Can Physical Therapy Help with Lymphedema after Neck Dissection Surgery?

Can Physical Therapy help with lymphedema after neck dissection surgery?

Yes, post-surgical physical therapy after neck dissection is strongly recommended in most cases.  Physical therapy can be very helpful to restore mobility and strength in the neck, shoulder and jaw, decrease swelling in the head and neck areas, reduce scar tightness and fibrosis and improve posture after surgery.

After procedures such as neck dissection for head and neck cancer, lymph nodes are often removed.  This disrupts the normal lymphatic drainage pathways, which can lead to swelling in the neck, jawline, chin, face and inside the mouth.  This type of swelling is very treatable.

How Head and Neck Lymphedema Physical Therapy helps?

A Physical Therapist with specialized training (ideally a Certified Lymphedema Therapist, CLT) can provide Complete Decongestive Therapy (CDT), the gold standard for lymphedema care.

1. Manual Lymphatic Drainage (MLD)

This lymphatic massage uses specific techniques to redirect fluid toward healthy lymphatic pathways, reduce visible swelling, improve tissue softness and decrease tightness and heaviness.  For head and neck lymphedema, treatment is very precise and differs from arm or leg protocols.

2. Scar & Soft Tissue Mobilization

Neck dissection surgery often causes scar adhesions, tissue fibrosis and tightness affection head rotation or jaw opening. Targeted manual therapy and individualized therapeutic exercise instruction helps restore mobility and reduce stiffness.

3. Therapeutic Exercise

Specific exercises help improve cervical range of motion, reduce radiation-related tightness, enhance the flow of lymphatic fluid and improve posture, which can affect swelling patterns.

4. Compression (When Appropriate)

Compression may include chin/face or neck compression garments, foam pads or swell spots, inserts or customized molds. Compression helps maintain gains made during therapy.

5. Education & Self-Management

Patient education in self-manual lymph drainage techniques, proper sleep positioning for lymphatic drainage and comfort, safe skin care, early signs of worsening swelling, education on the role of breathing and posture, daily self-management strategies, home exercise routines and how to manage flare-ups.

6. Personalized Care Plan

Your Physical Therapist with design a personalized treatment plan for you with the frequency of visits recommended, short and long-term goals and instruction in home exercises.

What does the research show about how Physical Therapy works as an intervention after head and neck surgery?

Research shows that Complete Decongestive Therapy significantly reduces external facial and neck swelling, internal lymphedema symptoms (tight throat, voice changes), fibrosis and discomfort and heaviness. Early intervention produces the best results, but even chronic lymphedema can improve.

When to See a Physical Therapist (Certified Lymphedema Therapist) after neck dissection surgery?

You should consider seeing a physical therapist with specialized training in treating this area if you notice persistent swelling after surgery in the face or neck areas, a feeling of fullness in the neck or jaw, reduced neck motion or hardening of tissue. Even months or years after surgery, physical therapy can still help. Physical Therapy is one of the most effective non-surgical treatments for lymphedema after neck dissection surgery.  With proper treatment swelling can decrease, tissue softens, function and pain improve and quality of life increases.

When Should You Start Head and Neck Lymphedema Physical Therapy after Neck Dissection Surgery?

As soon as your surgeon clears you for physical therapy, often within 3-4 weeks post-op. Physical therapy can begin after that time focusing on completion of an initial evaluation, home exercise instruction, neck/shoulder range of motion, jaw mobility and facial exercises.  Scar mobilization is not recommended right after surgery. Best to wait until the scar is healed, at least 3-4 weeks post-op and always based on skin integrity.

Learn more about Head and Neck Lymphedema Physical Therapy at Mobile Physical Therapy and Wellness with Dr. Elizabeth DPT, CLT.