Lymphoedema Self-Assessment – What To Do and How?

Lymphoedema is a chronic condition that affects men and women worldwide and is categorised into primary and secondary forms. The primary is a congenital type of Lymphoedema, which would present with swelling starting at the end of the limb and propagating upwards. Where the secondary is due to an external cause, which can potentially damage the lymphatic system, such as post-cancer surgery or radiation therapy, but it can also happen post-severe injury or major surgeries, and the swelling would start at the area of damage and spread away from it. So let’s look now into some self-assessment you can do at home to help you understand if you are presenting with Lymphoedema.

Signs and Symptoms of Lymphoedema

Lymphoedema presents as severe swelling in an individual body part, which can be a leg, an arm, the thoracic area, or even the genital area.
Most common signs of Lymphoedema are:

• Swelling
• Tight skin
• Lack of mobility in the limb involved
• Dry skin
• Skin that cracks easily
• Redness
• Feeling of tightness and heaviness in the limb

The aspect of tight skin and cracks on the skin when experiencing lymphoedema has to be taken seriously and needs immediate attention. The risk is of encountering severe infections if the skin cracks are not kept clean and sanitised. Consequences include infections, like cellulitis.

Who is at Lymphoedema Risk?

As mentioned in the introduction of this blog, there are several reasons why someone can suffer from Lymphoedema. Now let’s try to get some clarity about it, by analysing in more detail what primary and secondary lymphoedema are.

Primary Lymphoedema

A primary lymphoedema is a congenital condition, which means the subject suffering from lymphoedema was born with a damaged, missing, or malfunctioning lymphatic system.
Here is a further breakdown of this presentation based on the age at which the Primary Lymphoedema manifest:

• Congenital lymphedema – birth to age 2
• Lymphedema praecox – puberty to age 35
• Lymphedema tarda – after age 35

A specific characteristic of primary lymphoedema is that the swelling starts at the extremity of the limb.

Secondary Lymphoedema

A secondary Lymphoedema manifests itself after an external cause has damaged the Lymphatic System. An example of an external course is a cancer surgery, where, along with the cancer removal, there are lymph nodes removed, leaving the lymphatic system interrupted. Other causes of secondary lymphoedema include radiotherapy, which may damage the lymphatic system, but even a severe injury like a car crash or other types of surgery.

Indeed, if someone already experiences a weak lymphatic system, an external intervention, like a surgery, can further damage the structure, leading to lymphoedema as a consequence.

In comparison to the primary lymphoedema, the swelling in a secondary lymphoedema would start at the site of damage (surgery or radiated area) and travel down the limb.

Lymphoedema self-assessment

As a lymphoedema therapist in Fitzroy North, I help people who present with this symptom determine whether the swelling they are experiencing is related to lymphoedema.

But there is a series of Lymphoedema self-assessments that you can also do at home to start helping you understand what’s going on.

Stemmer’s Sign

The Stemmer’s sign is one of those Lymphoedema self-assessments that you can do on your feet or hands, and consists of the ability to pinch off the skin above your fingers or toes (based on which limb the lymphoedema is) just where the metatarsal (hand) or tarsal (feet). If the swelling is severe enough to stretch the skin tight, you would not be able to pick the skin off that area.

For more accuracy, it is suggested to do this test on both limbs to notice any difference.

Pitting Oedema

A pitting oedema is a mark left in the skin after pressure is applied. Similar to the sox mark, which we all may get after wearing sox for a prolonged period of time. The difference is that for a pitting oedema to be positive, it is enough to apply pressure for about 30 to 60 seconds. What you are looking for, for a positive test, is:

• Is any mark left behind?
• How fast does the skin recoil?
• How fast does the skin’s colour return to normal?

A positive pitting oedema is a sign of protein-rich fluid accumulating beneath the skin.

Online questionnaire – Lymphoedema Self-Assessment

Below, I provide two online questionnaires available to anyone to self-assess their risk of developing secondary lymphedema from post-cancer treatment.

Arm Lymphoedema Questionnaire


Leg Lymphoedema Questionnaire

These guides are designed as educational aids based on experience, with no supporting evidence in the literature, so do not take the result of this test as a diagnosis.

What’s After Lymphoedema Self-Assessment?

If the results of the questionnaire and the lymphoedema self-assessment above give you a hint of suffering from lymphoedema, I personally suggest to:

• Keep your skin clean and moist.
• Avoid skin cuts, so if you work in the garden or outdoors, wear protective clothing and take any precautions needed to maintain your skin integrity.
• Book a 15-minute free online consultation so that we can discuss what treatment plan may work best for you, and how we can manage your Lymphoedema.
• Keep yourself in motion. Any movement is better than no movement. Walking is great, go swimming, just don’t spend a prolonged period of time still.

FAQ – Lymphoedema Self-Assessment and Care