Who may benefit from an evaluation?
An evaluation may be appropriate when swelling, tissue changes, or discomfort is persistent, changing, difficult to explain, or limiting everyday function.
- Swelling, heaviness, fullness, or tightness in an arm, leg, hand, foot, trunk, or another area
- Swelling after cancer treatment, lymph-node surgery, radiation, trauma, infection, or another condition
- Reduced joint motion, walking tolerance, endurance, balance, or daily function
- Skin that feels tight, firm, thickened, or difficult to care for
- Recurrent skin problems or infections in an area affected by swelling
- Painful or tender fatty tissue, easy bruising, or disproportionate changes in both legs or arms
- Uncertainty about lymphedema, lipedema, venous disease, or another cause of swelling
- A need for medical guidance before therapy, compression, or a home-management plan
New or rapidly changing swelling can have causes other than lymphedema or lipedema. The appropriate next step depends on your history, examination, available records, and whether urgent evaluation or another specialist is needed.
Lymphedema and lipedema are different conditions
Lymphedema
Swelling caused by impaired lymph flow
Lymphedema occurs when lymph vessels or nodes are underdeveloped, damaged, blocked, or otherwise unable to drain lymph normally. It often affects an arm or leg but can occur in other areas. Symptoms may include swelling, heaviness, tightness, reduced motion, and skin changes.
Primary lymphedema results from developmental abnormalities of the lymphatic system. Secondary lymphedema can develop after surgery, radiation, cancer treatment, infection, trauma, or another condition that impairs lymph flow.
Lipedema
Painful, disproportionate tissue changes
Lipedema is a chronic disorder involving an abnormal, often painful distribution of fatty and connective tissue. It usually affects both sides of the body, most often the legs and sometimes the arms. The feet and hands are commonly spared.
Lipedema is not the same as lymphedema or general obesity. A person can have lipedema and another condition at the same time. Lymphedema occurring with lipedema may be called lipolymphedema.
Why evaluation matters: Diagnosis of either condition usually begins with a medical history and physical examination. Imaging or another specialist’s assessment may be needed when the diagnosis or cause of swelling is unclear.
What Physmedi may evaluate and coordinate
Physmedi’s role is medical evaluation, functional assessment, conservative-care planning, and coordination with appropriate therapists and specialists. Depending on your needs, an evaluation may include:
- Reviewing when and where symptoms began and how they have changed
- Assessing swelling, skin and tissue changes, joint motion, strength, gait, and effects on daily activities
- Reviewing cancer treatment, surgery, radiation, trauma, infection, vascular history, medications, and other possible contributors
- Reviewing prior therapy, compression garments, pneumatic compression devices, imaging, and lymphatic or vascular testing
- Determining whether additional records, testing, or input from vascular medicine, oncology, a certified lymphedema therapist, or a specialized lymphatic center may be appropriate
- Developing a function-focused plan based on the diagnosis, safety considerations, goals, and services available
Important scope limits: Physmedi does not perform ICG lymphography, lymphatic surgery, or lipedema-reduction surgery. ICG lymphography is specialized imaging used at some centers to visualize superficial lymphatic flow; it is not required for every evaluation.
Hands-on manual lymphatic drainage and multilayer compression bandaging are not performed in the Physmedi office. If appropriate, these services may be coordinated with a certified lymphedema therapist.
Conservative management may involve several parts
Management is individualized. Depending on the diagnosis, examination, contraindications, and services available through Physmedi, a plan may include:
Daily function
Education and movement
- Education about the condition, skin care, daily activity, and self-management
- A gradual, individualized movement or therapeutic-exercise plan
- Practical goals for walking, dressing, work, or another daily activity
Coordinated care
Compression, therapy, and referrals
- Evaluation of compression needs and coordination for correctly fitted garments or wraps
- Review of whether a pneumatic compression device may be appropriate
- Referral to a certified lymphedema therapist for complete decongestive therapy when indicated
- Coordination with oncology, vascular medicine, primary care, or a specialized lymphatic or surgical center
Compression garments, bandaging, pumps, and exercise plans are not one-size-fits-all. Fit, pressure, tolerance, skin condition, circulation, physical ability, and other health conditions matter. Do not begin or change compression or pump settings based only on information on this page.
An evaluation does not mean that a garment, device, therapy referral, imaging study, procedure, or surgery will be recommended.
When swelling may need urgent care
Do not use the appointment-request form for a new urgent problem.
- Seek prompt medical assessment for new or rapidly worsening swelling, especially on one side, with pain or tenderness, warmth, redness, or discoloration.
- Seek prompt care for a swollen area that becomes red, hot, increasingly painful, or is accompanied by fever or flu-like symptoms.
- Call 911 for difficulty breathing, chest pain, coughing up blood, a rapid heartbeat, severe lightheadedness, or fainting.
What to expect
1
Before an appointment is offered
Our team reviews your secure request. We may ask for medical records, prior therapy notes, imaging or vascular reports, medication information, insurance details, or referral and authorization information before offering appointment options.
2
During your evaluation
Your clinician may ask how the swelling or tissue changes began, whether one or both sides are affected, and how symptoms affect movement and daily life. The evaluation may include a review of your history and treatments along with an examination of the affected areas, skin, joint motion, strength, gait, and functional needs.
3
After your evaluation
Your clinician will explain the findings and discuss reasonable next steps. Additional records, testing, therapy, garment or device evaluation, or specialist coordination may be considered when appropriate. Recommendations depend on the findings and clinical judgment.
How to prepare
Please have the following available when possible:
- A current medication and allergy list
- A timeline of the swelling, tissue changes, pain, bruising, or skin concerns
- A history of related cancer treatment, lymph-node surgery, radiation, trauma, infection, vascular problems, or family history
- Relevant office notes, imaging, vascular studies, laboratory results, or prior lymphatic-test reports
- Notes from prior physical, occupational, or lymphedema therapy
- Information about compression garments, wraps, or pneumatic pumps you currently use, including fit or tolerance concerns
- Your insurance information and any referral or authorization required by your plan
- One or two functional goals, such as walking farther, dressing more comfortably, improving skin care, returning to work, or resuming an important activity
Do not place medical details or identifying information in a URL. Submit requested information only through the secure method our team provides.
Do not stop or change a medication unless the prescribing clinician has instructed you to do so. Do not change prescribed compression or pump settings without guidance from the clinician or therapist responsible for that plan.
A function-focused care approach
Physical medicine and rehabilitation physicians, also called physiatrists, focus on how medical conditions affect movement, independence, and participation in everyday life. A PM&R evaluation can connect the medical diagnosis with practical goals such as walking, skin care, dressing, exercise, work, and long-term self-management.
Care may require coordination among a PM&R physician, certified lymphedema therapist, primary-care clinician, oncologist, vascular specialist, surgeon, or other professional. The right team depends on the cause and severity of the condition, prior treatment, available services, and the patient’s goals.
Locations, insurance, and referrals
Locations
Central Florida access
Physmedi has offices in Orlando, Clermont, and Kissimmee. Clinician and lymphedema/lipedema service availability may vary by location. Our team will confirm the appropriate office after reviewing your request.
View all Physmedi locations
Coverage
Insurance and authorizations
Coverage, referral requirements, prior authorization, compression garments, and medical-device benefits vary by plan and service. Benefits and requirements may be reviewed before appointment options are offered, but verification does not guarantee coverage or payment.
For medical offices: Helpful information may include the suspected diagnosis and area affected; symptom onset; relevant cancer, surgery, radiation, trauma, infection, or vascular history; recent notes; medication list; imaging or vascular studies; therapy reports; current garment or pump information; and insurance or authorization details.
Use the secure referral pathway.
Frequently asked questions
What is the difference between lymphedema and lipedema?
Lymphedema is swelling caused by impaired lymph flow and may involve an arm, leg, hand, foot, or another body area. Lipedema is an abnormal, often painful distribution of fatty and connective tissue that usually affects both sides of the body and commonly spares the feet and hands. They can occur together, and other conditions can resemble either one.
Does Physmedi perform ICG lymphography?
No. Physmedi does not perform ICG lymphography. If specialized lymphatic imaging may be useful, the clinician can discuss whether evaluation at an appropriate center should be considered. The appropriate center and its availability would need to be verified.
Does Physmedi provide hands-on lymphedema therapy?
Physmedi provides medical evaluation and conservative-care coordination. Hands-on manual lymphatic drainage and multilayer compression bandaging are not performed in the Physmedi office. If appropriate, these services may be coordinated with a certified lymphedema therapist.
Are compression garments or pumps appropriate for everyone?
No. Compression and pneumatic devices must be selected for the individual’s diagnosis, circulation, skin condition, physical ability, tolerance, and other medical factors. An evaluation does not mean that a garment or pump will be recommended or covered.
Do I need a referral or medical records?
Referral and authorization requirements vary by insurance plan and clinical situation. Prior notes, imaging or vascular reports, therapy records, and information about current garments or devices can help the team review your request. We will tell you if additional items are needed.
Does submitting a request confirm an appointment?
No. Submitting the form begins a secure review. Our team reviews the information before offering appointment options.
This information is educational and does not replace individualized medical advice. Do not use this page or the appointment-request form for urgent or emergency care. If you believe you may be experiencing a medical emergency, call 911 or go to the nearest emergency department.
Patient-education sources
Sources reviewed August 9, 2026
