Lymphoedema - Treatment 

Treating lymphoedema 

Lymphoedema can be treated with special bandages and compression garments that move fluid out of the affected limb 

Future research

A number of ongoing clinical trials are investigating the treatment of lymphoedema. Clinical trials are a type of medical research that test one type of treatment against another.

Read more information about clinical trials for lymphoedema.

The recommended treatment for lymphoedema is a treatment plan called complex decongestive therapy (CDT). It is also known as decongestive lymphatic therapy (DLT).

CDT is not a cure for lymphoedema, but it can help control the symptoms of swelling and pain. Although CDT takes time and effort, it can be used to effectively control your lymphoedema.

Complex decongestive therapy (CDT)

There are four components to CDT treatment:

  • Manual lymphatic drainage (MLD) is a specialised massage technique designed to stimulate the flow of fluid and reduce swelling.
  • Multilayer lymphoedema bandaging (MLLB) uses bandages and compression garments to move fluid out of the affected limb.
  • Remedial exercises designed to activate muscles in the limb to improve lymph drainage. 
  • Skin care is required to prevent infection.

Each of these treatments is described in more detail below.

CDT begins with an intensive phase of therapy, during which you may receive daily treatment for up to six weeks. This is followed by the second phase, known as the maintenance phase. During the maintenance phase, you will be encouraged to take over your own care using simple lymph drainage techniques (MLD administered by either yourself or a carer) and exercise while wearing compression garments.

You will then have regular six-monthly review meetings to check how your treatment is progressing.

Manual lymphatic drainage (MLD)

During manual lymphatic drainage (MLD), your lymphoedema therapist will use special massage techniques to move fluid from the swollen areas into working lymph nodes where it can be drained.

It is important you receive MLD from a trained lymphoedema therapist and not a regular masseur. This is because the technique requires a detailed knowledge of the lymphatic system to be performed correctly.

Your lymphoedema therapist will also teach you a range of massage techniques you can use during the maintenance phase.

MLD may not be suitable if you have certain health conditions. For example:

Multilayer lymphoedema bandaging (MLLB)

Unlike the blood circulation system, there is no central pump, such as the heart, to move fluid around the lymphatic system. Instead, the lymphatic system uses the massaging effect of the muscles surrounding the lymph vessels and nodes to move the fluid.

The aim of multilayer lymphoedema bandaging (MLLB) is to support the muscles during exercise and encourage them to move fluid out of the affected limb. MLLB is often used after a session of MLD to prevent fluid accumulating in the limb again.

You will be taught how to correctly apply your own bandages and compression garments so you can continue to use MLLB during the maintenance period.

Remedial exercises

Remedial exercises are designed to strengthen muscles involved in lymph drainage. You will be given an exercise plan tailored to your requirements and ability.

Skin care

Taking good care of your skin is important because it will reduce your risk of developing an infection, such as cellulitis. You should be given a daily routine to follow, where you are required to meticulously clean your skin and check for any cuts, abrasions or signs of infection.

Read information about preventing lymphoedema for more advice about skin care.

Surgery

In some cases, a surgical procedure using liposuction (where a tube is used to suck fat out of tissue) can be used to treat lymphoedema.

Liposuction is used to remove excess fat from the affected limb to help reduce swelling. Once the surgery is complete, you will have to wear a compression garment on the affected limb for at least a year.

The National Institute for Health and Clinical Excellence (NICE) has announced that liposuction for chronic (long-term) lymphoedema is acceptable in terms of clinical safety. However, NICE states there is currently no evidence about its long-term effectiveness or whether there are risks of long-term complications.

Access to liposuction for lymphoedema may be limited depending on what is available from your local primary care trust.




Page last reviewed: 20/07/2012

Next review due: 20/07/2014

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The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

lock73 said on 14 April 2013

I read about this surgery happening in Oxford in an article in Daily Mail (9.4.13 you can read it on line). It seemed very positive as a treatment for lymphoedema and has certainly got good evidence of working from research. This supermicrosurgery seems to be happening in Japan, USA, Spain and Italy. Finally it seems as if the UK are waking up to the need to properly help sufferers of lymphoedema.

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Red panda said on 19 April 2012

I agree with Joop. There are favourable outcomes being achieved through microsurgery through the use of shunting the lymph system. However this occurring outside the UK. Why is this not reported? Why is the NHS closing it's eyes to this field or not a least conducting research to help find a surgical cure for this dreadful condition so thousands of sufferers can benefit?

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Red panda said on 19 April 2012

I agree 100% with Joop. The NHS has been at best lukewarm to research in finding a permanent solution to Lymphoedema through surgery. There is excellant work being conducted in Italy with shunting of the lymph system. Why is ot more resources put in helping the thousands of people suffering from this condition?

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Joop said on 22 April 2011

On surgery only the destructive technique of the liposuction is reported.
The scientifically on the hydrodynamics laws based constructive technique is not mentioned.
The results of a correct assessment may indicate a fair chance of amelioration by shunting the lymph system to the veins system. This is executed deep in the skin by microsurgery. In this technique an adequate number of lymph vessels are connected to nearby veins as to restore the lymph drainage. Immediately after the operation a reduction in the circumference of the limb occurs. Also the sensation of tension due to the accumulation of lymph disappears quite quickly. The long term (20 years) effectiness is proven.

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