Lymphoedema

Overview

Lymphoedema is a long-term condition where fluid builds up in body tissues, causing swelling, most often in the arms or legs. This happens when the lymphatic system — a network of vessels that normally drains fluid — is damaged or blocked.

Lymphoedema is not very common, but it affects millions of people worldwide. It can develop at any age, though it is more common in people who have had certain cancer treatments.

Lymphoedema can affect anyone, but it is more common in people who have had surgery or radiation for cancer, especially breast, pelvic, or head and neck cancers. It can also affect people with certain infections or inherited conditions.

Symptoms

Common symptoms

• Swelling in part of the body, such as an arm or leg, that may feel tight or heavy.
• A feeling of fullness or heaviness in the affected area.
• Skin changes, such as thickening, hardening, or a feeling of tightness.
• Jewelry, watches, or clothing may feel tighter on the affected side.
• Trouble moving the affected limb fully.

Symptoms in children

• Swelling in a limb or part of the body that may come and go.
• Tightness or discomfort in the affected area.
• Skin infections or redness that don't go away.

Symptoms in older adults

• Swelling that may be mistaken for normal aging or other health conditions.
• Increased difficulty moving the affected limb.
• More frequent skin infections or breakdown in the swollen area.

Causes

Main causes

• Damage to the lymphatic system from surgery or radiation therapy for cancer.
• Infection that blocks or damages lymph vessels, such as certain parasitic infections.
• Inherited conditions that affect how the lymphatic system develops.

Risk factors

• Having cancer surgery, especially removal of lymph nodes.
• Radiation therapy to a part of the body that contains lymph nodes.
• Obesity, which can increase fluid retention.
• Repeated skin infections in the same area.
• Family history of lymphoedema or lymphatic problems.

When to see a doctor

See a doctor urgently if:

• The swollen area becomes red, hot, or very painful — you may have an infection.
• You develop a fever along with new or worsening swelling.
• You have a cut or sore on the swollen area that looks infected.

Book a routine appointment if:

• You notice persistent swelling in any part of your body that does not go away.
• You have a history of cancer treatment and notice new swelling.
• Your swelling is making it harder to move or do daily activities.

Diagnosis

Lymphoedema is usually diagnosed through a physical examination and medical history. Your doctor will check for swelling, skin changes, and ask about your health history.

Tests that may be done

• Measuring the circumference of the swollen limb and comparing it to the other side.
• Imaging tests like lymphoscintigraphy, which uses a special dye to see how fluid moves through your lymph system.
• Ultrasound or MRI to rule out other causes of swelling.

What to expect at your appointment

A doctor or specialist will examine you and ask about your symptoms and risk factors. They may refer you to a specialist, such as a lymphoedema therapist or a vascular doctor. The process is generally painless and non-invasive.

Treatment

Lymphoedema cannot be cured, but it can be managed effectively with treatments that reduce swelling and prevent complications. Treatment usually involves a combination of self-care and medical therapies under the guidance of a healthcare team.

Self-care at home

• Wear compression garments, such as sleeves or stockings, as recommended by your doctor or therapist.
• Keep the affected limb elevated when possible to help fluid drain.
• Perform gentle exercises, like walking or stretching, to encourage lymph flow.
• Clean and moisturise the skin daily to prevent infections.
• Avoid cuts, burns, or injuries to the swollen area.

Medical treatments

Medical treatments may include manual lymphatic drainage (a gentle massage technique), compression bandaging, and pneumatic compression devices. A specialist may also prescribe specific exercises or recommend a low-level laser therapy. No specific medications or herbal remedies are recommended without a doctor's advice.

When is surgery considered?

Surgery is rarely needed for lymphoedema. In very severe cases that do not respond to conservative treatment, a doctor may consider surgical options such as lymph node transfer or liposuction. These are major procedures and require thorough discussion with a specialist.

Living with this condition

Living with lymphoedema means making daily choices to manage swelling and avoid complications. You'll need to care for your skin, wear compression garments as advised, and keep active. It's a lifelong condition, but with good management, most people lead full and active lives.

Lifestyle tips

• Wear compression garments or bandages as prescribed.
• Keep the affected limb clean and dry to prevent infections.
• Avoid tight clothing or jewelry that could restrict fluid flow.
• Protect your skin from sunburn, insect bites, and cuts.
• Stay at a healthy weight to reduce pressure on your lymphatic system.

Diet and exercise

A balanced diet rich in fruits, vegetables, and lean proteins supports overall health. Low-impact exercise, such as walking, swimming, or yoga, can help reduce swelling. Your doctor or therapist can suggest safe exercises for you.

Mental health and emotional wellbeing

Lymphoedema can affect how you feel about your body and may cause frustration or low mood. It's normal to feel this way. Talk to your doctor about support groups or counselling. If you're struggling, reach out to a mental health professional or crisis helpline.

Prevention

Lymphoedema cannot always be prevented, especially if it develops after cancer treatment. However, following good skin care, maintaining a healthy weight, and avoiding infections can reduce your risk of worsening the condition.

Vaccines

It's recommended to stay up to date with vaccinations, especially for influenza and pneumococcal disease, as infections can trigger or worsen lymphoedema.

Screening programmes

There is no routine screening for lymphoedema in the general population. If you are at high risk, your doctor may monitor you regularly for early signs.

Complications

If left untreated

• Frequent infections, such as cellulitis (skin infection), which can become serious.
• Hardening and thickening of the skin, known as fibrosis.
• Reduced mobility in the affected limb.
• Rarely, a serious complication called lymphangiosarcoma, though this is very uncommon.

Long-term outlook

With proper management, most people with lymphoedema can control their symptoms and lead active lives. It is a chronic condition, but treatments and self-care can make a big difference. Early treatment gives the best outcome.

Find support

International organisations

• World Health Organization – Lymphatic Filariasis (includes lymphoedema info)

Local organisations

• Lymphoedema Support Network (UK) ↗ · United Kingdom
• National Lymphedema Network (USA) ↗ · United States

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