Complete Decompression Therapy in a Patient with Chronic, Non-Surgical Upper-Extremity Lymphedema during Radiation Therapy: A Case Study

Abstract

Background and Purpose: The purpose of this case study is to describe complete decongestive therapy on the upper extremity as an intervention for an atypical patient with chronic lymphedema. Typically this is performed on women with acute lymphedema that have had breast cancer, have already completed radiation therapy, and have undergone a mastectomy and lymph node dissection. The patient in this case was atypical because he was male, did not have breast cancer, did not have any surgical intervention, and was being treated with concurrent radiation therapy.

Case Description: This patient was a 73-year-old male with a six month history of insidious right upper extremity pain and was diagnosed with a large thoracic costal cancerous tumor, a full thickness tear of the rotator cuff muscles, and three rib fractures. Then he presented to physical therapy with right shoulder girdle pain, limited function, and significant swelling throughout the entire right upper extremity.

Intervention: This patient was treated with daily Complete Decongestive Therapy treatment for lymphedema over a twenty-one day period, which included manual lymph drainage, compression bandaging, skin care, gentle stretching and strengthening exercises, and education. The goal of this intervention is to reduce girth, reduce pain, and improve function of the affected limb.

Conclusion: After complete decongestive therapy, circumferential measurements decreased in a non-surgical, male patient with chronic upper extremity lymphedema.