Types of treatment for lymphoedema

There are different types of treatment to reduce swelling (lymphoedema). This includes compression therapy and manual lymphatic drainage (MLD).

Unfortunately, lymphoedema can’t be cured, but can usually be well managed with treatment. The treatments available help to:

• reduce fluid build-up and

• encourage the flow of fluid through the lymphatic system

The aim of lymphoedema treatment

The aim of treatment is to:

• control and reduce the swelling when possible
• look after your skin and reduce the risk of problems, such as infection
• help you to live as normally as possible

Follow your specialist’s advice once treatment has reduced or controlled the swelling. This way you can try and stop it from getting worse.

Treatment is often long term. It can be difficult to cope with a condition that you need to think about every day. There will be things you need to do to keep your swelling under control. They will gradually become part of your daily routine.

It also helps to have support from people around you. It can make things easier for you if they understand what you need to do.

Types of treatment for lymphoedema

There are several treatments for lymphoedema. The main treatments include:

• skin care – keeping the skin in the swollen area clean, dry and moisturised and preventing injury and infection

• exercise – to keep lymph flowing through the lymphatic system and help you to maintain a healthy weight

• reducing and controlling the swelling. The main way of achieving this is by compression therapy and manual lymphatic drainage

An important part of treatment is that over time, you learn how to manage your lymphoedema. Your lymphoedema specialist teaches you how to care for your skin. They also show you how to wear compression garments if you need them. They will also teach you exercises that help keep the lymph flowing.

Intensive lymphoedema treatment

Some people with more severe lymphoedema may have a period of intensive treatment. You might have treatment 2 to 3 times a week for several weeks. This involves skin care, exercise, compression therapy, and manual lymphatic drainage. This treatment is tailored to your individual needs. 

It’s sometimes called complex or complete decongestive therapy (CDT). You might also hear is called decongestive lymphatic therapy (DLT). Not everyone who has lymphoedema needs to have intensive treatment. 

Maintenance lymphoedema therapy

Most people have maintenance therapy. This is long term treatment to help prevent the swelling from getting worse. Your lymphoedema specialist works out a treatment plan that is especially for you to control and manage your lymphoedema.

Compression therapy for lymphoedema

Compression therapy is an important part of treatment. It works by putting pressure on the area of swelling and encourages the movement of lymph fluid around the lymph vessels. The pressure needs to be even but firm in the swollen area.

There are different ways to apply compression. They include compression bandaging and compression garments.

Manual lymphatic drainage (MLD)

Manual lymphatic drainage is a way of reducing swelling caused by fluid build up after cancer treatment.

The aim of MLD is to move fluid from the swollen area into a place where the lymphatic system is working normally. This must only be performed by a specialist trained to do this.

You might be shown simple lymphatic drainage (SLD). This is a simpler version of MLD you can do yourself. A specialist needs to teach you how to do this.

Surgery for lymphoedema

There are some surgical treatments to treat lymphoedema, but they are not all widely available. 

Microsurgery for lymphoedema 

Doctors are developing specialised types of surgery called microsurgical techniques. The surgeon uses a microscope during surgery. They make tiny cuts in the skin and connect lymph channels and small veins just underneath it.

This type of surgery re-routes the lymph fluid so it can flow better. This may be more suitable for early stage lymphoedema. Research shows this surgery together with bandaging and compression garments may produce better results. But we need more research to understand more about this. This type of surgery isn't widely available.  

Liposuction

Liposuction is another type of surgery. Doctors sometimes use it for people who have had lymphoedema for a long time. And if other treatments no longer work.

Liposuction involves removing extra fatty tissue. The surgeon makes several small cuts in the skin and uses a vacuum system to remove the tissue. You usually have this surgery under a general anaesthetic.

After the procedure, you wear a compression bandage. You might also need to raise the limb for a few days. After a couple of weeks, you usually start wearing a specially made compression garment, instead of the bandage. 

Liposuction is a very specialised treatment. It is only available in a few hospitals.

Taping for lymphoedema

Taping is another way of managing lymphoedema. It was originally used for sports injuries. You might also hear it called by its trade name Kinesio taping.

Your lymphoedema specialist carefully applies a number of narrow tapes onto your skin in the area of the lymphoedema. The idea is that it lifts the skin so that the lymph flows better.

There is limited research into taping as a treatment for lymphoedema. But people with lymphoedema have found that it can help to reduce their swelling when used in combination with other treatments.

Your lymphoedema therapist can teach you to apply the tape yourself. Or they can teach a friend or relative to apply it.

You have a skin or patch test before you have the tape applied. This is to check you don't have a reaction to the tape. Your specialist will explain how they do this. 

Compression pumps for lymphoedema

This works like a muscle to pump and help encourage the flow of lymph fluid. It’s beneficial for people who are not very mobile. This is often used with other lymphoedema treatments to help them work better. 

This is not widely used as other treatments become available. But for some people, it can help. 

Mechanical compression pumps are machines. They gently ‘squeeze’ a swollen arm or leg (limb) in a sleeve or boot. This inflates and deflates at regular intervals. 

The limb might also swell again quite quickly when the pump is removed. But a pump can sometimes help to soften the tissues of a limb.

You shouldn't use the pump if:

• you have an infection or inflammation

• you have any pain when you use it

Your lymphoedema specialist will let you know how to get a compression pump if they think it will be suitable for you to use.

Low-level laser therapy

Research into low-lever laser therapy shows it can help reduce swelling for some people. It helps improve the flow of lymph fluid. This is used with other treatments for lymphoedema. It is not suitable for everyone. Your specialist will let you know more about this if you have it. 

Research

Researchers are looking at other types of treatment for lymphoedema and ways of spotting it earlier.