LYMPHOEDEMA

What is lymphoedema?

Lymphoedema is the swelling of a body part(s) occurring mostly in the arms or legs due to the collection of fluid in the interstitial space (space in between the body cells) which occurs because of a decreased capacity of the lymphatic system.

The lymphatic system and the formation of lymph

The lymphatic system is very similar to the blood circulatory system. It is part of the circulation system and acts as a drainage system parallel to the venous system. In normal circumstances, it usually pumps about 2 to 4 litres of lymph back into the bloodstream.

Lymph is a clear fluid which consists of water, protein and waste materials from the body cells and is formed during the exchange of materials, such as oxygen and nutrients, between the blood cells and the body cells. The lymph formed then goes into lymph vessels into the lymphatic system.

Lymphoedema occurs when there is a blockage or breakdown of the lymphatic system. This may be due to the lymph nodes getting clogged with fluid, not enough lymph vessels or even injury to the lymph nodes after some surgeries.

How common is lymphoedema and who gets it?

Approximately 250 000 Australians suffer from lymphoedema. This condition is more common in women than in men. There are 2 types of lymphoedema: primary lymphoedema and secondary lymphoedema. Lymphoedema occurring for no apparent reasons is called primary lymphoedema. It is caused by the abnormal development of the lymph vessels and the lymphatic system.
Secondary lymphoedema is much more common and it occurs after a surgery, injury to the lymphatic system or certain types of treatments for cancer.

Symptoms & complications of lymphoedema

The 1st sign of lymphoedema is an unexplained swelling, which may be indented by pressure. In this early stage, elevating the affected arm or leg can decrease swelling. As the swelling increases, the affected limb becomes heavy and painful and may affect mobility or use of the arm for everyday activities. In the later stages of lymphoedema, skin and nail changes also occur and you become more prone to infections such as cellulitis.

What makes the swelling worse?

The swelling in the limbs can be exacerbated by several factors:

1) Heat, hot showers and hot weather.
2) Too much exercise or too little exercise: gentle exercise helps the muscle pump back the excess fluid back into the lymph vessels. However, too much exercise will increase the body temperature and might increase swelling. The right amount of exercise should be performed everyday to control swelling.
3) Small cuts or insect bites: your body is more prone to infection and thus even a very small paper cut can lead to increased swelling.
4) Flying in an airplane: this also makes the lymphatic system work extra hard and can lead to increased swelling in some individuals.

What can you do?

1) Self massage of the nodes
2) Gentle exercises of arms and legs as shown by your physiotherapist
3) Elevation of limbs when lying down or sitting
4) Use of compression garments or bandages during flare ups
5) Moisturize skin regularly and have good skin hygiene.

How does physio helps?

Physiotherapists help maintain proper skin condition and control the swelling. It is important to understand that lymphoedema is a condition that cannot be cured but that can certainly be managed so that the swelling is under control.

1) Physiotherapists can provide a manual lymph drainage massage (about 1 hour) that helps promote lymph flow and decrease swelling.
2) Provision of compression garments and bandaging to keep the swelling under control.
3) Application of BODYFLOW to decrease the swelling in the limbs. BODYFLOW is a new technology that involves the application of electrodes to the affected limb that give a gentle electrical pulse. This causes contraction of the smooth muscle in the wall of the blood vessels, thus increases blood flow and drainage of the area. BODYFLOW can be used at our clinic, with smaller units available to hire for home use. See our section on BODYFLOW for more information about this machine and how it can work for you.

If you think you have lymphoedema feel free to call us and book in an appointment so we can help you reduce the burden of this condition.