What is Lymphoedema?

March is Lymphoedema awareness month and our lymphoedema therapist Jessica Kyneur would like the opportunity to educate the community about a little known condition called "Lymphoedema".

It is estimated that 40,000 people in Australia and New Zealand are living with lymphoedema. Lymphoedema is the abnormal accumulation of protein rich fluid in the body as a result of an impairment in the lymphatic system. This build up of fluid usually results in swelling of one or more regions of the body such as the limbs, breast, genitalia or head or neck.

The lymphatic system is an important part of the body which aids in:

• Maintaining fluid balance in the body

• Absorbing fat in the digestive system

• Fighting infection and boosting immunity

Lymphoedema can occur from a malformation of the lymphatic system (Primary Lymphoedema) or as a result of trauma to the body e.g. from surgery or injury (Secondary Lymphoedema).

PRIMARY LYMPHOEDEMA

This less common form of lymphoedema is usually a result of a genetic condition that affects the development of the lymphatic system e.g. the absence of lymph nodes/vessels or its malformation. There are different forms of primary lymphoedema which develop at different stages in life:

• Lymphoedema congenita is present from birth

• Lymphoedema praecox develops at puberty

• Lymphoedema tarda occurs later in life

• These conditions may sometimes be associated with other congenital abnormalities or syndromes

• About one in every 6,000 people will develop primary lymphoedema at birth

SECONDARY LYMPHOEDEMA

Secondary lymphoedema is the most common type of lymphoedema resulting from damage to the lymphatic system. It is commonly seen as a side effect of cancer treatment including the removal of lymph nodes, radiotherapy treatment or progression of malignant disease.

Conservatively, it is estimated that around 20% of cancer patients will experience secondary lymphoedema. Other non-cancer causes of secondary lymphoedema include:

• Trauma and tissue damage

• Burns

• Venous disease

• Cellulitis or other infections

• Filariasis

• Obesity

• Immobility and dependency

Lymphoedema may present at anytime; soon after trauma occurs or months to years later.
Lymphoedema is a progressive disorder which if left untreated can become a chronic condition leading to increased pain and risk of infection as well as loss of movement and mobility. This not only affects function and quality of life but can also lead to a large cost to the individual patient and healthcare systems. As a result, prevention and early intervention are paramount.

SYMPTOMS

• Visible swelling the area of swelling may look bigger than the other side of the body. Veins or muscle tendons may become less visible or noticeable.

• Heaviness, tightness or fullness of a limb or area of swelling

• Aching or pain in the swollen area

• Restricted range of motion

• Recurring skin infections

• Hardening or thickening of the skin

• Clothing or jewellery may feel tighter

DIAGNOSIS

Early diagnosis has been shown to minimise the severity of lymphoedema as this leads to early intervention. Diagnosis can be made clinically by through assessing history, signs and symptoms and performing a physical examination. A lymphoscintigraphy scan may also be used. Early detection and intervention of lymphoedema is important in reducing symptoms, discomfort and reduces the long-term effects such as infection, skin thickening and reduced function.

TREATMENT

There is no cure for lymphoedema however with the right treatment, lymphoedema can be reduced and managed thus improving quality of life. Treatment may vary depending of the severity and location of the swelling. Our lymphoedema therapists can design an individualised treatment plan best suited to your needs. It may include one or more of the following:

• Education

• Lymphatic massage

• Compression therapy including bandaging or garments

• Exercise

• Low level laser therapy

• Skin care

Tips for managing your lymphoedema

• Do not ignore any increase in swelling seek advice

• Elevate the swollen area

• Avoid overheating, baths or sunburn

• Wear appropriate clothing avoid clothes that are too tight and may restrict the flow of lymph fluid

• Wear compression garments when flying

• Maintain a healthy weight with regular exercise

Ensuring proper skin care will also help prevent and control lymphoedema. The skin is an important barrier against infection. If the skin is broken, bacteria may enter the body and cause infection which then may cause or worsen lymphoedema in the affected area of the body. Here are some ways you can help to keep your skin healthy and prevent infections:

• Keep the skin soft and supple by regularly moisturising the skin

• Clean any cuts, scratches or insect bites immediately using an antiseptic solution and cover the area with a clean dressin

• Wear gloves when gardening or cleaning and wear sensible enclosed shoes when outdoors to prevent injury

• Treat any infection immediately

If you are concerned about your swelling or are planning on having lymph node surgery, please contact us on (02) 9553 8145 to book in your lymphoedema assessment.

Phone: 9553 8145

Website: www.eqphysio.com.au

Or if you're in the area, drop by and have a chat with us. We're located at 1/45 Montgomery St Kogarah NSW 2217.