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Lymphedema Management

The Nexus Lymphedema Program offers therapy-driven treatments performed by Master-level therapists who are extensively trained in treatment techniques of decongestive therapy and manual lymph drainage. We work hand-in-hand with our interdisciplinary team comprised of physicians, nurses, therapists, and dietitians to provide a holistic treatment approach.

What is Lymphedema?

Lymphedema is the abnormal accumulation of protein and water in the interstitial space (the small space between tissues or organs).  This buildup is typically caused by a genetic malformation (primary lymphedema) or trauma to the lymphatic system (secondary lymphedema). 

Complete Decongestive Therapy (CDT) is a comprehensive approach to the treatment of lymphedema and consists of four integral components: manual lymph drainage (MLD), compression, decongestive exercise and skin care. There are 2 stages of treatment in CDT: Stage I (Intensive Phase) and Stage II (Self-Management Phase). CDT has been utilized over the last century and is considered the “Gold Standard” in treatment of lymphedema today.

Manual Lymph Drainage (MLD) is a method used to mobilize and re-route lymphatic fluid, so it may be reabsorbed back into the lymphatic system. Its application in lymphedema treatment has garnered the attention of physicians and therapists worldwide. MLD is a gentle manual treatment technique, applied utilizing a “pumping” motion redirecting lymph fluid to areas with sufficient lymphatic pathways or flow. MLD consists of 4 basic strokes used by certified lymphedema therapists to achieve the desired outcome of mobilizing lymphatic fluid. The direction of the MLD stroke is what re-routes lymphatic fluid from unhealthy to healthy tissue to be reabsorbed. MLD is a key  component in the treatment of lymphedema. If left untreated, the    accumulated proteins can cause lymphostatic fibrosis (hardening of the skin) leading to an increase in physical impairment.

Compression Bandaging can be used during phase I or phase II of CDT. Compression bandages apply a therapeutic pressure to the extremity aiding in the goal of decongesting the involved extremity.  During phase I, short-stretch bandages are used in conjunction with MLD, skin care, and exercise in order to reduce fluid volume. Compression garments are used during phase II of CDT; assisting in the goal of maintaining limb reduction achieved in phase I.

Skin Care is performed daily to reduce the overgrowth of bacteria and fungus. People with lymphedema have an increased risk of infections; hence, the importance of proper skin care. Specialized lotions are recommended for use after cleaning as part of daily skin care.

Decongestive Exercises are performed in 10-15 minute increments 1-2 times per day and are an integral part of lymphedema management. Exercises and deep breathing techniques help to improve lymph circulation with the use of muscle movement. These exercises should be performed with compression bandages in place.

All Nexus patients undergo a comprehensive evaluation to develop a patient specific treatment plan to restore and maintain the highest level of functioning.

Treatment plans may include, but are not limited to the following: manual lymph drainage, compression bandaging, taping, dietician consultation, diagnosis specific education, home exercise program, home skin care regiment, and coordination of home based ancillary services.

Nexus offers has Registered Dietitian on staff available for 1:1 on site consultation for diet modifications specifics to  individual needs.