I was recently certified in August and am working at a SNF/Rehab center. I have several residents who have edema/lymphedema in their UE's and really have little idea how best to treat this. I know that massage is often effective but that if it is done improperly can actually result in increased swelling. Any tips or ideas would be greatly appreciated as this is not something that was really covered in school!!
Caryn you are so right that you can do more damage if you don't do the CDT protocols correctly. I completed the lymphedema management course. You do need to attend one of the many courses out there that focuses on teaching you the correct techniques. You can do a search by typing in lymphedema and then compare the various schools for lymphedema and choose one that you feel comfortable with. It is worth your time and money to do this and I find this technique very rewarding to work with. You can see improvement in a very short period of time.
Courses are definately something I am looking into as I know this is something I will continue to encounter if I stay at the nursing home. Any suggestions that I can do until then - I really am clueless!!
How about contrast baths? I haven't really come across anything saying yea or nea to this for lymphedema..... Just trying to come up with some options that I as an entry-level therapist can do...
I am a Certified Lymphedema therapist... here are a few things that you can do....
Do simple AROM exercises with the patients...there is nothing better than the muscle pump action to decrease lymphedema. Also are your pts in the early phases where edema is reduced by elevation? if so then ask them to elevate their UE's. Remember heat increases circulation and worsens edema... so no hot baths... cold usually works.... Decongestive therapy includes superficial techniques to reduce edema vs. massage which more deep techniques to increase blood flow to the region...
Hope this helps...
Thank you, that was a big help! I started working with her on Monday and have already started to see an improvement.
I am working with a pt with edema (not early phases) that is limited PROM to form fists. He has central cord syndrome with slow return in both extremities, especially the right hand. I have been doing kinesio taping and edema massage as well as educating his caregivers in doing edema massage. I feel like we're plateuing. I also just added the tubigrip. After one day, I have not noticed significant change, but he also is working with PT where he is often up and walking (via Lokomat). Any other tips? The edema truly limits the PROM, but is not severe/pitting. Please help.
Audra Ray, OTR/L
Thank you for all your help. I ended up doing massage to the arm and medial epicondyle of his elbow and then sweeping gently towards his armpit across his upper arm. We'll see how it went (over the weekend). I found a lymphedema trained PT at work, too!