Lymphoedema: what it is and how we help

Lymphoedema at a glance

Lymphoedema (often spelled lymphedema in American sources) is long-term swelling caused by a lymphatic system that cannot drain fluid properly. It most often affects an arm or leg, and can follow cancer treatment that removes or damages lymph nodes, or develop because of genetic differences, injury, infection or reduced mobility. It cannot be cured, but it can be controlled well with the right care.

Symptoms of lymphoedema

• Swelling in an arm, leg, hand, foot or elsewhere
• A heavy, tight or aching feeling
• Clothes, rings or shoes feeling tighter
• Skin that becomes thicker or harder over time
• Repeated skin infections (cellulitis)

Lymphoedema in the legs

Leg lymphoedema often starts as swelling around the foot and ankle that gradually spreads up the leg, with heaviness, tight skin and shoes that no longer fit. Unlike ordinary ankle swelling, it does not fully settle overnight. It can follow surgery or radiotherapy to the pelvis or groin, or develop without a clear cause, and it is sometimes confused with lipoedema, a build-up of fat in the legs: see lipoedema vs lymphoedema. Natural ways to help leg lymphoedema include walking and calf exercises, raising the legs when resting, careful skin care and keeping a healthy weight, alongside the compression your lymphoedema team recommends.

How is lymphoedema treated?

The standard approach is decongestive lymphatic therapy, delivered by a specialist lymphoedema service. It combines skin care, exercise, compression garments and specialist manual lymphatic drainage. Early treatment gives the best results.

Compression socks and garments for lymphoedema

Compression is one of the main treatments for lymphoedema. Sleeves, stockings and compression socks for lymphoedema come in different strengths and should be measured and prescribed by a lymphoedema specialist or your GP, because the wrong size or pressure can make swelling worse or damage the skin. Ordinary travel or sports compression socks are not a substitute. Wear them as advised and ask to be re-measured if your swelling changes. Check with your doctor before using any compression if you have heart failure or poor circulation in the legs.

Lymphoedema treatment in Chiswick, London

• Manual lymphatic drainage: gentle, rhythmic massage that encourages fluid to move towards working lymph nodes. 30 minutes £65, 60 minutes £90.
• Compression therapy: Body Ballancer pneumatic compression, used only after checking it is suitable for you. First session with consultation from £60, then from £45 for 30 minutes.
• LPG Endermologie: mechanical tissue mobilisation that some patients use for comfort and tissue softening. Discovery Session £99.
• Physiotherapy: exercise that helps the muscles pump lymph. Initial assessment and treatment £99.

Omnia is the only clinic in London offering manual lymphatic drainage, Body Ballancer compression therapy and LPG Endermologie under one roof. Compare all three on our lymphatic drainage in London page.

What does the evidence say?

Compression and exercise have the strongest evidence. Manual lymphatic drainage adds benefit for some people as part of a combined programme. We work alongside your NHS lymphoedema service rather than replacing it. Read more in understanding lymphoedema and lymphatic drainage options compared.

Lymphoedema or oedema?

Oedema is general swelling, often in the ankles, caused by fluid leaking from blood vessels, for example after long periods of sitting, in hot weather or with heart, kidney or vein problems. It usually goes down overnight or when the legs are raised. Lymphoedema is caused by a lymphatic system that cannot drain properly, does not settle with elevation and tends to make the skin thicker over time.

Can lymphoedema be cured?

Lymphoedema usually cannot be cured, but it can be controlled well. With compression, skin care, exercise and lymphatic drainage, many people reduce swelling and prevent it progressing. Specialist surgery, such as lymph node transfer or lymphaticovenous anastomosis, is available in some centres for selected people.

Lymphoedema after breast cancer

Arm lymphoedema can develop months or years after breast cancer surgery or radiotherapy that affected the lymph nodes in the armpit. Early signs are a feeling of heaviness or tightness, or rings and sleeves feeling tighter. Tell your breast care team promptly if you notice these, because early treatment gives the best results.

What to expect at Omnia

We take a detailed history, including any cancer treatment and your current care from an NHS lymphoedema service, and check your skin and the swollen area. We then agree a plan that may include manual lymphatic drainage, compression therapy where suitable and exercise advice, and we measure the limb to track change. We work alongside your specialist team rather than replacing it.

What you can do at home

• Wear compression garments as prescribed
• Moisturise daily and protect skin from cuts and insect bites
• Keep active and raise the limb when resting
• Keep a healthy weight

For self-help and realistic expectations, see our guides to lymphatic drainage exercises and lymphatic drainage before and after, or read more about manual lymphatic drainage in London.

See also the benefits of lymphatic drainage massage and what compression therapy is.

Lymphoedema support is available at Omnia Lifestyle, 8 to 9 Bedford Corner, The Avenue, Chiswick W4 1LZ, close to Turnham Green station, on bus routes 94, E3 and 272. Limited parking is available on request when booking. Book online or call 020 4515 0000.