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What is Lymphedema?

Lymphedema impacts millions of people in the United States and occurs when the body cannot effectively transport lymph fluid. When the transport of lymph fluid is disrupted and lymph fluid cannot drain properly, swelling occurs. This swelling can be in any part of the body, most often in the arms and legs, but also the breast or chest wall, head, and neck, or genitals. While there is presently no cure for lymphedema, it can be managed with early diagnosis and diligent care.


  • Swelling in the arm or leg or affected body part.
  • Limb swelling can include the fingers or toes.
  • Heavy sensation or feeling of tightness to the skin of the affected area
  • Pain or discomfort in the limb
  • Skin dimpling like an orange peel
  • Recurring infections in the affected limb or body area
  • Hardening and thickening (fibrosis) of the skin
  • Decreased or loss of range of motion of the affected limb
  • Pitting or non pitting edema, prolonged capillary refill
  • Loss of functional use of an upper or lower extremity (UE or LE) due to size, weight, and loss of motion
  • Girth measurements indicating > 2cm difference between the affected and non-affected limb at 3 measured points along the extremity
  • Scar tissue formation that limits normal range of motion (ROM) and function, and disrupts normal lymphatic drainage
  • Palliative care pain relief, comfort and prevention of further functional loss of the affected limb


There are two forms of lymphedema. Primary lymphedema can occur from birth due to an impairment in the lymphatic system. Secondary lymphedema occurs from an insult to the lymphatic system and can occur at any age. These are the major diagnoses that are at risk for developing secondary lymphedema:

  • Congestive heart failure (CHF)
  • Nephrotic syndrome (Kidney Disease)
  • Hypoproteinemia
  • Drug reactions
  • Cirrhosis of the liver (Liver Disease)
  • Pretibial myxedema
  • Cancer
  • Constrictive pericarditis
  • Lower limb dependency syndrome
  • Lipedema
  • Chronic venous insufficiency
  • Malignancy
  • Deep vein thrombosis (DVT)
  • Malignant lymphedema
  • Postoperative complications following surgery for TKA, THA, Past C-Section, hysterectomy
  • Cellulitis
  • Baker cyst
  • Morbid obesity
  • Cyclical and idiopathic edema


When lymphedema is left untreated, swelling continues, which can lead to the hardening of the skin. This can lead to skin problems and infections such as cellulitis, which may require hospitalization. In the long term, leaving lymphedema untreated can also permanently affect the limb’s range of motion and flexibility. These challenges may promote the chance of the patient adopting a more sedentary lifestyle, which can lead to a decline in the patient’s health and functional ability. For these reasons, lymphedema must be treated as quickly as possible and maintained chronically.



Complex Decongestive Physiotherapy, or CDP, is considered the gold standard treatment for lymphedema and includes both a decongestive phase and a maintenance phase. In the decongestive phase, non-surgical treatment includes inelastic compression, exercises, skin care, and manual lymph drainage (MLD). This helps reduce fluid retention, improves flow of lymphatic system, and improves functional mobility. The maintenance phase of CDP includes intermittent pneumatic biocompression, which has been proven to help edema.

“Between 3 and 5 million people in the United States suffer from lymphedema, which in a significant number develops from cancer and its treatment.”

-Leslie Bagay MD, in Essentials of Physical Medicine and
Rehabilitation (Fourth Edition), 2020″

“Lymphedema may affect as many as 140 to 250 million people hroughout the world.”
– Arin K. Greene MD, MMSc, … Sumner A. Slavin MD, in Plastic Surgery Secrets Plus(Second Edition), 2010

Do you have lymphedema or would like to refer someone to Axiom for Lymphedema Therapy?

Our Referral Process

Choose the method most convenient for you.

  • Call referral info into 407.494.0644
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