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Lymphoedema

WHAT IS LYMPHOEDEMA?

Lymphoedema can occur when there is damage or disruption to the lymphatic system, such as following surgery, radiation therapy, infection, or injury. This can cause the lymphatic vessels to become blocked or damaged, leading to a buildup of lymph fluid in the affected area.

Symptoms of lymphoedema can include swelling, heaviness, tightness, aching or discomfort in the affected area, reduced flexibility and range of motion, and recurring infections or cellulitis. There is currently no cure for lymphoedema, but treatments such as compression garments, manual lymphatic drainage, and exercise can help to manage the condition and improve quality of life.

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WHAT CAUSES LYMPHOEDEMA?

Lymphoedema is most commonly associated with damage to the lymphatic system, which can occur due to cancer treatments such as surgery, radiation therapy, and certain types of chemotherapy. This is because these treatments can cause scarring or damage to the lymph nodes and vessels, leading to a buildup of lymph fluid in the affected area.

Other risk factors for lymphoedema include trauma to the affected area, infection (particularly cellulitis), obesity or a high BMI, and immobility. In some cases, lymphoedema may also be inherited or present at birth (primary lymphoedema).

The onset of lymphoedema can vary from person to person, and may occur immediately after cancer treatment or years later. It's important for cancer patients and survivors to be aware of the signs and symptoms of lymphoedema, and to work with their healthcare team to manage and prevent the condition.

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WHAT ARE THE EARLY WARNING SIGNS OF LYMPHOEDEMA?

Lymphoedema often has a gradual onset, and in its earliest stage, the patient may not be aware of the changes occurring within the body. As the condition progresses, patients may experience a range of symptoms such as aching, heaviness, stiffness, limitation of movement, tightness, or temperature changes in the affected area of the body, such as the arm or leg. Clothing, jewelry or shoes may feel tighter than usual due to the swelling.

Lymphoedema is generally not a painful condition, although patients may experience discomfort or pain if the swelling becomes severe or if there is an associated infection. Patients often report that their swelling is aggravated by heat, overuse, sustained positions, and prolonged periods of inactivity. Gentle exercise, elevation, massage, and compression garments or bandaging can help to reduce swelling and ease symptoms.

It is important for patients with lymphoedema to work with their healthcare team to manage and prevent the condition from worsening, and to report any changes or new symptoms to their doctor. Early detection and intervention can help to prevent complications.

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WHAT CAN BE DONE TO TREAT LYMPHOEDEMA?

Lymphoedema cannot be cured, but appropriate treatment can help to prevent, reduce, and maintain the swelling. Early intervention is essential to achieve the best outcomes, which is why it is recommended that patients at risk of developing lymphoedema see a physiotherapist to gain strategies to prevent it from developing and to ensure they are aware of the early signs.

Management for lymphoedema is provided by a physiotherapist who can perform "Complete Decongestive Therapy" (CDT). This treatment involves a combination of education, skin care, exercise, manual lymphatic drainage (MLD), and compression therapy. The treatment is individualized for each client, and not all components of treatment may be necessary in all cases.

  • Education about lymphoedema and self-care techniques is an important part of CDT, as it helps patients to understand the condition and take an active role in managing it.

  • Skin care is also critical to prevent infections and skin breakdown, which can worsen lymphoedema.

  • Exercise can help to improve lymphatic flow and maintain mobility, while MLD is a specialized massage technique that can help to reduce swelling and improve lymphatic function.

  • Compression therapy, such as wearing compression garments or bandaging, is also an essential part of treatment as it helps to maintain the reduced swelling achieved through other components of CDT.

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Overall, appropriate management of lymphoedema can significantly improve quality of life for patients and reduce the risk of complications.

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