Maria Mudford   - Vodder Private Lymphoedema Therapist

What is lymphoedema?
Lymphoedema is the abnormal swelling of the superficial body tissues caused by a failure of the lymphatic system to adequately collect or transport lymph. Initially there is an accumulation of protein-rich fluid but in later stages there is an increase in fatty and fibrous tissue.
Lymphoedema is most commonly associated with swelling of the upper or lower limbs. 

What causes lymphoedema?
The major cause in developed countries is due the damage caused to the lymph system as a result of cancer surgery and / or radiation. However, damage to the lymph system can be caused from surgery, burns, trauma, soft tissue damage.  In underdeveloped, tropical countries, the major cause is a parasitic infestation (filariasis) from a nematode worm which is transmitted by mosquitoes.  

How does lymphoedema occur?
Damage, blockage or absence of lymph vessels leads to a reduced transport capacity of the lymph vessel system. Fluid and proteins can then not be removed properly and they start to accumulate in the tissues especially in the skin where many lymph vessels are found. Accumulating proteins exert an attraction force for water (colloid osmotic pressure) and more water is attracted from the blood stream into the tissues.  At the same time, less fluid is able to leave the tissues because of the problems in the lymph vessel system.  The net result is that the tissue starts to swell.

When does the swelling occur?
Lymphoedema can occur at any time.  Some babies are born with this condition if they do not have a sufficiently intact lymph system (Primary).  Adolescents may develop lymphoedema in teenage years (Primary). Adults often develop lymphoedema after cancer surgery and / or radiation (Secondary). In this case the lymphoedema can appear months or years after the surgery and/or radiation or may never manifest. However all patients who have had damaged or deficient lymph systems are at risk of developing lymphoedema.

How can lymphoedema be treated?
Combined Decongestive Therapy (CDT) is a successful method of treating lymphoedema. It must be adapted to the specific requirements of each patient and treatment should only be attempted by a fully qualified therapist who understands not only the pathology but also the most appropriate treatment.

Combined Decongestive Therapy (CDT) is a combination of  
  1. Manual Lymph Drainage 
  2. Compression bandaging (or compression garments )
  3. Remedial exercise therapy  
  4. Skin care  
It may also include breathing and aquatic exercises, adjunct therapies such as low-level laser as well as dietary measures.
According to the International Society of Lymphology, this is the treatment of choice for lymphoedema.

Lymphoedema is a chronic condition that can be successfully managed with on-going maintenance.  At present there is no cure for lymphoedema.

Lymphoedema Classification:

  • Primary lymphoedema - is a congenital abnormality of the lymphatic system. Can become apparent from birth or present at puberty or as an adult
  • Secondary lymphoedema - is a result of obstruction or interruption of the lymphatic system. This can be due to cancer treatment (lymph node removal / radiation), surgery, burns, soft tissue damage (historic injuries)

References
  





http://www.lymphoedemanz.org.nz/
Kinesio Taping for Lymphoedema and Chronic Swelling
Cancer Research UK
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