Treatment Options for Lymphoedema

Hello, and welcome! I’m Giovanni, and today I want to share some insight into the available treatment options for lymphoedema. If you or someone you know is dealing with this condition, I understand how overwhelming it can feel to navigate the many different approaches to treatment.

As someone specialising in lymphoedema management through Manual Lymphatic Drainage (MLD) and Complex Decongestive Therapy (CDT), I aim to provide a holistic approach to managing and reducing the symptoms of lymphoedema. I’ve studied with the Vodder Academy and am a Clinical Myotherapist, so my work is built on solid, evidence-based practices. But I also believe that looking at all available treatment options for lymphoedema —medical, surgical, and holistic—is key to finding a management strategy that works for you.

What is Lymphoedema?

Before we dive into treatment options, let me quickly touch on what lymphoedema is. Lymphoedema is a condition that causes fluid retention and swelling, usually in the arms or legs, as a result of damage or blockage to the lymphatic system. This can occur after surgery, radiation treatment, or due to inherited conditions.

While lymphoedema may be chronic, the good news is that with the right treatment, symptoms can often be managed or reduced significantly.

Medical Treatments options for Lymphoedema

Medical treatments for lymphoedema typically focus on managing the fluid buildup and improving lymphatic drainage. Here’s a quick overview of what you might expect in a clinical setting:

1. Compression Therapy Compression garments are often a cornerstone of lymphoedema management. They help reduce swelling by applying controlled pressure, which encourages the flow of lymph fluid. These garments come in different forms, including stockings, sleeves, and bandages, and they can be custom-fitted to provide maximum comfort and effectiveness. Compression stockings are recommended to be purchased from a clinic who does take measurements of your limb and makes the stocking based on the measurements. The benefit of this approach is that you will have a compression that is ideal for your limb, with no less risk of fluid congestion and other side effects.
2. Pharmaceuticals and Diuretics In some cases, medications may be prescribed to address symptoms like inflammation or to reduce fluid retention. However, it’s important to note that diuretics are generally not a primary treatment for lymphoedema, as they don’t directly address the underlying lymphatic issue. Other medications that are prescribed for Lymphoedema are creams to maintain skin moisturised in order to reduce the chance of cracking and skin damage.
3. Manual Lymphatic Drainage (MLD): I specialize in MLD, a gentle, hands-on technique that stimulates the anastomosis of the lymphatic system and encourages the movement of excess fluid from swollen areas. MLD can be incredibly effective in reducing swelling and relieving discomfort. It works by targeting stretching and letting the skin recoil under some really gentle pressure. This way the lymphatic system is stimulated to work harder, and uptaking the fluid to healthier parts of the body where it can be processed more efficiently.
4. Combine Decongestive Therapy (CDT). It is part of the treatment I offer for Lymphoedema patients here at Melbourne Massage and Treatment. It consists of bandages used to compress the affected area. The compression is applied after MLD has been delivered, and it is applied to maintain fluid movement throughout the anastomosis, which is the alternative connection of the lymphatic system through which the liquid moves after the MLD stimulation. The bandages are applied and are recommended to stay on for about 24 hours. After this time, once you remove them, you will wash them, roll them and come back for another treatment. A back to back treatment would ensure that the swelling of teh lymphoedema can be managed and reduced as quick as possible.
5. Laser therapy: Laser therapy is a non-invasive treatment that can be used in a clinical setting to treat specific lymphoedema presentations. Indeed, Laser therapy is used when the patient already presents with fibrosis, the hardening of the skin. Low-frequency lasers are the ones used most often, and we know there are also portable pen lasers that are efficient enough for this therapy.
6. Pneumatic compression therapy: This therapy consists of using a sleeve pump machine, that get’s placed over the affected area and inflates sequentially to apply pressure. The rhythmic compression helps stimulate lymphatic flow, reduces swelling, and improves circulation by encouraging the movement of excess fluid toward lymphatic drainage sites.

All those therapies are recommended in combination with each other. To start with, for best result and quick reduction, MLD and CDT would be the more effective.

Surgical Treatment Options for Lymphoedema

While surgery is generally considered a last resort for lymphoedema, there are certain cases where it may be necessary or beneficial:

1. Liposuction for Lymphoedema This technique is sometimes used to remove excess fat tissue that has accumulated as a result of chronic lymphoedema. It’s not a cure, but it can help reduce the volume of swelling and improve the appearance of the affected area.
2. Lymphovenous Anastomosis (LVA)/Bypass: It involves connecting the lymphatic vessels and nearby veins, allowing excess lymph fluid to drain into the bloodstream instead of accumulating in tissues.
3. Vascularized lymph node transfer (VLNT): a surgical technique used to treat lymphoedema by transplanting healthy lymph nodes along with their blood supply to the affected area. The transplanted lymph nodes, typically harvested from the patient’s groin or other regions, are reconnected to the recipient’s blood vessels.
4. Lymph Node Transplantation In some specialized cases, surgeons may transplant healthy lymph nodes from one part of the body to another to help restore lymphatic drainage. This option is more complex and is usually reserved for severe, treatment-resistant lymphoedema.

Surgery, of course, comes with risks and recovery time, so it is typically considered only after all other treatments have been explored.

Holistic Treatments: Taking a Whole-Body Approach

While medical and surgical treatment options for lymphoedema can certainly help with this presentation, I firmly believe that a holistic approach is crucial for long-term success. Here are some natural and complementary therapies that can support overall well-being:

1. Exercise and Movement Regular, gentle exercise can play a significant role in lymphatic drainage. Low-impact activities like walking, swimming, yoga and or thai-chi, can help stimulate lymph flow and improve the function of the affected area. If you’ve been given the green light from your healthcare provider, incorporating movement into your daily routine can make a real difference.
2. Diet and Nutrition While there’s no specific “diet for lymphoedema,” maintaining a healthy, balanced diet can support your body’s ability to manage fluid and inflammation. Staying hydrated, eating plenty of fruits and vegetables, and focusing on anti-inflammatory foods which are natural food, less process as possible, can help improve your overall health and well-being. What can also help in terms of food intake, is to have a food diary, where you note what food you had what time/day so that you can monitor what reaction that food may gave to your Lymphoedema.
3. Stress Management Stress can exacerbate the symptoms of lymphoedema, so it’s essential to incorporate stress-reduction techniques into your routine. Practices like mindfulness, meditation, and deep breathing can help calm the nervous system and may indirectly support lymphatic health.
   An easy technique that I like to practice myself, too, for stress management is called the breathing box. This technique is about taking a breath in via the nose for the count of 4 seconds, holding the breath for 4 seconds, breathing out for 4 seconds, and holding no breath for another 4 seconds. Repeat 4 times. At the end of the 4th time, you woul most luckily notice a general sensation of wellbeing and calmer feeling. This is possible thanks to the stimulation of the Parasympatetic nervous system.

My Approach to Lymphoedema Treatment

In my practice, I emphasize a personalized, holistic approach to managing lymphoedema. I work with each client to develop a tailored treatment plan that may include MLD, CDT, and lifestyle advice designed to improve overall well-being. Whether you are new to lymphoedema or have been managing it for some time, my goal is to help you feel empowered, comfortable, and supported in every step of the journey.

So, if you are suffering from Lymphoedema and need some help, book now your free 15-minute online consultation, where we can go through your clinical history and establish a treatment plan that can work best for you.