Lymphoedema Treatments

There is currently no cure for lymphoedema and treatment is aimed primarily at managing the swelling. Effective and sustained efforts at managing the swelling can prevent many of the changes/problems described above.

The mainstay of managing lymphoedema is management of the skin and management of the swelling.

Skin management is aimed at good skin hygiene (daily washing, drying skin properly and moisturisers), wearing loosly fitting non-synthetic clothing, preventing traumatic or accidental damage and controlling infection.

Management of the swelling can be achieved by simple measures like elevating the affected limb as high as possible, ideally above the level of the heart. This can be achieved by raising the foot of your bed, for example, by four to six inches.

Compression bandages or stockings are also effective at managing swelling. It is important that the bandaging is correctly applied by someone trained in the specialized technique and that stocking are specially fitted. The stockings are much stronger than ordinary support tights.

Sometimes machines are used to squeeze the fluid out of the legs. This treatment is known as external pneumatic compression (EPC).

Manual lymph drainage or lumphatic massage is another specialist technique uses to reduce the swelling.

A combination of many of the above techniques called Complex Decongestive Therapy (CDT) has been shown to be very effective in controlling swelling.

What about Surgery?

Surgery has a limited role in the management of lymphoedema and can be divided into operations aimed at improving the lymphatic drainage (reconstructions) or reducing the size of the affected limb (reduction/excisional procedures).

These are generally reserved for patients in whom all the non-operative techniques mentioned above have failed.

Reconstruction operations are aimed at trying to join the damaged lymphatic system to either the main blood vessels (veins) or connecting them to a functioning part of the lymphatic system. The results of these operations have generally found to be disappointing.

Reduction or excision operations traditionally involved removing some of the affected tissue (Charles' or Homans operation) but more recently a technique using liposuction known as lymphatic liposuction has been shown to be a promising alternative.

What ever method is chosen, the aim of surgery is to control symptoms and not cure. You will still need to use compression garments and non-surgical therapies.

Rehabilitation

Lymphoedema is not curable only manageable. All of the treatments listed will be needed in some form for life.

It is important to build a good support network around you to help keep the lymphoedema under control.

The best results of treatment are obtained were a team of specialists are involved in treatment of the condition.