What is Lymphoedema?

Lymphoedema is a chronic progressive swelling caused by the accumulation of protein-rich fluid in the tissues, which occurs as a result of the failure of the Lymphatic System.(1) Lymphoedema affects approximately 200,000 people in the United Kingdom.(2)

A healthy Lymphatic System drains 2.5 litres of fluid waste from tissue spaces. It provides an immune response mechanism to fight infection and illnesses by transporting lymphocytes through a network of lymph vessels and lymph nodes. Groups of lymph nodes are situated throughout the body, especially in the head and neck, armpits (axillary), abdomen and groin (inguinal), elbows and knees.

Primary lymphoedema (malformation of the lymphatic system) can occur from birth, but Secondary lymphoedema (damage to the lymphatic system) is most commonly as a result of cancer, radiotherapy for cancer or surgery. Additional risks of trauma to the lymphatic system also include orthopaedic surgery, chronic venous insufficiency and recurrent varicose vein stripping, or vein harvesting for coronary artery bypass grafting (CABG). Other causes include infections such as cellulitis, thrombophlebitis, leg ulcers and skin wounds, as well as obesity and immobilisation.

 

Lymphoedema causes numerous physical and psychosocial problems. These include swelling in the legs and arms primarily, shape distortion, tightness and heaviness; pain due to swelling, nerve compression, reduction in joint range of movement; lethargy, low immune system, chronic fatigue syndrome; poor body image, immobility, depression and social isolation.(3)

 

 

BLS Awareness Week

Although lymphoedema is a long-term condition which cannot be cured, its main symptoms of swelling and the risk of infection can, with appropriate treatment, be controlled and often significantly improved’ (www.thebls.com)

 

 

 

Preventative approach is best. You can reduce risks by:

Protecting skin: cover up by wearing rubber gloves, wear trousers and gardening gloves, avoid tight underwear and clothing, moisturise and maintain supple, clean skin, protect from sunburn and insect bites.

Exercise: maintain gentle movement with breathing techniques as directed by your physiotherapist, sustain a healthy weight, avoid saunas, steam rooms and hot baths.(6,7)

MLD (see MLD page)

Compression Garments (see MLD page)(4; 5)

 

A simple explanation of the lymphatic system is available on:

Useful Links

 

 

 

1        Keeley V (2008) Lymphoedema and cellulitis: chicken or egg. British Journal Community Nursing, 13(4): S4–S10.
2        Mortimer P and Easton G (2012) Chronic oedema and lymphoedema: http://learning.bmj.com/learning/modules/flow.html?execution=e1s1 (accessed 121118)
3        Preston NJ, Seers K and Mortimer PS (2008) Physical therapies for reducing and controlling lymphoedema of the limbs: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003141.pub2/abstract;jsessionid=F0D6782D2F552ADE1F0E9563E2F2A39C.d03t02  (accessed 121120)
      British Lymphology Society (BLS) (2012) What is Lymphoedema?:  http://www.thebls.com/ (accessed 121120)
5        Royal College of Anaesthetists (2010) Breast Cancer Related Lymphoedema – information for doctors:www.rcoa.ac.uk/docs/Lymphoedema_doctors.pdf (accessed 121120)
6        Lymphoedema Framework (2006) Best Practice for the Management of Lymphoedema: International Consensus.  London: Medical Education Partnership Limited.
7        Breast Cancer Care (2010) Physiotherapy to Prevent Lymphoedema After Surgery: http://www.breastcancercare.org.uk/media-centre/all-our-latest-news/our-statements/13.01.10-release (accessed 121120)
8        WHO (2010) Lymphatic Filariasis: http://www.searo.who.int/linkfiles/lymphatic_filariasis_sea-cd-203.pdf(accessed 121120)