Lymphoedema treatment and management

This is the standard treatment used for chronic lymphoedema. The majority of people will respond well to CLT. It aims to reduce symptoms such as swelling, improve the condition of the skin, prevent infections and improve quality of life.

CLT consists of a treatment phase and a maintenance phase. During the treatment phase, a lymphoedema practitioner will provide a combination of regular skin care, manual lymphatic drainage (MLD), exercises and compression bandaging to reduce the swelling. This phase may last for only a few days or up to several weeks.

Once the swelling has been reduced you will enter the maintenance phase. Your lymphoedema practitioner will teach you how to care for your skin, how to perform self-massage known as simple lymphatic drainage (SLD), and how to do some suitable exercises. Wearing the compression garments prescribed by your practitioner will ensure that the gains made in the treatment phase are maintained. It is recommended that you see your lymphoedema practitioner for regular reviews every 6–12 months. 

Skin care

It is very important to care for your skin to prevent infections. You should regularly look over your skin for cuts and scratches, redness, dryness, and signs of bacterial or fungal infections. Make sure to dry your skin thoroughly after washing to help prevent fungal infections. Apply a moisturiser every day to help protect your skin – dry skin can lead to small skin tears and infections. See How to prevent and/or manage lymphoedema for more tips on looking after your skin.

Manual lymphatic drainage (MLD)

This specialised type of massage is performed by a trained lymphoedema practitioner. It involves applying light pressure to the skin around the swollen area to stimulate the lymph vessels and improve the flow of lymph fluid. The technique used during MLD will be different for each person depending on the location of the swelling and stage of lymphoedema.

Simple lymphatic drainage (SLD)

Your lymphoedema practitioner may teach you a simplified form of MLD, which you may be advised to do daily.

Sequential intermittent pneumatic compression

This device applies pressure by using a compression pump to inflate and deflate a plastic garment placed around the affected area. It is given alongside MLD or SLD. The device can be used as a home treatment under the guidance of a trained professional to ensure you apply the correct amount of pressure for your situation.

Exercise

Regular physical activity such as walking can reduce the severity and symptoms of lymphoedema by encouraging the lymph fluid to move around the body. Flexibility exercises can help with maintaining your mobility. Your lymphoedema practitioner may develop a program of exercise tailored to your particular situation and abilities. For more information, see Exercise for People Living with Cancer or Exercises after breast surgery.

Compression therapy

Compression therapy involves applying pressure to the area to help control the swelling associated with lymphoedema. It can help prevent the redevelopment of lymph swelling in the affected area and soften any thickened tissue. Pressure can be applied using compression bandages or compression garments. It can also be applied by a compression pump.

Compression is a long-term treatment: if stopped, the swelling will return. If you find it difficult to take your garments on and off, talk to your lymphoedema practitioner about what aids are available to help you. Some people find rubber gloves helpful.

If compression therapy is done incorrectly, it can cause swelling in other parts of the body, pain and further damage to the lymphatic system. It is important that you talk to your lymphoedema practitioner about appropriate therapies for you.

Compression garments can be expensive. For information about available subsidy schemes visit the Australasian Lymphology Association. If you have private health insurance, check with your provider whether you are entitled to a rebate on compression garments.

Low-level laser therapy may reduce the volume of lymph fluid in the affected area, any thickening of the skin and any pain. Your lymphoedema practitioner will apply infrared light beams to the affected area using a hand-held device or a larger scanner. You will not feel any heat. There is some evidence that this therapy is effective when used alongside lymphatic drainage and compression therapy. Research is still ongoing into the most effective treatment regimen.

There is no proven drug treatment for lymphoedema. Although diuretics help remove fluid from the body, they do not remove lymph fluid and can cause dehydration. Your doctor may prescribe you diuretics for other conditions such as high blood pressure, but they are not recommended for lymphoedema.

There is little evidence to support taking naturopathic medicines or supplements such as selenium to help reduce the symptoms of lymphoedema. High doses of selenium can be harmful.

Talk to your doctor about any supplements or medicines to ensure they don’t interact with any other medicines you are taking and are not harmful.