A leading vascular surgeon once described lymphedema as "a plumbing problem." Not exactly medical jargon, but when you consider the role of the lymphatic system and what happens when it gets blocked up, it does seem to fit.




Most of us are familiar with the circulatory system - the veins, arteries and capillaries that move blood to and from all the places in our body. The arteries carry oxygenated blood from the lungs, along with nutrients, to all the cells in the body. They end in capillaries that nourish the tissue. The capillaries then lead to the veins, which return the depleted blood back to the lungs.

The lymph vessels are also an important part of the circulatory system. As the blood flows through the capillaries, it is under pressure. Because of this pressure, fluid and proteins seep out of the arterial side of the capillaries. The tiny lymph capillaries pick up these lost fluids and proteins and transport them through progressively larger lymph vessels. As this "lymph fluid" flows through the lymph vessels, it is filtered through lymph nodes, where white blood cells remove bacteria and other foreign materials. The fluids are then returned to the blood stream. We can think of the lymph vessels as the body's "water system," with "watersheds" where the smaller lymph vessels drain off directionally into bigger collectors, and "purification stations" at the lymph nodes, where white blood cells remove bacteria and other foreign materials.




The amount of fluid processed by the lymphatic system is truly huge. At any one time, nearly 90% of the water found in our blood is being filtered through the lymphatic system. In cases of overload, healthy lymphatic vessels can absorb up to ten times their usual capacity. But when the lymphatic system is malformed or damaged, blockages can result. The lymphatic fluids from that particular area "serviced" by the blocked channel cannot be transported adequately. Excess fluids build up and produce swelling. This condition is called lymphedema, and can appear in various parts of the body, but most often affects the arms or legs. The swelling can cause the affected limb to become extremely large and heavy, causing disfigurement and disability. Proteins accumulate in the trapped fluid, which can lead to fibrosis, a hardening of the surrounding tissues, making the drainage process even more difficult. This protein-rich fluid also provides ideal growing conditions for bacteria that lead to infection. So people with lymphedema must maintain a strict regimen of skin care, avoiding any wounds or abrasions that might allow bacteria to enter.



Lymphedema can be caused by malformed or inadequate lymphatics - an inborn defect. In keeping with our "plumbing" theme, you can think of a faulty pipe system - not enough pipes, or pipes with the wrong shape or made from the wrong materials. This type of lymphedema is called primary lymphedema.

Primary lymphedema can be evident from birth, when the baby is born with a swollen arm or leg, or it can develop later in adolescence or even in adulthood.


Primary l ymphedema in 16 year-old boy

Secondary lymphedema, sometimes called acquired lymphedema, is caused by blockage or disruption of the lymphatic vessels due to disease or trauma.


Secondary lymphedema of the arm

Examples of secondary lymphedema include those caused by mastectomy surgery and/or radiation, other surgeries, tumors, trauma due to accidents, and occasionally as a result of liposuction surgery. Filariasis, a parasitic infection, is a frequent cause of secondary lymphedema in tropical countries.



Left untreated, lymphedema can cause serious complications.
So it is extremely important that the patient receive effective and consistent treatment. Surgical methods are currently not generally recommended.
If lymphedema is caused by parasitic or other infection, medications may be prescribed. But in general, treatment focuses on reducing the accumulation of lymphatic fluid.

The most basic form of treatment consists of increasing pressure on the limb to encourage fluid uptake by the lymphatics. One such method is limb elevation, which utilizes the force of gravity to move fluids out of the limb. Another way to increase pressure on the limb is by wearing medical (prescription) compression stockings, or by applying special bandaging.

Static compression garments are fastened around the limb at a specific pressure. These garments usually need to be worn many hours at a time.

All forms of stockings, bandaging and static garments can be cumbersome and uncomfortable, especially in hot climates. But they are generally necessary, either as the main treatment or as adjunctive therapy for other treatment methods, and consistent use is important for successful treatment. Compression stockings for both the arms and legs allow freedom of motion to the treated limb, and are cosmetically acceptable.

Manual Lymph Drainage is a specialized form of massage that must be performed by a trained professional therapist. There are various "schools" or techniques of manual lymph drainage. In this treatment method, directional manual pressure is applied to the limb and torso to help drain excess lymphatic fluid. In between treatment sessions, the patient must wear a static compression garment, bandaging or compression stockings to maintain treatment results and keep the fluid from accumulating again.

The main advantage of manual lymph drainage is its ability to treat the patient's torso as well as the affected limb. However, because manual lymph drainage is performed by specially trained therapists, this method is expensive and requires frequent clinic visits. Often patients find that having to visit a manual lymph drainage therapist on a regular basis is both costly and inconvenient - and sometimes downright impossible. Many manual lymph drainage professionals, aware of this problem, advocate home treatment with Lympha Press® compression therapy systems in between clinic visits as a way to extend and enhance treatment.

The quality of manual lymph drainage treatment is highly dependent on the expertise of the individual therapist. There are a number of excellent manual lymph drainage clinics, especially in Europe. Some of these clinics even have complete in-patient facilities, where they address the entire spectrum of lymphedema treatment, including exercise, skin care, and psychosocial aspects.

Sequential compression therapy, sometimes referred to as pressotherapy, is another method of treatment for moderate to severe lymphedema. A special device inflates and deflates a garment worn over the affected limb, applying directional pressure. The pressure and release cycle encourages emptying and refill of the lymphatics, while the directional compression promotes the flow of lymph upward towards the torso and assists the lymphatic fluid in finding its way around the blockage to healthy lymphatic channels. The patient wears a medical compression stocking in between treatments.


left image: Moderate lower limb lymphedema before treatment
right image: After 10 days of treatment with Lympha Press®

When using this method, it is very important to use a high quality sequential compression device. Lympha Press® is internationally acknowledged as the very best device of this kind, and is medically recognized as one of the most effective treatment methods for lymphedema.

To read more about what makes the Lympha Press so effective, click here.



The Lympha Press® device applies pressure in sequence from the farthest (most distal) part of the limb, proximally towards the body. The gentle pressure wave is created by up to 12 overlapping inflatable chambers inside a special garment which is worn around the limb. Each chamber inflates in sequence, applying a smooth directional massage action that assists trapped lymphatic fluid to find its way to alternative, open lymphatic channels. Once the entire limb has been compressed, the Lympha Press® releases the pressure, allowing the emptied lymphatic channels to refill. Then the process starts over again, and is repeated until treatment is complete.
The pressure cycles have been set to mimic as closely as possible the body's own lymphatic return, to maximize emptying and reuptake.
An added benefit: the rapid cycle time also makes treatment fast and comfortable. In addition, the Lympha Press® has clinically demonstrated removal of trapped proteins (Partsch et al., "Phlebologie und Proktologie, May 1980, pp. 124-128.)




Patients with lymphedema, especially those with particularly severe conditions, may benefit from using a combination of various treatment methods. Particularly helpful: a combination regimen of manual lymph drainage and Lympha Press®. This treatment can be carried out entirely in clinic, or with the Lympha Press® portion of the treatment done the patient's home. This "combined therapy" allows patients the independence and efficiency of home treatment, with the added benefit of the skilled therapist's touch. The therapist can oversee treatment and make sure everything is "on track."



Lympha Press® Plus systems in use in a Manual Lymph Drainage clinic

Some patients with extreme lymphedema are treated with Lympha Press®, manual lymph drainage, and bandaging. After the initial reduction is achieved, the patient can maintain the reduced state with Lympha Press® treatments at home, compression garments, and manual lymph drainage as needed.



Whatever treatment method is chosen, the patient must keep up with it. Lymphedema treatment is for a lifetime. Proper and consistent treatment will help maintain limb form and function.

Convenience is a major factor contributing to patient compliance. Home treatment with Lympha Press Mini helps patients treat themselves at their own convenience, in their own surroundings. Treatment costs are also a factor in compliance, both from the patient's perspective and for hospitals struggling to provide care in today's economy. Lympha Press® Mini provides effective treatment at home, at a fraction of the cost of regular clinic visits. Hospitals around the world value the flexibility, safety, and effectiveness of Lympha Press® and Lympha Press® Plus for treating their large and varied patient population.



Lymphedema is a chronic disorder. But it can be effectively treated, and the patient's quality of life can be restored. There are excellent treatment options available. Our hope is that this web site will help provide some information about treatments. But this web site should in no way be considered a medical source, and should not replace your own physician's recommendations.