Once in a while, lymphedema treatment may not work for an individual. Why would that be? One reason may be the type of swelling.
Pure vs combined forms of lymphedema
Lymphedema can be pure & uncomplicated, or it can be combined. Pure, uncomplicated lymphedema means primary injury to the lymph system (such as lymph node removal). Combined means a combination of edema & lymphedema.
Lymphedema vs edema in combined forms
Swelling has different causes. When the swelling is caused by a damaged lymphatic system allowing protein to accumulate, it is lymphedema. When the lymphatic system is intact (whether there is protein accumulation or not), it’s edema. Another way of describing swelling is to say: One cause of swelling is lymphedema. Everything else is edema. Knowing what type of swelling a person has & why will impact treatment & treatment outcome.
“It must be emphasized that after the diagnosis of lymphedema has been made & its etiology has been determined, a comprehensive examination is necessary in order to detect possible accompanying diseases.” 1 (Pexels photo by Maksim Goncharenok)
Lymphedema has one cause: A damaged (or blocked) lymphatic system. Edema has numerous possible causes (trauma, post-op swelling, infection, heart or kidney problems, liver or dietary problems, vein problems, hormones, etc.) While aspects of lymphedema treatment (such as bandaging) may help edema in some cases, the cause of edema must be determined & medically treated to resolve.
“If accompanying diseases [causing edema] are undiagnosed &/or untreated, CDT [complete decongestive therapy or lymphedema treatment] will not be successful.” 2 (In some cases, treating someone can even be a contraindication until the edema & its cause has been treated.)
Reasons Lymphedema Treatment May Not Work
Reason 1 – It’s a Combined Form
It is possible for a person to have both lymphedema (an impaired lymph system) & edema (non-lymphatic cause of swelling) at the same time. (It is also possible for chronic edema to cause a secondary lymphedema!) While lymphedema treatment will improve the lymphedema type of swelling, it will not resolve the edema or fix the problem causing it (such as heart or kidney failure, etc.). The medical cause of edema must be discovered & medically treated to resolve the edema.
In combined form (when lymphedema & edema occur together), lymphedema treatment should improve the lymphedema. But the edema will still create an influx of fluid until the edema cause is medically treated (& adequately treated).
1, 2 Foldi, M, Foldi, E. (2006). Foldi’s Textbook of Lymphology (2nd ed.), p. 257, 281. Germany: Urban and Fisher. Foldi, M., & Foldi, E. (2012). Foldi’s Textbook of Lymphology (3rd ed.). Urban and Fisher.