Lymphoedema is a chronic progressive swelling caused by the accumulation of protein-rich fluid in the tissues, which occurs as a result of the failure of the Lymphatic System. Lymphoedema affects approximately 200,000 people in the United Kingdom.
A healthy Lymphatic System drains 2.5 litres of fluid waste from tissue spaces from all areas of the body. It provides an immune response mechanism to fight infection and illnesses by transporting lymphocytes through a network of lymph vessels and lymph nodes. Groups of lymph nodes are situated throughout the body, especially in the head and neck, armpits (axillary), abdomen and groin (inguinal), elbows and knees. These lymph nodes filter and return lymph fluid, which is rich in proteins and fats, back into the blood circulation.
Primary Lymphoedema (malformation of the lymphatic system) can occur from birth, but Secondary Lymphoedema (damage to the lymphatic system) is most commonly as a result of damage to the lymphatic system from radiotherapy or surgery for cancer, sentinel lymph node biopsy, obesity or trauma. Additional risks of damage to the lymphatic system also include orthopaedic surgery, chronic venous insufficiency and recurrent varicose vein stripping, or vein harvesting for coronary artery bypass grafting (CABG). Other causes include infections such as cellulitis, thrombophlebitis, leg ulcers and skin wounds, and dependence Lymphoedema from immobilisation. Worldwide the most common cause is filariasis. The onset of secondary lymphedema may be delayed by months or even years after the initial injury.
Lymphoedema causes numerous physical and psychosocial problems. These include swelling in the legs and arms primarily, shape distortion, tightness and heaviness; pain due to swelling, nerve compression, reduction in joint range of movement; lethargy, low immune system, chronic fatigue syndrome; poor body image, immobility, depression and social isolation.
Lymphoedema Awareness Week – 2-8th March
‘Although lymphoedema is a long-term condition which cannot be cured, its main symptoms of swelling and the risk of infection can, with appropriate treatment, be controlled and often significantly improved’ (www.thebls.com)
World Lymphoedema Day – 6th March
Lymphatic drainage can be used:
Preventative approach is best. The gentle action of MLD can help reduce limb volume and discomfort by stimulation of the body’s lymphatic system to reduce swelling, remove toxins and promote gentle relaxation of the sympathetic nervous system to improve well-being. CHHC can help you manage the many challenges of self management of Lymphoeodema with individual care and quality assistance to overcome problems. Our specialist dedicated support, expert advice and experienced guidance will enable you to self manage with confidence in a timely manner.
CHHC Holistic management:
We support a holistic approach to management providing advice and support to enable patients to live a full and active life. We encourage self management by patients and carers, with appropriate and effective education about their condition, medical information and psychosocial support in an understanding and non rushed environment, where listens to patients and give them the benefit of our vast experience to help them maintain the daily cornerstones of care.
You can reduce risks by:
- Exercise – sustaining a healthy weight, obesity and high BMI substantially increase risk of developing Lymphoedema. Regular maintenance by gentle activity and movement, together with breathing exercises as directed by our physiotherapist will help. Always avoid saunas, steam rooms and hot baths
- Skin care - protect the skin, cover up by wearing rubber gloves, wear trousers and gardening gloves, avoid tight underwear and clothing, moisturise and maintain supple, clean skin, protect from sunburn and insect bites.
- Compression – compression garments application (Donning and Doffing)
- Simple Lymphatic Drainage SLD – we can teach you how to do this effectively
Recent systematic reviews state Lymphoedema management can be proven successful of if patients have one or more of the following (Kwan et al., 2011; NHS Choices Information 2014):
- Reduction in size volume
- Improved skin condition
- Improved subcutaneous tissue consistency
- Improved limb shape
- Improved limb function
- Improved symptom control
- Enhanced patient/family/carer involvement and self-management skills
A simple explanation of the lymphatic system is available here:
Keeley V (2008) Lymphoedema and cellulitis: chicken or egg. British Journal Community Nursing, 13(4): S4–S10.
Mortimer P and Easton G (2012) Chronic oedema and lymphoedema: http://learning.bmj.com/learning/modules/flow.html?execution=e1s1 (accessed 121118)
Preston NJ, Seers K and Mortimer PS (2008) Physical therapies for reducing and controlling lymphoedema of the limbs: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003141.pub2/abstract;jsessionid=F0D6782D2F552ADE1F0E9563E2F2A39C.d03t02 (accessed 121120)
British Lymphology Society (BLS) (2012) What is Lymphoedema?: http://www.thebls.com/ (accessed 121120)
Royal College of Anaesthetists (2010) Breast Cancer Related Lymphoedema – information for doctors:www.rcoa.ac.uk/docs/Lymphoedema_doctors.pdf (accessed 121120)
Lymphoedema Framework (2006) Best Practice for the Management of Lymphoedema: International Consensus. London: Medical Education Partnership Limited.
Breast Cancer Care (2010) Physiotherapy to Prevent Lymphoedema After Surgery: http://www.breastcancercare.org.uk/media-centre/all-our-latest-news/our-statements/13.01.10-release (accessed 121120)
WHO (2010) Lymphatic Filariasis: http://www.searo.who.int/linkfiles/lymphatic_filariasis_sea-cd-203.pdf(accessed 121120)
Provan, D., 2019. Body weight and the management of lymphoedema. British Journal of Community Nursing, 24(12), pp.576-579.
Kung, T.A., Champaneria, M.C., Maki, J.H. and Neligan, P.C., 2017. Current concepts in the surgical management of lymphedema. Plastic and reconstructive surgery, 139(4), pp.1003e-1013e.