What is Lymphoedema?

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Lymphoedema is a type of swelling due to an abnormal collection of high‐protein fluid just beneath the skin due to a damaged or impaired lymphatic system. This occurs mostly in the arm or leg, but it also may occur in other parts of the body including the breast or trunk, head and neck, or genitals depending on the affected region. 

 

Edema (swelling) is a symptom whereas lymphedema is a disease. Other conditions that may cause edema, but are not lymphedema include:

• Venous insufficiency (leaky or obstructed veins)

• Cardiac conditions like heart failure or sleep apnea

• Kidney failure

• Other inflammatory conditions

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Primary versus Secondary Lymphoedema

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Lymphoedema usually develops when lymph vessels are damaged or lymph nodes are removed (secondary lymphoedema) but can also be present when lymphatic vessels are missing or impaired due to a hereditary condition (primary lymphoedema).

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Lymphoedema is most commonly seen in patients who have had lymph node removal and/or radiation therapy over lymph node region. E.g, post-surgery in breast cancers, ovarian or prostate cancers and post-radiation therapy in head and neck cancers.  

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Stages of Lymphoedema

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Symptoms may not be immediate post-treatment and in some cases, appear only after months or years later. 

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Stages 1 and 2 are typically reversible with aims to reduce swelling with early intervention and management.

Stages 3 and 4 are typically irreversible with aims to maintain and prevent complications like skin infections and mobility issues. When lymphoedema remains untreated, it will progress. 

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How to treat Lymphoedema

 

Complete Decongestive Therapy (CDT) is well researched and effective in treating lymphoedema. CDT includes:

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• Skin care and education

• Manual lymphatic drainage (MLD)

• Compression bandaging

• Compression garment prescription

• Exercise ​

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Depending on the stage of lymphoedema, a CDT trained therapist will help you manage your condition.

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Aims of Treatment

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Treatment of lymphoedema focuses on slowing down the progression of lymphoedema while also improving symptoms. Specifically, treatment focuses on reduction of fluid volume but also on softening tissue fibrosis, reducing risk of infection, and maintaining or enhancing the function of the limb. 

 

Precautions and Contraindications to Treatment

 

• Signs of infection (pain, redness, rash, increased swelling, increased temperature of skin, sudden fever or chills)

• Presence of blood clots or unresolved Deep Vein Thrombosis (those with history of venous or arterial diseases or on anti-coagulants)

• Close monitoring for patients with congestive heart failure; to seek medical attention if there is shortness of breath after 1-2 days after CDT

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At Rehab Space, we have experienced physiotherapists that are Certified Lymphoedema Therapists (CLT) who can treat this condition. If you have concerns or are at risk of developing lymphoedema, please seek help early. Contact us to book an appointment.

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