Treatment for Lymphedema of the Legs

This video explains treatments for lymphedema, and we'll show you how to perform exercises and stretches that will help keep lymphedema under control.

If lymphedema gets worse, the swelling will stay around longer or not go away unless you get treatment. Over time, simply putting your legs up will not be enough. At this point, you will need to work with a lymphedema therapist to treat the condition. Your doctor can refer you to a lymphedema therapist at MSK.

Treatment for lymphedema is called complete decongestive therapy, or CDT. CDT includes bandaging, manual lymphatic drainage, compression stockings, skin care, and exercises. You may have additional treatments depending on what you need.

Bandaging is covering your legs with a special type of short-stretch bandage, which provides layered compression. Not every person will need to do this. If you need bandaging, there are many different ways to bandage. You and your therapist can discuss which option is best for you.

Manual lymphatic drainage is a gentle type of massage. It moves fluid from your legs to where it can be reabsorbed by your body. Manual lymphatic drainage is done in a certain order, depending on which lymph nodes were removed. Your therapist will determine what order or sequence is appropriate for you.

People often ask whether it's safe to get a regular massage. It is okay to have a massage, but it will not prevent lymphedema. When getting a massage, you need to make sure that the massage is not so hard that your skin becomes red. Also, make sure that it is performed in a one-way direction from your feet to your hips only. This is the direction of your normal path of fluid return.

Compression stockings help to keep the fluid from collecting in your legs. They work best in mild cases of lymphedema. If you have a more severe case, you may need other therapy first.

It is important to get stockings that fit you well. Poor-fitting compression stockings may actually cause lymphedema instead of helping it. Make sure the stockings do not cause any irritation or cut into your skin.

It is best if your lymphedema therapist or skilled fitter measures you for stockings so you can be sure they fit well and are safe for you to wear.

The stockings come in knee-high and thigh-high lengths, as well as pantyhose. Stockings come in different compression levels. You may need to wear a higher compression level depending on your swelling. Always speak with your doctor or therapist to decide which is best for you.

Keep your skin clean and well moisturized to decrease your risk for infection. Your risk for lymphedema is lower if you do not get infections in your legs, feet, or anywhere on your skin from your belly button down.

Gentle exercises are a great way to help the fluids in your body move a little better. Talk with your doctor before you start doing any exercises.

The following exercises will help you maintain flexibility and strength. Do them once a day. Stop if you have any pain, discomfort, or fatigue.

Start with deep breathing. Breathe in through your nose and out through your mouth. When you breathe in, your belly should rise or get bigger, and when you breathe out, it should lower or get smaller. This will stimulate the movement of fluid. Take no more than 3 deep breaths at a time to prevent lightheadedness.

Next, start marching. While sitting, lift one knee and then put it down. Then lift the other knee and put it down. Do this 10 to 15 times.

Now do kicks. While sitting, straighten one leg at the knee and return it to the starting position. Then, straighten the other leg at the knee and return it to the starting position. Do this 10 to 15 times.

The last exercise is called ankle alphabets. Move your feet to spell the letters of the alphabet. Go through the alphabet at least 2 times with each foot.

Stretching exercises will help to loosen your hamstring and your internal hip rotators. Start these stretching exercises only when your doctor tells you it is safe.

This exercise is called a calf stretch. Sit with your legs straight out in front of you. Loop a towel around the ball of one foot. Gently pull the towel, keeping your knees straight. Hold this position for 30 seconds. Repeat 5 times, then switch legs and repeat.

This exercise is called a hamstring stretch. Sit with your legs straight out in front of you. Reach to touch your toes. Keeping your knees and back straight. Hold this position for 30 seconds. Repeat 5 times.

This exercise is called a hip stretch. Lie on your back with your knees bent. Cross one leg over the other and pull the bottom leg close to your chest. Hold this position for 30 seconds. Repeat 5 times. Then, switch legs and repeat the stretch.

Talk with your doctor if you see or develop signs of lymphedema, or if you have any additional questions.

You can find more information about lymphedema in the resource Reducing Your Risk of Lymphedema of the Legs. You can also find it online at www.mskcc.org/pe.