Managing Lymphoedema With Physiotherapy
Lymphoedema is a chronic and progressive condition that involves the build-up of protein-rich excess fluid within the lymphatic system, which is a network of vessels and nodes underneath the skin. This collects in bodily tissues and results in swelling, which is also known as oedema.
Lymphoedema is a common condition with approximately one in every two hundred people experiencing it. Lymphoedema can be the result of several issues that cause the lymphatic system to be unable to process the fluid. This may be because of decreased function or because of an increase in the lymphatic load. This condition can occur in any part of the body, such as the abdomen, head, neck, breasts, or genitals, but it most commonly affects the legs or arms.
There are several ways our physiotherapists can help you if you are living with lymphoedema. Early intervention can be most beneficial, but we can assess and develop a plan for you at any stage.
What Is The Lymphatic System?
The role of the lymphatic system involves the collection of lymph fluid from tissues, its movement to the lymph nodes, and its transportation into the bloodstream.
The lymph nodes are found in various parts of the body, such as behind the knees, in the groin, deep in the abdomen, and in the armpits. The lymph fluid drains via the nodes further into the vessels of the lymphatic system and into the blood.
What Causes Lymphoedema?
When the lymphatic system’s function is reduced for one reason or another, it can become congested, and the fluid is unable to find a way to travel further. This is when swelling occurs.
Sometimes, it is necessary for some lymph nodes to be surgically removed from a person’s body. This may happen in the case of certain cancers as a form of treatment, for example. There can also be issues or treatments that damage the lymphatic system, such as trauma, skin infections such as cellulitis, increased body mass index, some chemotherapy options and radiotherapy to the lymph nodes, cardiac disease, and immobility. This form of lymphoedema is known as secondary lymphoedema.
According to the National Breast and Ovarian Cancer Centre (NBVOCC), twenty percent of survivors of melanoma or gynaecological, breast, or genitourinary cancers experience lymphoedema. This may happen soon after treatment or even years later.
Primary lymphoedema is caused by the insufficient development of lymphatic vessels. This is a congenital condition that occurs in approximately one in six thousand births and most often seen in the lower limbs on both sides. Some people never know they have the condition due to no or minimal symptoms. Something may trigger swelling, such as a mosquito bite or cellulitis.
What Are The Symptoms Of Lymphoedema?
Lymphoedema typically has a gradual onset. When it begins, there are no symptoms. As it progresses, a person may experience the following symptoms:
- Aching and stiffness
- A feeling of heaviness and tightness in the affected area/s.
- Reduced movement.
- Temperature changes in the affected area/s.
- Jewellery, shoes or clothing may feel tight.
Lymphoedema generally does not cause pain.
What Can A Physio Do For Lymphoedema?
Many patients report that swelling can be aggravated by prolonged positions, lack of activity, and heat, and that it can be worse at the end of the day. Lymphoedema is an incurable condition, but it can be managed with care. Intervention is more successful if it begins early in the condition’s progression. If treatment is not acquired, tissues can become thicker due to the swelling, which increases the risk of skin ulcers and infections.
Physiotherapy can work to improve the swelling and help patients find relief. After investigations have been carried out and a clear medical diagnosis is made, our physios will assess you and gain an understanding of your medical history and symptoms and create a treatment plan that addresses your requirements and goals.
Physiotherapy treatment options for lymphoedema may include:
Gaining an understanding of what lymphoedema is, the risk factors, symptoms, and symptom management options can be a fundamental factor in treatment.
Gentle resistance exercise can increase lean muscle mass and maintain a healthy weight, which can help to improve some of the load placed on the lymphatic system. Furthermore, during exercise, muscles are stimulated and pumped, which helps to increase lymphatic drainage. It can be difficult to undertake regular exercise when dealing with this condition, but we can help you with guidance and support.
Reducing limb volume is often achieved with compression techniques. This may include one or more of the following options:
- Manual therapy and lymphatic drainage massage.
- Garments, which are generally worn all day and removed at night and can allow for graduated compression. These may be made with circular or flat knit materials in a standard or customised design. Stronger pressure is placed at certain areas so that fluid is not moved away from the mid-section. This should be done by an experienced professional so that the fluid is directed the right way.
- Wraps, which can be beneficial for night-time use and for people who have difficulty using garments.
- Regular and long-term bandaging.
- Intermittent pneumatic compression, which is a pump that can be a useful option for home massage therapy.
Our Physiotherapists Can Provide Care For Lymphoedema
Living with lymphoedema can be uncomfortable and difficult, and as a progressive, incurable condition, it can be daunting to find ways to find relief and improvement. Physiotherapy can be a beneficial approach, and our experienced team are committed to helping you.
Get in touch so that we can discuss with you the options and develop an appropriate treatment plan for you.