Treatment of lymphostasis of the arm after surgical removal of the mammary gland

Folk recipes

Author Ksenia Petrova Reading time 7 min. Views 3k. Published 12/24/2015

Lymph, just like blood, is important for our body. A viscous, yellowish-brown substance ensures the outflow of fluid from the intercellular space. Violation of the lymphatic ducts and fluid drainage can cause the development of stagnant processes - lymphostasis, accompanied by swelling and bursting pain. One of the most common types of disease is lymphostasis of the upper extremities (arms), and the main risk group is women. Lymphostasis can be easily treated at an early stage, so you should not miss the chance to quickly defeat the disease. Traditional medicine provides great assistance in treatment.

• Application of herbal medicine
• Other traditional medicines
• Basic nutrition and diet for illness

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What is lymphostasis

Lymphatic edema or lymphostasis is a condition caused by a violation of the production and outflow of lymph, its circulation through the vessels and exit into the thoracic duct. This pathology occurs in approximately 10% of the total population of the planet. When some nodes and ducts are removed, the outflow of fluid from the upper limb is disrupted. If the disease becomes protracted, fibers begin to disintegrate in the tissues with the proliferation of connective tissue. The blood supply to the affected area is also disrupted.

Lymphostasis of the arm after mastectomy is accompanied by increasing swelling of the soft tissues on the side of the removed gland. The volume of the limb increases, the subcutaneous tissue thickens. The skin changes - hyperkeratosis increases, cracks and ulcerations appear. The maximum degree of development is called elephantiasis. Due to the problem that has arisen, the patient develops depression. Since the functions of the hand suffer with lymphostasis, the woman eventually becomes disabled.

How to avoid lymphostasis after mastectomy?

Methods for preventing lymphostasis after mastectomy are usually discussed by the attending physician. These include:

• limiting the load on the hands;
• exclusion of work that requires prolonged bending of the back or lowering of the arms;
• avoiding injury to the arm (try to avoid cuts, abrasions, scratches, as well as injections into the arm on the operated side);
• minimizing salt intake (it retains fluid);
• compliance with the rules of rational nutrition;
• performing gymnastic exercises prescribed by a specialist.

At the Yusupov Hospital, you can undergo not only treatment for lymphostasis, but also receive recommendations for eliminating this condition in the future. Conservative methods of therapy can eliminate the development of pathology and prevent its recurrence in the future.

You can make an appointment with rehabilitation therapists, massage therapists, exercise therapy instructors and other rehabilitation clinic specialists, and find out more information about the work of the rehabilitation center and other questions of interest by calling the Yusupov Hospital.

Author

Elena Evgenievna Shevtsova

Speech pathologist-defectologist, candidate of medical sciences

Reasons for the development of the disease

The main cause of congestion in the upper limb after mastectomy is damage or removal of lymphatic vessels or nodes. As a result, tissue fluid is not excreted naturally and accumulates in the soft tissues of the hand. Other factors contribute to the development of edema:

• upper limb injuries;
• decreased range of motion in the arm and shoulder joint, leading to blood stagnation;
• the addition of a bacterial infection during surgery or during the rehabilitation period;
• the formation of metastases of a malignant tumor in adjacent soft tissues and mechanical compression of the ducts;
• non-compliance with recommendations for postoperative care - refusal of massage, special corrective underwear, physical therapy;
• scar tissue degeneration after surgery or radiation therapy;
• exposure to bad habits.

The severity of the complication among patients can vary greatly. Some women have their breast tissue completely removed, along with the pectoral muscle and a regional group of nodes, and they do not experience lymphostasis. In others, complications develop even when a small area of ​​tissue is removed.

How to treat

Treatment methods for arm lymphostasis are determined by the doctor after a thorough examination and study of the diagnostic results. Self-medication is strictly prohibited, since there is a high probability of significantly aggravating the problem and causing irreversible consequences. Only a doctor will tell you what to do if swelling occurs after surgery and select the most effective and safe treatment method.

After mastectomy

Treatment of lymphostasis after removal of the mammary gland should begin in the early stages of the development of swelling. Worrying symptoms that appear after surgical therapy are a signal to immediately visit a doctor and undergo the necessary examination.

Not everyone develops lymphedema after a mastectomy. In the early stages, the pathology responds well to treatment. In advanced conditions, the doctors' prognosis will not be so rosy. The same applies to situations where limb deformation has begun. Therapy in this case is ineffective and does not completely eliminate the disease.

At home

Treatment at home is only permissible in combination with drug therapy. All means used must be agreed upon with the attending physician. Self-medication is completely excluded. If treatment is accompanied by a worsening of the problem, it should be stopped and a doctor should be visited to adjust the therapy.

The main goal of the home remedies used is to restore lymph flow, blood flow in the limbs that are affected by the disease. It is also necessary to normalize the nutrition of hand tissues with all necessary substances.

For home therapy, not only medications are recommended, but also massage and a set of special exercises. Particular attention is paid to proper nutrition and compression therapy.

Medicines

The necessary therapy after surgery is prescribed by the attending physician. Its main task is to relieve swelling. The duration of treatment and dosage of recommended drugs are also prescribed on an individual basis. Treatment will last for at least a month.

In the first days after surgery, diuretics are prescribed for everyone.

If there is a need to reduce the elevated temperature and eliminate the fever, then antibiotics are necessary.

There are several main groups of medications:

1. medications to strengthen blood vessels and relieve inflammation - angioprotectors;
2. medications to increase the tone of the veins and relieve inflammation - phlebonitics;
3. It is mandatory to take therapeutic agents that consist of enzymes. They will enhance the impact of the first two groups - enzymes;
4. During the treatment period, immunomodulators are required. This activates the body's defenses and increases its resistance to diseases and viruses.

Self-selection of medications is strictly prohibited; this can lead to deterioration of well-being. During the treatment period the following is prescribed:

• Troxevasin;
• Troxerutin;
• Detralex;
• Aescusan;
• Phlogenzyme;
• Eleutherococcus;
• Lycopid;
• Furosemide;
• Ibuprofen;
• Trental.

Only comprehensive intake of recommended medications can achieve positive dynamics and improve a woman’s condition.

Compression therapy

During the rehabilitation period after the stitches are removed, the woman is recommended to wear a compression sleeve. This is another one of the therapeutic methods that should not be neglected at this time. By wearing compression garments, the load will be evenly distributed throughout the entire limb, this will prevent swelling.

Thanks to compression therapy, lymphatic drainage can be activated. A special sleeve can be fully replaced by a tight elastic bandage. In this case, the limb should not be too tight, otherwise blood circulation will be disrupted.

There are certain contraindications for wearing a compression sleeve:

• diseases of the heart, arteries;
• purulent infection of soft tissues;
• partial or complete loss of sensation in the affected limb;
• allergic reaction to the material of compression garments.

The compression sleeve is individually selected by the doctor, taking into account the woman’s body type.

Nutrition

After diagnosis, a woman should carefully plan her diet. A diet menu is one of the components of a full recovery. The basis of the diet is low-calorie foods. It is necessary to minimize, or better yet completely avoid, salt, which retains fluid in the body.

It is allowed to consume foods containing starch in minimal quantities. Alcohol, soda, and spices are completely prohibited. Even after recovery, you should control your diet, limiting yourself to things that can cause harm, provoking a relapse of the disease.

Exercises

Simple gymnastics, simple exercises recommended by experts will help a woman cope with the disease faster.

It must be remembered that you can exercise provided there is no discomfort or pain. The recovery complex should begin with simple exercises, gradually moving on to more complex ones.

• Take a sitting position and place your palms on your knees, turning them upward, eliminating any tension;
• maintain the position of the first exercise, begin to slowly squeeze your fingers, then relax;
• lean slightly towards the operated side, lower your arm, rocking - if discomfort occurs, finish the exercise;
• sit up straight, place your palms on your shoulders, slowly begin to raise your elbows, then slowly lower them down. Do two or three repetitions;
• raise the affected limb and hold it in the air for a few seconds, then slowly lower it;
• perform circular movements with your shoulders;
• smoothly place your hands behind your back, clasping your fingers. Try to straighten your arms without sudden movements or discomfort.

At first, you can do exercise therapy under the guidance of an instructor. This will help avoid injury, sudden movements, and discomfort. At home, for your condition to begin to improve, it’s enough to find 10-15 minutes of exercise every day.

Massage

If swelling develops, hand massage will help. It can be carried out by a qualified specialist or the patient himself. Place the palm of the swollen hand on any hard surface, slightly raising the forearm. Massage the affected hand with gentle circular movements of your fingers. It is better to start the massage with your fingers and end in the forearm area. One procedure should take approximately 10 minutes and should be carried out 4-5 times a day.

Folk remedies

Treatment with folk remedies is carried out only in consultation with the attending physician. Otherwise, complications may develop that will negatively affect your overall health. The most effective recipes:

• Place the onion in the oven and bake until done. Remove the husks and chop the onion until mushy. Mix the onion with the tar, stir thoroughly until smooth. Use the composition for night compresses. In the morning, remove and wash your hand with a soft cloth. Use daily for about a month and a half;
• Mix in one container 50 g of Islamic moss thallus, 20 g of sandy immortelle flowers, Astragalus dense-flowered, oak and birch bark, horse chestnut fruits. Take 2 tbsp. l. the resulting composition, add 400 ml of water, boil, remove from the stove. Leave for about 20 minutes. Be sure to strain before use. Take no more than 100 g at a time 3 times a day;
• Grind ¼ kg of garlic until mushy, mix with the same amount of honey. Infuse in a tightly closed glass container for about 8 days. Take one spoon before meals for a week.

The effectiveness of therapy is always different. Some patients will experience a significant reduction in symptoms, while others will experience no relief at all or develop side effects.

If conservative methods are ineffective, the doctor may prescribe surgical therapy.

Types of lymphostasis

There are 2 types of arm lymphedema after breast removal. Primary or early lymphostasis occurs in the first days after surgery and is associated with mechanical damage to the lymph nodes and blood vessels. The secondary or late type of edema develops some time after the intervention. Most often, the second type of lymphostasis is found in women who have received radiation therapy. Depending on the form of edema, soft and dense types of lymphostasis are also distinguished.

During the course of the disease, it is customary to distinguish several degrees according to the severity and severity of the development of pathology. The mild stage is characterized by minimal clinical symptoms. Pain and swelling appear only during physical activity. At rest, women do not feel discomfort. If you gather the skin on your hand, you get a small fold.

In moderate cases, thickening of the skin is observed. Pain in the affected limb increases. It becomes much more difficult to gather the skin into a fold on the hand, but it is still possible.

The severe stage of the disease is accompanied by constant swelling, which does not go away even after a long rest. The volume of the diseased limb can be twice as large as that of a healthy one. It is no longer possible to gather the skin on the hand into a fold.

Some experts also distinguish the terminal stage of lymphostasis, when irreversible changes in blood circulation and limb deformation develop. At this stage, the woman is recognized as disabled.

Other traditional medicines

Wash several raw potatoes thoroughly and grind them with their skins to form a paste. Spread the mixture in an even layer on a clean cloth or bandage and wrap your hand, securing the bandage with a towel. Leave the compress for 1-1.5 hours, placing your hand on the pillow. Carry out the procedure daily before bed for a month. Cucumber has the same effectiveness. Prepare a homogeneous paste from fresh vegetables and use it as a base for a compress.

Birch tar is used in the treatment of lymphostasis in combination with baked onions, which enhances its effect

Bake the onion in the oven for 20-30 minutes, remove, cool slightly and crush with a fork. Mix with one tablespoon of birch tar, put the pulp on a cloth and put a compress on your hand. Leave it on all night. It is recommended to repeat the procedure once every two days. The method helps reduce swelling and pain.

Red wine helps normalize the functioning of the lymphatic system; for this you need to drink 30 ml of the drink in the morning on an empty stomach for a month.

Mix flour, alcohol and kefir in equal proportions. Soak a clean bandage in the resulting product, apply to the areas of swelling, cover the top with cling film or a clean towel and leave for 2-3 hours.

Beetroot juice will help normalize the functioning of the lymphatic system. To do this, it is recommended to drink 150 ml of juice diluted in half with water twice a day for two to three months.

White clay wraps will help reduce pain and relieve swelling. The prepared clay is diluted with water until a paste is obtained, the hand is lubricated with simple vegetable or mint oil, and the clay is placed on top. Wrap in cling film and a clean cloth. Leave the compress for 3-4 hours. Then carefully rinse your hand in warm water. It is recommended to repeat the procedure once a day.

Symptoms

Clinical manifestations of lymphostasis depend on its type and the time elapsed after surgery. The primary form is characterized by the following symptoms:

• the appearance of aching or bursting pain in the joint and the entire arm;
• swelling of soft tissues;
• limited mobility and stiffness;
• numbness and burning in the fingertips;
• increase in the volume of the diseased limb;
• swelling increases after sleep or significant physical effort;
• a secondary infection occurs, inflammation of the skin develops;
• phantom pain may occur at the site of the removed gland;
• Posture changes due to muscle stiffness, pain and discomfort appear in the back.

In the long-term period after surgery (more than a year), secondary lymphostasis is diagnosed. The swelling of the hand increases, the tissues become denser.

If the process is caused by secondary infection, intoxication is observed and body temperature rises. Erysipelas of the hand begins. The color of the skin of the limb changes to bright red or bluish. In advanced stages, hyperpigmentation occurs. The patient suffers from severe pain, burning and cramps in the affected arm.

Diagnostics

The basis for diagnosing arm lymphostasis due to mastectomy is anamnestic and clinical examination data. A detailed questioning of the patient about the nature of the manifestations of edema and examination, already at this stage of the examination, allows not only to determine the diagnosis, but also to indicate the stage of lymphedema.

Additional and specialized studies:

1. Clinical profile: general blood and urine analysis, biochemical profile.
2. Ultrasound examination of the limb.
3. Lymphography is a specialized x-ray examination.

The stage of non-permanent soft lymphedema does not have pronounced anatomical changes in the limb. Its diagnosis presents certain difficulties. But it is the mild form that is most amenable to restorative therapy, which once again reminds us of the advisability of early treatment of patients. Other diagnostic tests are prescribed as indicated, depending on the general and local clinical manifestations.

Treatment of lymphostasis

Treatment of arm lymphostasis after mastectomy is carried out by mammologists, phlebologists and surgeons. If necessary, consultations with other specialists are prescribed. The range of measures includes medications, physiotherapy, and exercise therapy. Additionally, you can use folk recipes.

Drug therapy

Only a specialist should prescribe medications and determine the specific dosage. The following groups of drugs are used in the treatment of lymphostasis:

• broad-spectrum antibiotics (Doxycycline, Erythromycin, Ceftriaxone);
• painkillers and non-steroidal anti-inflammatory drugs (Nimesulide, Diclofenac);
• diuretics (Furosemide, Mannitol);
• angioprotectors and venotonics (Detralex, Troxevasin);
• immunostimulants (Likopid, Immunal, Derinat);
• antihistamines (Suprastin, Tavegil).

When the skin is damaged, external preparations are used - antiseptics, ointments and gels with antibacterial and wound-healing effects (Levomekol, etc.). Medicines relieve swelling and pain, help normalize blood circulation and lymph flow.

Physiotherapy

After surgery, patients experience pain in the chest and shoulder. To reduce discomfort, they press their hand to their chest and slouch. As a result, the spine is deformed and the blood supply is disrupted, causing pain in the shoulder and neck. It is possible to improve your condition with the help of physical therapy. You can practice at home or in a medical facility. In any case, the complex must be selected by a doctor or exercise therapy instructor.

It is necessary to perform therapeutic exercises with your shoulders back and your back straight. Under no circumstances should you overexert yourself. If discomfort occurs, you need to take a break. Each movement is done from 4 to 10 times. An approximate set of exercises:

1. While sitting, lower your hands to your knees. Turn them one by one up and down with the back side, without straining the entire limb.
2. Raise your hand forward and hold for 10 seconds. If condition allows, raise it up.
3. Interlace your fingers behind your back and straighten your arms. Then carefully lift it up.

When performing exercises, frequency and regularity are important. Strength and speed don't matter.

Healing massage

You can take a massage course in a medical institution or on your own at home. The procedure should be carried out in a warm room, sitting as comfortably as possible. For self-treatment, the swollen limb is pulled out and rested against the wall with the palm of the hand. The second hand is used to massage.

Begin the procedure by lightly stroking the arm, moving from the fingertips up to the shoulders. Next, the effect is slightly intensified, moving on to rubbing. This movement is carried out with displacement of the skin.

The next stage is kneading. The arm muscles can be treated with light pinching. All movements should be smooth and soft. You need to finish the treatment with stroking. Intermittent vibration, effleurage and deep kneading are excluded.

To enhance the effect, you can use special creams recommended by your doctor. The duration of one session is no more than 5 minutes. You can repeat the procedure 2-3 times daily. The general course is 10 days. In addition to manual massage, you can sign up for hardware procedures. They are carried out in physiotherapy clinics.

Diet

An important component of the treatment of arm lymphostasis is proper nutrition. It is necessary to reduce the amount of table salt in the diet. Sodium ions, which are part of it, retain water in the body and cause swelling. To reduce them, you will have to give up fatty, spicy and salty foods, foods high in carbohydrates, and alcoholic beverages.

The menu should include a large number of plant products. They are rich in fiber and help remove toxins and excess moisture from the body. Protein-rich dishes such as low-fat fish and meat are also beneficial.

Folk remedies

Folk remedies have proven themselves to be effective as auxiliary measures for hand lymphostasis. They can be used internally or externally in the form of compresses. It should be remembered that they cannot replace full treatment.

At home, you can prepare a medicinal tincture of garlic. To do this, peel 200 grams of garlic and chop the cloves. Mix the resulting mass with a glass of liquid honey and leave for a week in a cool, dark place. You can take 15 ml of the product an hour before each meal.

An infusion of plantain leaves will help relieve lymphedema of the hand. Dry raw materials are used to prepare the medicine. It is filled with hot water and left in a thermos overnight. The finished infusion is filtered and drunk. To enhance the effect, take 2 teaspoons of honey along with the liquid.

A medicinal tincture of Sophora fruits will help reduce inflammation and restore soft tissue during lymphostasis. To prepare it you will need 50 grams of plant material. It is poured with 500 ml of vodka and infused for 3 weeks. Place 30 drops of the prepared product into a glass of water and drink it on an empty stomach three times a day.

If your hand is very swollen, you can relieve pain and swelling with the help of compresses. Every evening, bandages of grated raw potatoes and cottage cheese are applied to the affected limb. The products are used alternately. Cover the affected arm with polyethylene and a warm scarf. The therapeutic compress is left overnight.

Lymphostasis of the hand can be eliminated by collecting medicinal plants. Mix equal amounts of dandelion roots and willow bark, meadowsweet grass and sweet clover, and elderberry flowers. Pour 2 tablespoons of the mixture into two glasses of boiling water and keep on low heat for 3 minutes. Take half a glass of decoction three times a day.

Treatment of arm lymphedema at the Innovative Vascular Center

The innovative vascular center has been developing the direction of conservative and surgical treatment of arm lymphostasis for more than 10 years, relying on the German experience of conservative treatment used by Dr. Shingale and microsurgical technology of lymphovenous anastomoses and lymph node transplantation.

We provide a full-fledged treatment and rehabilitation complex, which allows you to reduce swelling by 70-100% and control it. The course of treatment is 14 - 28 days.

Surgical treatment is used for stage 2-3 lymphedema of the arm and requires a preliminary course of conservative therapy. The experience of our clinic shows that the manifestations and progression of lymphedema can be significantly reduced and even reversed.

Preventive actions

Prevention of lymphostasis begins on the second day after surgery. The doctor develops his own rehabilitation program for each patient. It includes physical therapy, manual and hardware massages, and physiotherapy. Explanatory work is carried out with the patient and recommendations are given:

• rejection of bad habits;
• dosed physical activity;
• avoid hypothermia, stress and injury;
• the use of softening and disinfecting ointments and creams.

Many women try to fix the sore limb, but this only worsens the situation with lymphostasis. As a result, joint contracture may develop. To avoid this, from the first days of the postoperative period it is necessary to give the arm a feasible load.

Possible complications

Lymphenema leads to a pronounced decrease in the protective functions of the skin. Minor injuries are prone to infection. The risk of erysipelas increases. Increasing swelling puts pressure on blood vessels, nerves, muscles and tendons. As the disease progresses, the motor functions of the limb decrease proportionally, the range of motion in the joints and muscle strength decreases, and fine motor skills of the fingers are impaired. In severe cases, elephantiasis and limb loss may occur.

The largest percentage of the development of lymphedema and its complications is associated with the patient’s lifestyle. A sedentary regime with chronic hypoxia, excess weight, low demand for medical help and self-prescription of medications often lead to a diagnosis already in the stage of dense edema. It should be remembered that before treating lymphostasis of the hand, it is necessary to determine the regenerative capabilities of the affected lymphatic system. And, importantly, contraindications to certain prescriptions.