Lymphoedema occurs when the lymphatic system is impaired or obstructed. It is a specific tissue swelling (oedema) of the limbs and body that occurs when the lymphatic system does not adequately drain the lymph from the tissues under the skin. Lymphoedema can occur if parts of the lymphatic system develop incorrectly before birth, are damaged or overwhelmed by other medical conditions, trauma after surgery and may occur following cancer treatment.
Early diagnosis and treatment is important to prevent the condition progressing and to limit the overall impact on a person’s life. Early lymphoedema is common and with appropriate treatment, can be reversed upon early detection. Lymphoedema can be progressive if it is not managed and can develop into a chronic life-long condition. Over time, this can lead to changes to;
- The skin and tissue of the swollen/ affected area (the skin can become hard and thickened)
- A reduce in function
- Reduced ability to complete day to day activities
- Increase in the risk of infection
Common signs and symptoms;
- A body area feeling uncomfortable or tight, such as an arm or leg
- Feelings of heaviness
- Swelling to a part of the body
- Jewellery and clothing (to an affected area) may feel tighter
There are two classifications of lymphoedema, primary and secondary.
- Primary Lymphoedema: can be developed from an inherited lymphatic dysfunction.
- Secondary Lymphoedema: is caused when there is damage to the lymphatic system as a result of surgery, radiotherapy, trauma, parasites, lack of movement or allergies.
Note: short term swelling often occurs after surgery, but this generally settles within a few weeks. Not all swelling is chronic lymphoedema
Stages of lymphoedema:
- Stage 1: Early onset of the condition, may be transient and subside with elevation.
- Stage 2: An increase (or worsening) of symptoms as the tissue expands, the skin becomes stretched, and protein rich fluid starts to build up in the affected area. Tissue changes and skin thickening becomes more evident and limb elevation alone, may no longer relieve discomfort or reduce swelling.
- Stage 3: As the condition progresses again, the skin can begin to thicken, and the tissue becomes hard (fibrotic). Increases in skinfold can also be experienced with the formation of fatty tissue. The progression to stage 3 increases the risk of cellulitis (skin infection).
Lymphoedema management and care:
A diagnosis of Lymphoedema requires lifelong self-care to manage it effectively, so it is important to be actively involved in the management of the condition. Complex therapy involves education, skin care, manual lymphatic drainage (MLD) and compression garmenting (with or without prior compression bandaging).
Here are some possible treatment options;
- Manual lymphatic drainage (MLD): lymphatic drainage massage is used to move congested fluid areas by encouraging new pathways. MLD is only part of treatment and may not be sufficient on its own but maintains positive results when used in conjunction with compression garments.
- Compression Garments: garments are an essential part of managing and/or improving lymphoedema.
- they help to limit the amount of fluid build up in a limb
- provide your muscles with a firm resistance, promoting fluid drainage
- encourages fluid to move towards the body (where is can drain away more easily)
- provide support for stretched skin
- helps to soften tissues that may have become firm.
- Skin Care: maintaining your skin barrier by keeping your skin clean, moisturised and trying to avoid breakages to the skin will aide with reducing inflammation while helping the risk of infection.
- Moderate Exercise: (eg, walking, swimming and hydrotherapy). Inactivity, or being sedentary slows lymph flow down, whereas exercise helps lymph flow. Individually tailored exercise is safe for all of those who suffer from lymphoedema.
- Healthy Weight management: carrying excess weight means that your lymphatic system is required to work harder and if your system is already impaired, it is even harder for the lymphatic system to cope. Maintaining a healthy weight can significantly improve outcomes.
- Complex decongestive therapy: this is a combination of skin care, compression therapy, exercise and MLD, followed by ongoing use of compression garments
- Psychological and social support
- Self-monitoring: is a vital aspect of detection, monitoring and management.
- Laser Therapy: involves the use of red or near-infrared light to stimulate, heal and regenerate cells. This also assists with softening the tissues.
- Sequential intermittent compression pump therapy: the garment is inflated and deflated sequentially for a set period of time, providing a massaging effect along the length of a limb. This encourages the lymph to return by inflating one chamber at a time, starting at the end of the lymph movement centre.
- Lymph taping: adhesive, lightweight medical tape is applied to the skin to help improve the lymph flow and drainage. The tape gently lifts and stretches the skin.
- Self massage/ simple lymphatic drainage: our massage therapist can provide education on self-massage techniques. For more info on lymphatic drainage massage.
Our Lymphoedema Therapist
Ruth Hodson: is a certified Vodder Trained CDT Therapist. She has extensive knowledge and training in the treatment of lymphoedema, MLD, and offers a variety of services including;
- Manual lymphatic drainage
- Self management guidance, education and skincare advice
- Advice on compression bandaging, garments and wraps
- Assistance with garment prescription and referral for garment supply
- Exercise to stimulate lymphatic transport capacity
- Intermittent pneumatic compression pump therapy
- Low level laser therapy
- Lymph taping
FUNDING:
Ruth is a massage therapist and can provide private health rebates with eligible private health coverage.