Breast Cancer Awareness Month: Managing Lymphedema with Physical Therapy

All too often, women who are treated for breast cancer find themselves free of the disease but hindered by complications from surgery. Lymphedema, a chronic condition involving pain and swelling, is one of the most common complications from breast cancer surgery. About one in five breast cancer patients experience the condition, according to the National Institutes of Health.

While there is no cure for lymphedema, studies show that specific physical therapy techniques can reduce symptoms of the disorder. Earlier this year, Brooks Rehabilitation’s Nassau County locations added lymphedema therapy to meet the demand for services.

Therapists trained to treat lymphedema are available at the Brooks locations in Fernandina Beach and Yulee, says Eleanor Corbett, a lymphedema therapist with Brooks Rehabilitation in Fernandina Beach. “We are passionate about helping people at every stage of their cancer journey,” she says.

In cancer patients, lymphedema can develop after treatment that removes sections of the lymphatic system. Fluid that typically flows through the lymphatic system builds up. Breast cancer patients experience swelling in the arm or chest wall as well as heaviness, itching or burning, pain and numbing. The condition can cause infections.

“There is no cure for lymphedema, meaning once you get it, it’s with you for life,” Corbett says. “Lymphedema can stop you from doing the things you want to do because it makes moving harder and makes you tired … What can be the hardest thing to deal with is the way it changes how our bodies look. Lymphedema makes one or more parts of the body swell, which many people find uncomfortable.”

People with the condition can find some relief by exercising and eating a healthy diet, Corbett says. Compression garments are often useful. Surgery to treat the condition is only recommended when less invasive treatments have been tried and failed.

Physical therapy, however, is non-invasive and frequently successful. In particular, a technique known as complete decongestive therapy (CDT) has been shown to be effective in scientific studies. The therapy has four parts, Corbett says. Manual lymph drainage is a special hands-on technique to encourage the lymph fluid to drain. Compression bandages are then applied to keep the fluid out. Therapists then teach patients exercises to help push the fluid out. Once the swelling has subsided, patients receive compression garments, worn daily, to prevent the lymphedema from returning.

“Through the entire process, we teach the patients how to do the techniques on themselves at home so they can maintain progress between treatments,” Corbett says. “Perhaps most importantly, we provide education and support as they get used to their new normal.”

The CDT process typically involves two to 10 visits, depending on the severity of the case. The goal is to relieve symptoms and restore strength and flexibility. A 2021 review of non-medication treatments for lymphedema found that complex decongestive therapy (CDT) reduces swelling and symptoms and improves quality of life. CDT is considered the gold standard of conservative lymphedema treatments, according to the authors of the study.

“The therapy works surprisingly fast,” Corbett says. “We usually see a reduction in the amount of swelling even after the first few treatments. Motivation is the biggest factor. If the patient is doing their part at home, they will see better results.”

Medicare covers physical therapy for lymphedema as do most other insurers, she notes. Moreover, earlier this year the federal Lymphedema Treatment Act went into effect that mandates insurance coverage for compression garments and other lymphedema-related equipment.

People battling lymphedema should speak with their health care provider for a recommendation to a therapist. Look for a certified lymphedema therapist who has ample experience in CDT.

“Brooks Rehabilitation also offers therapy for many other complications that come from having cancer,” Corbett says. “This includes improving range of motion, increasing endurance, decreasing pain, and helping with cognitive changes that often happen with cancer treatment.”