Lymphoedema - What is it?
Lymphoedema is a chronic swelling (oedema) usually in either an arm or a leg, but it can also occur in other parts of the body.  Lymphoedema may occur following damage to the lymphatic system by injury or surgery, or the cause may be unclear.
What causes lymphoedema?
There are two types of lymphoedema. Both involve accumulation of lymphatic fluid (that clear pinkish fluid that you notice leaking from a wound, including after you squeeze a pimple).
  • Secondary Lymphoedema (the most common type), is caused  when the lymphatic system is damaged or blocked as a result of surgery, radiation, or injury. it may take some time after the damage occurs for the symptoms to appear.
  • Primary Lymphoedema, results when the lymphatic system is inadequate, for reasons not yet understood. In primary lymphoedema the swelling can be present at birth or can appear at any stage of life.
Who gets lymphoedema?
  • People of all ages may develop lymphoedema but not everyone who sustains damage to the lymphatic system will go on to develop it.
  • The efficiency of individual lymphatic systems can differ quite markedly. So if damage is major and/or your lymphatic system is not as efficient as it could be, you are likely to develop lymphoedema.
  • If  the damage is minor or you have an exceptionally efficient lymphatic system, you are less likely to develop lymphoedema
  • Approximately one in three women who have breast cancer will develop lymphoedema.
How do I know if I am developing or have developed lymphoedema?
Symptoms of lymphoedema may appear fairly soon after the event or may appear many years later.The early symptoms include
  • Unexplained, slow, and generally painless swelling. Clothes or jewellery may feel tighter than normal
  • A feeling of heaviness or fullness in the affected arm or leg
  • One limb feeling "different" from the other
  • You may notice slight dents on your skin after leaning on a firm surface or more marked sock imprints above the ankle. This may be an early sign of pitting oedema.
What can I do to avoid developing lymphoedema?
No-one yet knows why some people develop lymphoedema and others do not. No-one can guarantee that doing this or that will ensure you don't develop lymphoedema, but you can reduce your risk of developing secondary lymphoedema if you understand the various things that might trigger its onset.
  • Protect yourself against cuts and insect stings  - always wear gloves when gardening, use insect repellent, and be careful with knives and sharp tools.
  • If you are stung by an insect or cut yourself clean the wound and apply an antiseptic such as Betadine immediately
  • Seek medical treatment immediately if
    • the area around the site of a bite or cut becomes inflamed, hot, or painful
    • any part of the limb becomes red, hot, or painful
    •  you develop a high temperature, nausea or vomiting
  • Wear a compression garment on the affected limb if flying or going on a long car, bus, or train trip
  • Maintain the health of your skin by practising good hygiene and moisturising regularly
  • Limit activities where the muscles in your affected limb are contracted and immobile for protracted periods. This can be carrying heavy items (what "heavy" is, is relative!), or indulging in activities such as knitting, needlepoint, writing by hand etc. This is not to say you should give up such activities, but that you should make sure that you take frequent breaks to relax and move the muscles.
  • Keep as active as possible. This helps the lymphatic fluid to keep moving, but also take rests where the affected limb is elevated.
  • Keep well hydrated. Drinks lots of water, but limit alcohol and caffeine (found in coffee, tea, chocolate, and energy drinks).
  • Avoid injections in the affected limb
  • Avoid having your blood pressure taken on the affected limb.
  • Avoid tattoos and piercings
  • Avoid saunas or sitting in hot water in a bath or jacuzzi
  • Maintain your dental health
  • Keep up your immunisations
  • Ensure you have adequate sleep every night
Why is it important to have treatment for lymphoedema?
The lymphatic system plays a very important part in your body's defence against infection.  It is therefore important that it be kept as efficient as possible. Lymphoedema compromises this defence. Treating and managing your lymphoedema helps keep your lymphatic system efficient and thus reduces your risk of developing cellulitis (infection in the tissues).

What should I do if I notice symptoms of lymphoedema?
The sooner treatment is started the better the outcome. If you ignore the symptoms and allow the swelling to continue untreated it will progress until the lymph fluid thickens in the tissues and the are involved can become hard and fibrotic. Laser and massage helps to soften hardened tissue, but it is much easier if this is prevented.

Obtaining a baseline assessment
If you are about to have surgery that will remove or damage lymph nodes, it is a good idea to make an appointment to have a baseline clinical assessment so you have a record of what is normal for you. This could assist in a very early diagnosis if you do subsequently develop lymphoedema and result in the best possible outcome for you.


Good to know:
Fiveways Physiotherapy provides professional treatment and advice to assist you in managing your Lymphoedema  >>   more information