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Causes Symptoms Treatments Patient Information

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					 Patient Information

Causes

Lymphoedema develops for many reasons, some of which are as yet not fully understood.

Primary lymphoedema can develop at any age and is due to an ‘inbuilt’ problem with the lymphatic system, that
may occur at birth or develop later in life. The most common problems are absent or obstructed lymphatics or
scarring of the lymph nodes.

Secondary lymphoedema can occur when part of the lymphatic system gets damaged and may result from
cancer treatment, injury or infection. Sometime people with vein problems and ulcers get lymphoedema. Other
conditions such as heart and kidney problems or limb paralysis can also lead to swelling.

Symptoms

These are some possible signs of lymphoedema but they can be due to other conditions so you need to get
advice from an appropriately trained practitioner if you think you may have lymphoedema.

  * swelling of one or more limb/s that does not go down over night and continues over 3 months
  * swelling of other parts of the body such as the back, face, breast, hand/fingers, foot/toes, armpit, shoulder
     or genitals
  * tightness of clothing or shoes, with indentations and creases appearing on the skin
  * skin becomes hard and sometimes warm or hot to the touch

Treatments

Your lymphoedema practitioner, nurse or physiotherapist will talk to you individually about what treatments are
suitable for you but these are usually based on four main areas:

  * skin care and preventative care
  * compression therapy (multi-layer bandaging and lymphoedema garments)
  * manual lymph drainage (MLD) or patient self massage
  * exercises

In the long term you will need to decide how you can adapt your lifestyle and get into a routine with doing the
various self-treatments including daily skin care, wearing of lymphoedema garments, regular exercising and
use of self-massage where necessary. It will be important to try to keep your body weight within normal limits.
Making these self-treatments a natural part of your daily life is the key to successful control of your lymphoe-
dema.

Some people require an Intensive Treatment programme combining bandaging and manual lymphatic drainage
massage to reduce the swelling. This Intensive Treatment course is usually given over 2 or more weeks.
FAQ’s

What can I do to help prevent problems?

    * Every day wash and carefully dry your limb and use a good quality moisturiser to keep the skin supple and
healthy
    * Try to avoid scratching, burning or injuring your skin on the affected limb
    * Treat any scratches, burns, insect bites or cuts with antiseptic to avoid infection and use insect repellent
where required
    * Take care when cutting or filing your nails to avoid damaging the skin and consult a chiropodist or podiatrist
if you have problems with your toenails
    * If you have arm swelling, wear gloves when gardening and use oven mitts when touching hot dishes
    * If you have leg swelling, wear comfortable socks and shoes and try to avoid going barefoot
    * Ensure that your underwear or clothing is not too tight to cause restriction
    * Do not let anyone use the limb to give you an injection, take blood or take your blood pressure
    * Try to move the limb as normally as possible, exercise as advised but avoid repetitive activities that make
the swelling worse
    * Be aware that hot weather, flights and sunburn can worsen the swelling
    * Try to keep healthy, eat well and keep body weight within normal limits
    * Consult a lymphoedema practitioner where possible

What is cellulitis and how can I prevent it?

Some people with lymphoedema get an infection called cellulitis. This can reoccur in some people making the
lymphoedema worse. It is vital that cellulitis is properly treated and you should see your doctors immediately if
you get any of these signs of infection:

  * Red, hot, painful swollen limb
  * Blotching, rash or red streaking (lymphangitis) present on the limb
  * Other symptoms such as pyrexia, flu-like symptoms and nausea

If you get cellulitis you should:

  * Stop all lymphoedema treatments such as manual lymph drainage
  * Remove compression garments or bandages and rest the limb
  * Consult your doctor as soon as possible for antibiotics and take these regularly (usually for two weeks)
  * Consult your lymphoedema practitioner, nurse or physiotherapist for other advice

Further Information

Once the early symptoms are controlled, it may be possible to recommence lymphoedema treatment. Limb
swelling will probably have increased due to the infection and compression therapy will be important in manag-
ing any changes.

Information on your local lymphoedema practitioner or lymphoedema clinic will be available through your doc-
tor or breast care nurse or by contacting:

The Lymphoedema Support Network
St Luke’s Crypt
Sydney Street
London
SW3 6NH
Telephone: 020 7351 0990
www.lymphoedema.org/lsn

				
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