocytes (fat cells), resulting in a special type of lymphedema, known as “lipedema.”

How Is It Treated?

Treatment Overview

At Indiana Vein Specialists, our team has received specialized training in the fitting and application of compression stockings, and are able to fit >95% patients that present with chronic lower extremity swelling.

Identifying the etiology of chronic swelling is also key to managing this disease process. With lower extremity lymphedema, compression strategies are considered the cornerstone of treatment.

Certified Lymphatic Therapists

We utilize an extended team of physical and occupational therapists that are well versed on manual lymphatic drainage therapy and have assisted many of our patients throughout Central Indiana.

We also have our own in-house physical therapist, Natalie Dereka, who is a Certified Lymphatic Therapist and provides evaluations and lymphatic treatment.

Lastly, we have seen a significant amount of success with patients utilizing at home intermittent pneumatic compression (IPC) systems, e.g. “Flexitouch” as part of a comprehensive home care regimen to manage this chronic condition.

About the Treatments

Vein Disease Diagnosis

Vein disorders are not always visible; therefore, modern vein disease diagnosis requires diagnostic techniques and tools to determine the cause and severity of the problem. Depending on the results of your screening, we may recommend additional tests such as a diagnostic ultrasound to identify where and how badly your veins are damaged.
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Venous Treatment Phases

We take an "Inside-Out" Approach® to evaluation and treatment. During your initial consultation, it is very important to us that you have time to review the ultrasound scan with your provider. We will also review your history, symptoms, the scan, and initial exam to determine the next steps for evaluation.
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Conservative Measures

Conservative measures are often the first step in managing chronic venous insufficiency (CVI). While these measures don’t treat the underlying issue of CVI, they do provide symptomatic relief and slow the development of other problems caused by CVI. They can also aid your recovery after treating varicose and spider veins.
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Lymphatic Physical Therapy

With lower extremity lymphedema, compression strategies are considered the cornerstone of treatment. Our in-house Certified Lymphatic Therapist, Natalie Dereka, PT, DPT, CLT, is available for evaluation and treatment.
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