Lymphoedema

The lymphatic system
Lymph is a clear fluid which forms in the body and normally drains back into the blood circulation through a network of lymph vessels and lymph nodes. The lymphatic system plays an important part in the body’s defense against infection.

How lymphoedema occurs
If the drainage routes through the lymphatic system become damaged or blocked, lymph accumulates in the tissues and swelling occurs. Unlike other oedemas, lymphoedema leads to changes in the tissues, such as fibrosis and an increased risk of infection. When this happens, the swelling can become even more difficult to control.

Signs and symptoms 
– A heavy, tight, or full feeling in a limb or body part
– Swelling: you may notice indentations in the skin from tight clothing, jewellery or shoes
– Ache, pain or tension in the limb or body part

Types of lymphoedema
Primary lymphoedema develops as a result of a congenital condition that affects how the lymph vessels were formed. The number of lymphatic vessels maybe reduced, increased or absent. This form may be present at birth, or develop at the onset of puberty, or not become apparent for many years into adulthood. It may also be associated with other congenital abnormalities/syndromes and can include lipoedema.

Secondary lymphoedema is the result of damage to the lymphatic pathways. This maybe a result of treatment of cancer following surgery or radiation therapy. Lymphoedema can also occur as a result of infection, severe injury, burns, or any other trauma or surgery that causes damage to the lymphatic nodes and vessels.

Lymphoedema affects all ages and may occur months or years after surgery, so it is important to understand and manage the life-long risk.

How is lymphoedema treated?
Research shows the best results are obtained through Combined Decongestive Therapy, which consists of:

• MLD (Manual Lymphatic Drainage)
• Elevation
• Compression garments/compression bandaging
• Exercises
• Skin care: the use of antibacterial cleaners and pH neutral lotions
• Other aids such as kinesiotaping and LASER therapy may be useful to help the lymphatic system work more efficiently

Treatment may vary depending on the stage and severity of the lymphoedema. Education to recognise early warning signs and learning to manage your condition is very important.

Conditions for which MLD therapy is helpful include:

• Primary and secondary lymphedema
• Lipoedema
• Venous insufficiency and leg ulcers
• Post-traumatic oedema
• Post-operative oedema
• Promotion of wound and scar healing
• Sinus congestion
• Conditions of the nervous system with local oedema (e.g. migraines, Parkinson’s Disease, Multiple Sclerosis)
• MLD has a calming effect on the autonomic nervous system helping with relaxation. It can help improve the quality of sleep, relieve constipation and generally aid digestion.

Lymphoedema management is available at our Midland, Spearwood and Swan View clinics.

Meet our lymphoedema therapist, Valerie Lorenz. Valerie is an accredited lymphoedema therapist with the Australasian Lymphology Association.

Valerie Lorenz
Lymphoedema Physiotherapist
Continence and Women’s Health Physiotherapist
BSc Physio, Master Clinical Physio (Continence and Women’s Health), APAM, ALA