Lymphoedema is a long-term (chronic) condition that causes swelling in the body's tissues. It can affect any part of the body, but usually develops in the arms or legs.

It develops when the lymphatic system doesn't work properly. The lymphatic system is a network of channels and glands throughout the body that helps fight infection and remove excess fluid.

It's important that lymphoedema is identified and treated as soon as possible. If it isn't treated, it can get worse.

Understanding Lymphoedema

The main symptom of lymphoedema is swelling in all or part of a limb or another part of the body. It can be difficult to fit into clothes, and jewellery and watches can feel tight.

At first, the swelling may come and go. It may get worse during the day and go down overnight. Without treatment, it will usually become more severe and persistent.

Other symptoms in an affected body part can include:

  • an aching, heavy feeling
  • difficulty with movement
  • repeated skin infections
  • hard, tight skin
  • folds developing in the skin
  • wart-like growths developing on the skin
  • fluid leaking through the skin

Lymphoedema is caused by a problem with the lymphatic system, a network of vessels and glands spread throughout the body. The main functions of the lymphatic system are helping fight infection and draining excess fluid from tissues.

There are two main types of lymphoedema:

  • Primary Lymphoedema
  • caused by faulty nodes that affect the development of the lymphatic system; it can develop at any age, but usually starts during infancy, adolescence, or early adulthood

  • Secondary Lymphoedema
  • caused by damage to the lymphatic system or problems with the movement and drainage of fluid in the lymphatic system; it can be the result of an infection, injury, cancer treatment, inflammation of the limb, or a lack of limb movement

Primary lymphoedema is rare and is thought to affect around 1 in every 6,000 people. Secondary lymphoedema is much more common.

Secondary lymphoedema affects around 2 in 10 women with breast cancer, and 5 in 10 women with vulval cancer. About 3 in every 10 men with penile cancer get lymphoedema.

People who have treatment for melanoma in the lymph nodes in the groin can also get lymphoedema. Research has shown around 20-50% of people are affected.

In many cases, lymphoedema can be diagnosed from your symptoms and medical history, and by examining the affected body part and measuring the distance around it to see if it's enlarged.

In many cases, lymphoedema can be diagnosed from your symptoms and medical history, and by examining the affected body part and measuring the distance around it to see if it's enlarged.

There's no cure for lymphoedema, but it's usually possible to control the main symptoms using techniques to minimise fluid build-up and stimulate the flow of fluid through the lymphatic system.

These include wearing compression garments, taking good care of your skin, moving and exercising regularly, having a healthy diet and lifestyle, and using specialised massage techniques.

Cellulitis is the most common complication of lymphoedema. It can also have a significant psychological impact.

Living with a long-term condition that affects your appearance can cause a great deal of distress and lead to periods of depression.

If this is the case, talk to your GP or a member of your lymphoedema treatment team. Effective treatments are available for depression.

Talking to other people with lymphoedema can be reassuring and decrease feelings of isolation, stress and anxiety.

A Therapy Session

Before your first Manual Lymph Drainage treatment takes place, a full consultation is conducted to check for any contraindications to treatment. Details about general health, medication, diet and hobbies will also be discussed.

The MLD treatment itself is conducted in a warm, comfortable room where you will be asked to undress down to your underwear, and lie on a plinth. You should be covered with towels throughout the massage, and only the parts of the body being massaged should be uncovered. A massage that is very specific to your needs will then begin. Therapy sessions may last from one hour to ninety minutes, depending upon your personal needs. It is not unusual for a client to nod off during the treatment, as it is so relaxing. Unlike other massages, no oils or powders are usually used during the treatment. Normally the treatment will focus on specific and relevant body parts at each session as opposed to a full body massage. The areas that will be treated will be discussed with you at the time of your appointment

Following the Manual Lymph Drainage massage, you will be given follow-up and aftercare advice. General lifestyle advice will also be given that is related to your specific needs, including some dietary advice and muscle stretching. Some information about using natural products at home may also be given if deemed appropriate.


  • Photographs and measurements taken before and after the treatment
  • An intensive period of treatment based on individual needs
  • A progress report post treatment for referring GP and/or consultation
  • Referral for compression garments following an initial intensive treatment


January is a popular month to start a detox, after the excesses of Christmas and New Year's celebrations.
However, there are lots of other times in the year when we look to "clean up our act' – preparation for a big event such as a wedding, as part of a beach body regime for spring or summer holidays, or fishing into that Little Black Dress for a birthday or Christmas party.

Many people embark on a detox by changing their dietary and drinking habits, introducing regular exercise and renewing a beauty regime. Adding MLD to the detox mix or trying it out as a stand-alone therapy will deliver powerful and noticeable results.

Described as "one of the best kept secrets on the health and beauty scene," the intensely relaxing effects of MLD mask the strength of the treatment itself. It is a very gentle, light touch massage that improves the ability of the body's lymphatic system to cleanse from the inside out. Specific and gentle movements of the skin stimulate and increase the rate a removal of waste products, toxins and excess fluid from the bodies tissues resulting in:

  • Clearer and cleaner skin

  • Reduced puffiness around the eyes

  • Reduced fluid retention

  • Improved skin tone

MLD also has a tonic effect on intestinal peristalsis, which in turn will aid digestion

There are usually no bad side effects, and it is perfectly safe to eat before and after an MLD treatment. It helps to drink some water after your treatment and you may need to go to the toilet more often, as the re-energized lymphatic system starts to detox the body and recycle excess fluid and waste. After an MLD treatment, you should feel more relaxed and clear headed.


According to the International Society of Lymphology, Combined Decongestive Therapy, also known as Decongestive Lymphatic Therapy, is the treatment of choice for Lymphoedema.

This is a proven combination of treatments aimed at reducing the volume of your limb. It involves an intensive treatment phase and a maintenance phase.

Manual Lymphatic Drainage to decongest the affected areas by opening up the lymphatic channels and diverting the fluid to areas with normal drainage.

Multi layer Lymphedema bandaging, where layers of bandages are applied over padding to provide a compression force to the limb. This maintains the fluid reduction achieved by MLD and may result in further reduction.

Exercises. You will be given a program of specific exercises to do while the bandages are in place. Bandages apply a compression force to the lymphatics and exercising in bandages augments the pumping force of the muscles.

Skin Care and Hygiene. Good skincare plays an essential part in the treatment of Lymphedema. Daily washing with pH neutral cleansers and application of moisturizing cream will help to eliminate possible bacterial fungal growth and so minimise the possibility of repeated attacks of cellulitis.

Breathing exercises. The thoracic duct runs upwards through the chest cavity and carries lymph back to the heart. Flow in this vessel can be improved by breathing exercises which create a suctioning effect.

The intensive phase of treatment may continue for as long as 2 to 4 weeks. Towards the end of this phase you will move towards the maintenance phase. You will be measured for a compression garment which may be off-the-shelf or custom-made. This garment is an essential element in maintaining the reduction in volume achieved in treatment. The garment style recommended will be carefully chosen for you to try to ensure it fits into your lifestyle so that it will be worn.

Longer-term follow-up and support will be provided as necessary and the physiotherapist will be happy to show you or a loved one how to bandage the limb if this is considered necessary.
The aim of treatment is to enable you to manage your condition in the longer term to minimise the risk of complications such as cellulitis. This document is a useful resource and may be helpful to bring to your GP if you have an infection, as many doctors don't have a great deal of expertise in dealing with Lymphoedema.

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