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Physical and Occupational Therapy for Lymphedema


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Lymphedema is swelling of a body part due to a buildup of protein-rich fluid in your tissues. It occurs most commonly in the arms or legs, but can also occur in the face, trunk, abdomen, or genital area. The severity of symptoms depends on the stage of lymphedema. During early stages, the main symptom is swelling. As the lymphedema progresses, the protein-rich swelling causes a hardening of the affected tissues. Other complications that are seen in the later stages of lymphedema may include:

  • Increased hardening
  • Extreme increase in volume of the swollen extremity
  • Fungal Infections

Lymphedema can be primary or secondary. Primary lymphedema is caused by congenital (present from birth) malformations of the lymphatic system. This form of lymphedema:

  • Can appear around puberty or pregnancy
  • Can be present at birth or develop later in life
  • Usually affects the lower extremities, but can be seen in the upper extremities

Secondary lymphedema can affect either the arms or legs. This form of lymphedema is caused by trauma to the lymphatic system, such as:

  • Removal of lymph nodes
  • Severe venous insufficiencies (when the veins have trouble sending blood from your limbs back to your heart)
  • Surgery or radiation therapy for cancer
  • Trauma or infection of lymphatic system

It’s important that you seek treatment immediately if you think you are experiencing this condition, as it will not go away on its own. If left untreated, lymphedema can cause serious long-term consequences.

Tests & Treatments

Physical exam
Your therapist will conduct a thorough physical exam – as well as collect a full medical history – to make the diagnosis of lymphedema.

Imaging tests
Your specialist may recommend you undergo an imaging test – such as a magnetic resonance imaging (MRI) scan, a computerized tomography (CT) scan, Doppler ultrasound, and/or lymphoscintigraphy – to closely examine the area of your body affected by lymphedema.

Compressive garments/bandaging
Specialists apply short-stretch bandages to an affected area to provide pressure and reduce fluid buildup.

Complete decongestion therapy (CDT)
University of Miami Health System has developed a specialized rehabilitation program to help patients with lymphedema, called complete decongestion therapy (CDT).

Manual lymph drainage (MLD)
A technique that helps to move the lymph fluid out of the swollen extremity. A special, short-stretch compression bandage is then applied to the affected extremity after MLD to prevent the re-accumulation of fluid.

Pneumatic pumps
As a treatment for lymphedema, pneumatic pumps use air to inflate a sleeve that encases the affected area. The sleeve has multiple chambers that inflate one after the other to prompt fluid to flow in the right direction.

Decongestive exercises
Decongestive exercises activate the cardiovascular system and help improve fluid mobility. The lymphatic system relies on you moving your muscles to get the lymph fluid moving. As muscles pump, it moves the lymph fluid out of the affected area.

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