However, reports link pump therapy to increased incidence of edema proximal to the affected limb, such as genital edema arising after pump therapy in the lower limb. Current literature has suggested the use of IPC treatment in conjunction with Kinesiotape (KT) is more effective in the overall reduction of lymphedema as well as increasing shoulder ROM than the traditional treatment of IPC paired with complete decongestive therapy. Kinesiotape (KT) is an elastic cotton strip with an acrylic adhesive that is used commonly used to relieve the discomfort and disability associated with sports injuries, but in the context of lymphedema, this increases the space between the dermis and the muscle which increases the opportunity for lymphatic fluid to flow out naturally. The use of IPC treatments with KT tape as well as subsequent lymphatic drainage has proven to significantly reduce the circumference of lymphatic limbs in patients experiencing lymphedema secondary to breast cancer postmastectomy. Exercise
In those with lymphedema or at risk of developing lymphedema, following breast cancer treatment, resistance training did not increase swelling and decreases in some, in addition to other potential beneficial effects on cardiovascular health. Moreover, resistance training and other forms of exercise were not associated with an increased risk of developing lymphedema in people who previously received breast cancer-related treatment. Compression garments should be worn during exercise (with the possible exception of swimming).Physical therapy treatment of patients with lymphedema may include trigger point release, soft tissue massage, postural improvement, patient education on condition management, strengthening, and stretching exercises.
Grade 2 (moderate edema): Involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is 4–6 cm. Tissue changes, such as pitting, are apparent. The patient may experience erysipelas. Grade 3a (severe edema): Lymphedema is present in one limb and its associated trunk quadrant. Circumferential difference is greater than 6 centimeters. Significant skin alterations, such as cornification or keratosis, cysts and/or fistulae, are present. Additionally, the patient may experience repeated attacks of erysipelas. Grade 3b (massive edema): The same symptoms as grade 3a, except that two or more extremities are affected. Grade 4 (gigantic edema): In this stage of lymphedema, the affected extremities are huge, due to almost complete blockage of the lymph channels. Differential
Lymphedema should not be confused with edema arising from venous insufficiency, which is caused by compromise of the venous drainage rather than lymphatic drainage. However, untreated venous insufficiency can progress into a combined venous/lymphatic disorder. Treatment
While there is no cure, treatment may improve outcomes. This commonly include compression therapy, good skin care, exercise, and manual lymphatic drainage (MLD), which together is known as combined decongestive therapy. MLD is most effective in mild to moderate disease. In breast cancer-related lymphedema, MLD is safe and may offer added benefit to compression bandages for reducing swelling. Most people with lymphedema can be medically managed with conservative treatment. Diuretics are not useful. Surgery is generally only used in those who are not improved with other measures. Compression
Garments
Once a person is diagnosed with lymphedema, compression becomes imperative in the management of the condition.