Lymphoedema
Many individuals, including some patients undergoing cancer treatment, may be affected by a disruption in the lymphatic system, resulting in lymphoedema – it’s a condition that often remains misunderstood.
This blog will cover the following points on Lympoedema:
What is the Lymphatic System?
Think of the Lymphatic system as your body's unsung defense system, working tirelessly behind the scenes to keep you healthy. Comprising an open network or highway of vessels, nodes, and organs, this system plays a crucial role in fighting off infections, maintaining fluid balance, and transporting waste substances. Lymphatic vessels absorb fluid from tissues and then contract to pump and propel it towards the heart supported by a series of valves. The lymphatic vessels carry lymph fluid, immune cells, lipids, and molecules which are processed in nodes and lymph organs. Here waste material is removed and destroyed and then the purified fluid is returned to the circulatory system aided by our breathing muscles (1).
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What is Lymphoedema?
Lymphoedema is a chronic condition that is characterised by localised swelling, occurring when there is an impairment or obstruction within the lymphatic system. Disruption may occur due to lymph node removal but damage to lymph vessels may happen from excessive tissue pressure, fibrosis from radiation and inflammation, and nerve conduction problems. This results in the accumulation of lymph fluid, leading to characteristic swelling, mostly observed in the arms or legs (2). This swelling acts like a roadblock in the lymphatic superhighways and if left untreated may have an impact on a person’s quality of life. It is essential to differentiate between primary lymphoedema, which arises from birth variations within the lymphatic system, and secondary lymphoedema, which occurs due to damage or trauma to the lymphatic system which may include surgery, radiation therapy, and infection (3).
"Lymphoedema: A roadblock in our immune system superhighway"
Do you have Lymphoedema?
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Healthy Habits for those at risk of Lymphoedema:
Prevention is always better than cure. When it comes to lymphoedema, adopting a few healthy lifestyle habits can make a significant difference and maintain a smooth-flowing lymphatic highway. These include:
- Maintaining a healthy weight through diet
- Engaging in regular exercise and avoiding prolonged inactivity.
- Protecting your skin by keeping it clean and moisturised and using sunscreen.
- Preventing cuts, insect bites, or constriction of the skin and monitoring for infection.
- Avoiding extremes of temperature.
- Having regular medical check-ups.
Warning Signs and Symptoms of Lymphoedema:
Early identification of lymphoedema is vital for prompt intervention and management. People who are at risk for lymphoedema need to be vigilant and alert for warning signs of lymphatic impairment such as:
Experiencing Persistent swelling
Feeling of heaviness or tightness in the affected limb
Having a limited range of motion
Having recurrent infections
If you notice any of these signs, it's essential to consult with your physiotherapist or healthcare provider for assessment and development of a management strategy. Contact us, and let us help you with your condition.
How to manage Lymphoedema:
The good news is that there are several ways to keep those lymphatic superhighways flowing smoothly and minimise the impact of lymphoedema. A multimodal tailored approach is often best. The strategies aim to assist the flow of lymph through the lymph vessels that have been obstructed, refluxing, or are leaking lymph fluid resulting in inflammation and swelling. Interventions may include:
Compression:
Wearing compression garments, like specially designed stockings or sleeves, can help reduce swelling by providing gentle pressure and encouraging the lymphatic fluid to flow in the right direction, reducing swelling and promoting tissue health. (2). It's like giving those highways a little nudge!
Exercise:
Physical activity is not only great for overall health but also for managing lymphoedema. Under the guidance of a healthcare professional, exercise can stimulate lymph flow and reduce swelling by using your muscles and lungs to provide an external pump to support the lymphatic system. Engaging in regular activities such as walking, stretching, swimming, and yoga has shown promising results in managing lymphoedema (3). So, let's get you moving!
Manual Lymphatic Drainage (MLD):
This specialized massage technique, performed by trained professionals, can work wonders for lymphoedema. It involves gentle massage strokes to redirect fluid and enhance lymphatic flow (5). This therapeutic intervention can also be taught to patients by their therapist and serves as a valuable adjunct to other strategies in managing lymphoedema. It's like having a personal traffic controller for your lymphatic system!
Skin Care is Essential:
Proper skincare is crucial for those with lymphoedema. Keeping your skin clean, moisturized, and protected from cuts or infections is essential in preventing complications and ensuring a smooth journey for your lymphatic highway!
Getting Help for Lymphoedema
Living with lymphoedema can be challenging, but it doesn't have to define you. It's important to remember that you are not alone in this journey. Adopting healthy preventative measures, monitoring, and seeking early assessment, and following a comprehensive management plan, can effectively manage lymphoedema and maintain a fulfilling life. So, seek support from your healthcare team, connect with support groups, and don't hesitate to share your concerns and experiences. Together, we can navigate the ups and downs and make the most out of your life!
Stay positive, stay proactive, and keep that lymphatic system happy and healthy!
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Author
This blog was written by Julie Allen, Principal Physiotherapist of The Pentimento Project, a cancer rehabilitation service operating independently within the clinic of Physiotec Physiotherapy since 2010, supporting people with cancer to reach their goals, improve their quality of life, and move beyond their cancer experience. You can read more about Julie here.
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References:
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Hutchinson N.A Evaluation and Management of Oedema and Lymphoedema in the Cancer Patient. Cancer Rehabilitation: principles and practices (Stubblefield; Springer Publishing) 2019 Ch 85 pp1075-1099
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Rockson, S. G. (2018). Lymphedema. American Journal of Medicine, 131(8), 778-783.
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Mortimer, P. S., Rockson, S. G., & Lalor, P. F. (2018). Lymphedema: State of the art and future directions. American Journal of Clinical Dermatology, 19(6), 739-751.
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Brown S et al. (2022). Exploring novel interventions for lymphoedema: A review of recent advancements. Journal of Rehabilitation Medicine, 54(7), 565-573.
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Tan IC et al Assessment of lymphatic contractile function after manual lymphatic drainage using near infrared fluorescence imaging. Arch Phys Med Rahab 2011; 92 (5) 756-764