HealthInfo Waitaha Canterbury

Lymphoedema

Pupuhitanga nā te raru pūnaha waitinana

Lymphoedema is swelling caused by a build-up of lymph. Lymph is a clear, protein-rich fluid containing many white blood cells. Your lymphatic system carries lymph through your body.

Your lymphatic system is a network of channels and nodes (filters). It's part of your immune system and helps fight infection.

Lymphoedema happens because your body's lymphatic system is not working properly. Lymphoedema can affect any part of your body, but it most commonly affects your arms or legs.

While lymphoedema is not life-threatening, it also cannot be cured. But treatment can improve and control your symptoms.

Swelling of arms and legs can also be caused by a different condition called lipoedema, which is a long-term condition that mainly affects women. Lipoedema is an abnormal build-up of fat cells. It affects both sides of your body evenly but doesn't affect your hands and feet. The affected areas can be painful to touch and bruise easily.

Causes of lymphoedema

Sometimes your body produces more lymph than normal. For example, when you have an infection, injury or disease, or when your muscle cells work hard during strenuous exercise. Some diseases, such as venous disease, can also change the amount of lymph that your body produces.

Normally, your lymphatic system and blood vessels can cope with this extra fluid, but if either is damaged, the fluid builds up in your tissues. This causes swelling.

You can inherit lymphoedema from your parents, but this is rare. If you inherit lymphoedema, it can start at birth or soon after. It can also occur at puberty or later in life. It most often affects your legs.

More commonly, an injury or damage to your lymphatic system causes lymphoedema.

The following things increase your risk of developing lymphoedema:

• trauma to your lymphatic system due to things like surgery, radiotherapy, an infection or an accident
• advanced cancer
• reduced mobility
• being overweight
• venous disease.

Symptoms of lymphoedema

If you have lymphoedema, you're likely to notice swelling or a feeling of fullness in your arm or leg. Your arm or leg might also feel heavy or painful, and your clothing or jewellery might feel tighter. This is common in the early stages of lymphoedema. You should get it checked out, even if the swelling comes and goes.

Reducing your risk of lymphoedema

If you've been told by a doctor that you're at risk of lymphoedema, there are ways you can reduce your risk.

• Keep your skin moisturised.
• Treat cuts, skin infections (including athlete's foot) and insect bites quickly and avoid getting sunburnt.
• Wear gloves when gardening and doing dishes.
• Avoid having blood pressure checks, injections and blood tests on arms or legs that might be at risk.
• Take care when using hot water bottles, ice and heat packs.
• Avoid tight, restrictive clothes on arms or legs that might be at risk.
• Maintain a healthy weight. Being overweight may slow your lymphatic flow.
• Keep active with regular activity such as walking, swimming, Pilates, tai chi and yoga.
• If you want to remove hair on arms or legs that might be at risk, use an electric shaver.
• Get early treatment from a physiotherapist for any injury to your arms or legs, such as sprained ankles.

Treating lymphoedema

There aren't any medicines for lymphoedema. Diuretics (substances that make you produce more urine) can help with swelling in legs due to heart failure. But they do not help with lymphoedema.

If you have lymphoedema, you should follow the advice above under Reducing your risk of lymphoedema. There are also other ways to help manage your lymphoedema symptoms.

• Raise your affected arm or leg whenever you can.
• Avoid getting overheated from hot baths, spas or saunas. This may increase your swelling.
• Be careful with strenuous activity such as sport and gardening in hot weather. Physical activity is good for your wellbeing, but you may need to return to activity slowly and see how it affects your body. If your arm or leg swells, you should wear a compression garment when doing these activities.
• Learn how to do lymphatic massage and do it daily. A lymphoedema therapist can teach you how to do this. It helps move the lymph out of your swollen arm or leg.
• Get fitted for compression garments by a lymphoedema therapist and wear them every day from morning till night.

Get advice from a lymphoedema therapist or your general practice team if you're going to be travelling for longer than four hours.

See your doctor immediately if you get any pain, redness or heat in your affected arm or leg, especially if you also have flu-like symptoms or a fever. If this happens, you may have cellulitis, which is a bacterial infection. You'll need to take antibiotics immediately for this.

Think about your work activities and if they affect your lymphoedema. Heavy lifting and repetitive movements aren't good for lymphoedema. Pay attention to your posture and how you sit at work. It's a good idea to wear a compression garment at work.

Go to one of Te Whatu Ora – Health New Zealand Waitaha Canterbury's lymphoedema education sessions held in the chapel at Burwood Hospital.

Lymphoedema therapists are usually nurses, physiotherapists, or massage therapists who are specially trained to manage lymphoedema. They provide several types of treatment including bandaging, massage, exercise and taping. They can also measure and fit you for compression garments and tell you what you can do to manage your condition.

You can get treatment at the Physiotherapy Departments of Burwood and Timaru hospitals. There are also private lymphoedema therapists. You may be able to get help to pay for this through WINZ, the Cancer Society or another agency. Talk to your health professional about this.

Other treatment options

There are some types of surgery for lymphoedema, but surgery is rarely done in New Zealand and there is no surgery that removes the need to wear a compression garment.

  HealthInfo recommends the following videos

• DME-Direct – Mediven Butler Stocking Aid

  This video shows you how to use a device to help you put your compression stockings on.

  HealthInfo recommends the following pages

• DermNet – Lymphoedema

  This page has information about lymphoedema, including who is at risk of getting it, why it happens and how it's treated.

• Lymphoedema Therapists – Compression garments and bandages

  This page has information about how compression garments and bandages are used to help keep lymphoedema under control.

Written by Canterbury lymphoedema specialists. Adapted by HealthInfo clinical advisers. Last reviewed June 2022.

Sources

Page reference: 30588

Review key: HISKW-128569