Lymphoedema / Lipoedema

Lymphoedema

Lymphoedema arises when lymphatic nodes or vessels have either not correctly formed (primary lymphoedema) or have been damaged (secondary lymphoedema). Secondary lymphoedema can occur after cancer surgery, radiation treatment or with certain medical conditions.

When the lymphatic system does not work properly, or when the need for lymphatic drainage is bigger than the lymphatic system can cope with, the build-up of too much protein-rich fluid in the tissue results in swelling of that part of the body.

Lymphoedema usually affects the limbs (arms and legs) although it may also involve the trunk, breast, head and neck or genital area.

Who is at risk of Lymphoedema?

  • people who have had surgery and/or removal of lymph nodes

  • those who have had radiotherapy

  • people who have had a trauma or injury to the lymphatic system

  • people with chronic cellulitis

  • people with primary lymphoedema

Signs and Symptoms:

  • swelling of any part of the body

  • heaviness, tightness, or fullness of a limb

  • aching or pain in the swollen area

  • clothing, shoes, or jewellery may feel tighter

Lymphoedema is progressive
and has four stages:

  • Subclinical - No swelling present but feelings of fullness, heaviness with or without pain. 

  • Stage one - Swelling appears, then resolves or reduces overnight.

  • Stage two - Swelling is present all the time and tissue becomes firmer. Cuffs and creases develop.

  • Final stage - The texture of skin and its flexibility change, cuffing becomes established and skin folds deepen.

All these stages can be worked with to help with lessening of the lympheodema.

Manual lymphatic drainage massage

In the event that the lymphatic system is compromised or sluggish the lymph can also be moved effectively by light rhythmic direct massage. Manual lymphatic drainage is a gentle and specific treatment that aims to move the excess lymphatic fluid that accumulates in body tissues back into the bloodstream. With lymphatic drainage massage for lymphoedema, the lymph fluid can be re-routed through unaffected lymph nodes. The superficial lymphatic system, which is what we predominately work with, sits just under the skin, therefore, the massage is light, never inflammatory and is opened handed.

When it is safe to do so, Ann can address the surgery scar for increased range of motion and comfort, axillary cording, and shoulder dysfunction post-surgery for breast cancer.

Complex Lymphoedema Therapy (CLT)

In some cases, Complex Lymphoedema Therapy (CLT) is required – this uses additional techniques such as multi-layer compression bandaging, compression garments, low-level intensity laser, skin care management and special exercises to manage the swelling.

Multi-layer Compression Bandaging

Multi-layer compression bandaging may be used to reduce swelling and improve lymph drainage before fitting a compression garment. The bandages act as a counterforce to muscles, which stimulates more effective lymph drainage. The tension of the bandages is graduated up to the part of the limb closest to major lymph nodes.

Your therapist will take measurements of your affected limb prior to bandaging commencing and at every bandage change. When the drop in swelling plateaus is when compression garments are purchased. If garments are purchased before bandaging you may end up with ill-fitting garments that will not provide the compression level you require.

Garment Prescriptions 

Compression garments are a necessary component of lymphoedema management and are designed to significantly slow the rate of swelling to the affected area. The garments are to be worn daily and there many different styles depending on your needs.

There are many options to choose from when picking a compression garment and the goal is to find the best fit, colour and style for you.

Low Level Laser

Low-level laser therapy is used to treat lymphoedema fibrosis due to its beneficial effects on tissue healing, inflammation reduction, and stimulation of cellular processes. The laser is used to release scar tissue, fibrosis and also used in areas that are too sore to be touched. The laser light penetrates into tissue where it is absorbed by cells and converted into energy that influences the course of metabolic processes. This can help reduce the thickening and scarring of tissue that commonly occurs in lymphoedema, making the skin and underlying tissues less rigid and more flexible. I use the LTU-904 which is the only low level laser cleared by the FDA for the treatment of Lymphoedema.

Skin Care

Lymphoedema can make your skin dry which can then cause small cracks which can increase your chances of infection. Keeping your skin clean and moisturised and ensuring you dry carefully between your fingers and toes on the affected limb is essential for self-care.

Exercise

Exercise and physical activity are important for lymphoedema as it works your muscles which helps the lymphoedema pump through the lymphatic system. It also assists with weight management which can help reduce the swelling. As with all exercise, slow incremental progress it best for your body.

It is important to note that Lymphoedema should only be treated by a qualified Lymphoedema Therapist, always check that your therapist is fully qualified in this field before starting treatment.

Support and more information can be found on the Australian Lymphology Association website and you can also to find all qualified therapists in your area. https://www.lymphoedema.org.au/

Lymphoedema Appointments

If you currently have cellulitis (skin infection), or an open or wet wound, significant heart problems or have a medical device attached, please seek medical advice, if you have not already, prior to making an appointment. Please phone Ann if you have any questions or concerns - 0402 622 914

Lipoedema

Lipoedema is a chronic condition that causes an abnormal buildup of adipose tissue. This can then present as symmetrical swelling in the legs, thighs, and buttocks, and sometimes the arms. It is progressive and incurable but it can be managed, either conservatively or with surgery. Lipoedema Australia quotes that it affects around 11% of the population, predominately women.

The cause of lipoedema is unknown, however, there is evidence of hormonal and hereditary influences. Lipoedema is sometimes seen in multiple members of the same family. Many people with lipoedema have a family history of similarly enlarged legs.

The affected areas can bruise easily, feel painful, be tender to touch and some people also have fluid retention. Fluid build- up that is not addressed can result in Lymphoedema.

Lipoedema is sometimes mistaken for lymphoedema, weight gain, obesity, or cellulite. Many people with Lipoedema have faced misdiagnoses, if you think you have Lipoedema there are resources on the Lipoedema Australia website that you can take to your doctor. https://www.lipoedema.org.au/resources

Symptoms:

  • legs/arms can be extremely painful, even to touch

  • increase in fat tissue in the legs, abdomen, hips, or arms compared to the rest of the body.

  • lumpy nodular fat texture - orange peel appearance to skin

  • feet and hands are not affected but a 'bracelet' effect can appear just above the ankles and wrists

  • skin can be cool to touch

  • easy bruising of affected limbs

  • may develop secondary lymphoedema

Management:

Managing Lipoedema involves a multifaceted approach that includes lifestyle changes, medical treatments, and emotional support.

  • Massage – Manual lymphatic drainage can help reduce fluid retention and improve lymphatic function.

  • Compression garments – Wearing compression garments (such as compression stockings or leggings) can help manage swelling and improve circulation. They reduce fluid retention and prevent further fat accumulation and can reduce pain and heaviness. These need to be properly assessed so they do not exacerbate any pain.

  • Exercise – Regular, low-impact exercise such as swimming, cycling, or walking helps improve circulation, reduce swelling, and maintain overall fitness. Avoid high-impact activities that might stress the joints or worsen pain.

  • Diet and Nutrition - Although diet alone will not eliminate the condition, maintaining a healthy weight can alleviate some symptoms and reduce additional stress on the body. Connecting with a dietitian to work out what will work best for you might be very helpful.

  • Support Groups - Joining online or in-person support groups for people with lipoedema can provide emotional support, resources, and shared experiences to help you feel less isolated.

Support and more information can be found on the Lipoedema Australia website. https://www.lipoedema.org.au/

Lipoedema Appointments

Struggling with the discomfort of Lipoedema? Book your lymphatic drainage massage today and take a step toward relief and renewed confidence