LYMPHOEDEMA

The lymphatic system is part of the circulatory system and plays a vital role in the immune system acting to fight infection and to breakdown some of the body’s waste products. The lymphatic system is also responsible for transporting fluid from the tissue spaces back into the venous system.

“Lymphoedema is a chronic swelling that occurs when the lymphatic system is overloaded. ”

This can occur if the lymphatic vessels have not formed correctly (primary lymphoedema) or if the lymph nodes have been removed or lymphatic vessels have been damaged as a result of cancer treatments or trauma (secondary lymphoedema). Overload of the lymphatic system causes an excess in protein-rich fluid to accumulate in the tissues of the affected arm, leg or adjacent trunk area. Early detection and treatment is important before tissue changes occur which lead to inflammation and thickening in the tissues.

It is important to note that swelling in the early post-surgical period is part of the normal post- operative process however any type of swelling that does not go away should be discussed with your doctor or lymphoedema therapist. Whilst Lymphoedema is most common in the first twelve months after treatment it may develop any time, including years later. 

Not all people who have lymph nodes removed will get lymphoedema. The body’s response to changes in the lymphatic system is different from one person to the next. Knowing the early symptoms and signs, reducing your lymphoedema risk and seeking early treatment if swelling persists or you notice any changes can reduce the impact of lymphoedema.

Risk factors for Lymphoedema:

  • Surgery to remove lymph nodes – the more nodes removed, the greater the risk of developing lymphoedema; however, it can occur in a small percentage of people who only have a sentinel node biopsy.

  • Other cancer treatments such as radiation therapy and the extent of the radiation field – this causes scarring and thickening in the tissues and can impede lymphatic flow. Some chemotherapy treatments also affect the fluid in the body’s tissues and may be associated with oedema.

  • Infections in the limb at risk.

  • Injuries to the limb at risk.

  • Being overweight or inactive.

Early warning signs and symptoms for Lymphoedema:

  • A feeling of heaviness, tightness or fullness in the affected limb

  • Aching in the affected limb

  • Swelling – these may be subtle changes and may come and go

  • Clothing or jewellery is feels tighter than usual

  • Gentle pressure leaves an indent in the skin

Things you can do to reduce your Lymphoedema risk:

  1. Use your arm as normally as possible. Be aware of possible symptoms and adjust what you do accordingly.

  2. Skin care - keep your skin well moisturised and avoid damage to the skin of your arm and hand.

  3. Early identification and treatment for infections or cellulitis is essential.

  4. Avoid restricting the circulation to the upper body or arm by tight clothing, bra straps, heavy shoulder bags or backpacks or jewellery.

  5. Protect your skin - For example, wear gloves and a long-sleeved top while gardening, use an insect repellent, and avoid getting sunburnt. Ask for blood pressure readings and injections in your other arm.

  6. Avoid long periods of not moving. The lymphatic system needs the muscles to pump to assist with lymphatic flow.

  7. If you are travelling a long distance (for example by bus or car) it is important to take regular breaks to stretch and move around. If you travel by plane, your lymphatic system is affected by both the inactivity and the change in cabin pressure. If you are planning to fly, speak to your lymphoedema therapist about things you can do to help your arm while flying. This can include wearing a compression sleeve and completing regular exercises.

  8. Exercise regularly – this helps the lymph fluid flow. See your Physiotherapist/ lymphoedema therapist for a graduated individual exercise program to facilitate the lymphatic system.

  9. Maintain a healthy diet and body weight.

Remember that early detection is important and early symptoms of lymphoedema can be managed well. At Karen K Physiotherapy you will have a comprehensive assessment, including Lymphoedema monitoring using the Impedimed SOZO which can pick up changes often before symptoms present. If you already have a diagnosis of lymphoedema there are many treatment techniques to help to reduce and manage it.

At Karen K Physiotherapy we will develop a treatment plan for you based on your individual needs. Treatment aims to reduce the swelling, to alleviate the associated symptoms and prevent infection. The goal is to prevent the progression of the condition and to maintain the improvement whilst also enhancing the individual’s quality of life and optimizing function. Please see list of Services available or call Karen K Physiotherapy for more information.