Managing lymphoedema can include:
- exercises
- wearing compression garments
- skin care
You may have decongestive lymphatic therapy (DLT). This is also called complex decongestive therapy (CDT).
Decongestive lymphatic therapy (DLT)
DLT is not a cure for lymphoedema. DLT can improve your symptoms but it takes time and effort.
You may have DLT if you have significant swelling that needs decongestion.
There are 4 parts to DLT:
- compression bandages - to help move fluid out of the affected limb and reduce more build-up
- skin care - to keep the skin in good condition and reduce the chances of infection
- exercises - to use muscles in the affected limb to improve lymph drainage
- manual lymphatic drainage (MLD) - specialised massage to improve the flow of fluid in the lymphatic system
You may need daily treatment for 2 to 3 weeks. This helps to reduce the size of the affected body part.
Maintenance phase
After any initial treatment, your team will work with you on a care plan to maintain the results.
Your maintenance plan may include:
- wearing compression garments
- skin care
- exercises
- self-massage
You'll have reviews every few months to check how your treatment is working. You may need to continue the maintenance phase for many years.
Compression bandages and garments
The lymphatic system has no central pump to move fluid to the lymph nodes. It uses the massaging effect of surrounding muscles to move the fluid. This is why exercise is important.
You can wear compression bandages or garments to put gentle pressure on your muscles. These include compression sleeves, gloves, stockings or tights.
The combination of exercise and compression helps the fluid to move out of the affected limb.
You may need to wear compression garments after a massage session. This prevents fluid from building up in the limb again.
You can use adjustable wraps instead of bandages or compression garments. These are easier to put on yourself.
Your therapist will teach you how to put on compression garments or adjustable wraps. You continue using them during the maintenance period.
Skin care
Daily skin care is important. It helps to reduce your risk of developing an infection, such as cellulitis.
Do
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keep your skin clean and dry - wash with warm water every day
-
moisturise your skin every day
-
wear gloves to protect your skin when you do activities such as gardening
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clean any cuts or grazes straight away with clean water and put on antiseptic cream
Movement and exercises
Your care team will create an exercise and movement plan for your needs and abilities.
The plan will help strengthen and stimulate the muscles involved in lymph drainage. It can also help you to lose weight if you're overweight.
Your plan may have limb exercises and gentle activities for the whole body.
Examples of activities
There are many activities you can do, including:
- swimming or other activities in water - the pressure of the water helps to move the fluid
- walking
- yoga
- Pilates
- gardening or housework
To stay motivated, choose activities that you enjoy.
It can also help to do activities with other people. This can be with friends, neighbours, a club or a support group. Your care team can tell you about groups in your area.
Tips for doing activities
Do
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check with your therapist before you start a new activity that involves weights or resistance
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wear your compression bandages when you do activities
-
start slowly and gradually build up the activity
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reduce or stop the activity if the affected area feels tired or uncomfortable
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do breathing exercises at the start and end of every session
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try to use your unaffected arm for everyday tasks or change sides often
Surgery
In rare cases, you may have surgery to treat lymphoedema.
Types of surgery for the condition include:
- liposuction - to remove fat from the affected limb
- lymphaticovenular anastomosis - to restore the flow of fluid in the affected area by connecting the lymphatic system to blood vessels
These treatments may help reduce the size of areas of the body affected by lymphoedema.
Liposuction
The accumulation of fat can be a significant feature of lymphoedema swelling. Liposuction removes excess fat from an affected limb to help reduce its size.
During the procedure, your surgeon:
- inserts a thin tube through a small incision (cut) in the skin
- uses suction to remove the excess fat from the tissue
After surgery, you must wear a compression garment on the affected limb day and night. This helps to keep down the swelling.
Content supplied by the NHS and adapted for Ireland by the HSE
