Swelling in the legs, ankles, or arms isn’t always just a minor issue—it could be a sign of more serious underlying conditions like lymphedema or chronic venous insufficiency (CVI). While they may look similar, these two conditions have different causes, treatments, and long-term health effects. Knowing the difference and getting the right care early on—especially from a physical therapist trained in swelling disorders—can make all the difference.
In this article, we’ll break down what lymphedema and CVI are, how they differ, and why physical therapy is an essential part of managing these conditions.
What is Lymphedema?
Lymphedema is a chronic condition that occurs when the lymphatic system becomes damaged or blocked. This causes fluid (lymph) to build up in soft tissues, leading to swelling. It most commonly affects the arms or legs but can occur anywhere in the body.
There are two types of lymphedema:
- Primary lymphedema – Caused by inherited or congenital problems in the lymphatic system.
- Secondary lymphedema – More common and usually occurs after cancer treatment, surgery, radiation, or trauma that damages lymph nodes or vessels.
Common Signs of Lymphedema:
- Persistent swelling in a limb
- Heaviness or tightness
- Aching or discomfort
- Skin changes or thickening
- Decreased flexibility
What is Chronic Venous Insufficiency (CVI)?
CVI is a condition where the veins in your legs can’t efficiently return blood to the heart. This happens when valves in the veins become weak or damaged, allowing blood to pool in the lower legs.
CVI is often progressive and worsens over time without treatment.
Common Signs of CVI:
- Leg swelling (especially at the end of the day)
- Pain or heaviness in the legs
- Skin discoloration (often brown or reddish)
- Varicose veins
- Leg ulcers or sores that don’t heal
- Flaky or leathery skin texture
How Are Lymphedema and CVI Different?
While both conditions cause swelling, they result from different problems:
| Feature | Lymphedema | Chronic Venous Insufficiency | ||||
|---|---|---|---|---|---|---|
| Cause | Lymphatic system damage | Venous valve dysfunction | ||||
| Swelling type | Firm, may not reduce overnight | Soft, may reduce with elevation | ||||
| Skin changes | Thick, fibrotic skin over time | Discoloration, ulceration | ||||
| Onset | Gradual, often after injury/surgery | Gradual, worsens throughout the day | ||||
| Treatment | Compression, manual lymph drainage | Compression, elevation, wound care | ||||
It’s also possible for someone to have both lymphedema and CVI, especially in cases where long-standing venous disease overwhelms the lymphatic system—a condition sometimes called phlebolymphedema.
Why Physical Therapy is Key in Managing Both Conditions
Specialized physical therapists trained in swelling disorders can help manage symptoms, reduce swelling, and prevent complications. Here’s how they help:
- Comprehensive Evaluation
A PT will assess your limb size, skin condition, mobility, and functional limitations. They may use girth measurements, bioimpedance tools, or photographs to track progress.
- Manual Lymphatic Drainage (MLD)
This is a specialized, gentle massage technique used to help move lymphatic fluid and reduce swelling.
- Compression Therapy
PTs help fit you with the right type of compression—whether that’s wraps, garments, or pneumatic pumps. Compression helps reduce fluid buildup and maintain results.
- Exercise Programs
Light exercises stimulate lymph and blood flow. PTs design safe, effective routines tailored to your condition and mobility level.
- Skin Care Education
Both conditions increase the risk of skin infections. Your PT will educate you on hygiene and moisture control to protect your skin.
- Functional Training
If swelling has affected your ability to walk, climb stairs, or perform daily tasks, physical therapists help you regain independence through strengthening and mobility training.
Risks of Not Treating Lymphedema or CVI
Ignoring swelling can lead to serious health issues:
- Lymphedema: Can become irreversible and progress to stage 3 (elephantiasis). Infections like cellulitis or lymphangitis are also common.
- CVI: Can result in non-healing leg ulcers, increased infection risk, and chronic pain.
The earlier you begin therapy, the better your long-term outcome.
Hohman Rehab’s Approach to Swelling Disorders
At Hohman Rehab and Sports Therapy, we offer specialized care for patients with lymphedema and chronic venous insufficiency. Our certified therapists are trained in:
- Complete Decongestive Therapy (CDT)
- Compression wrapping and garment fitting
- Individualized exercise and mobility plans
- Ongoing patient education and support
We treat you with compassion, consistency, and a personalized plan that helps you feel and function better.
We serve patients at three convenient Central Florida locations:
Clermont Office
236 Mohawk Road, Clermont, FL 34715
Phone: 855-404-6908
Ocoee Office
11095 W. Colonial Drive, Ocoee, FL 34761
Phone: 855-404-6908
Apopka Office
125 S. Park Ave., Apopka, FL 32703
Phone: 407-410-3200
Take the First Step Toward Relief
Lymphedema and chronic venous insufficiency are serious conditions, but with the right care, they can be managed. Physical therapy is a vital part of your recovery and prevention plan.
If you or a loved one is dealing with persistent swelling, don’t wait. Schedule a consultation with our skilled therapists at Hohman Rehab and Sports Therapy today. We’re here to help you get back to living your best, most comfortable life.
Written By:
Dr. Katie Hohman
Physical Therapist, Certified Lymphedema Therapist, Founder
