Every March, lymphoedema is put in the spotlight to raise awareness (as well as knowledge) about management options for those at risk of and experiencing lymphoedema symptoms. This year’s theme, “Living well with Lymphoedema” fits well with our philosophy at Calm & Connection Physiotherapy. We believe that regardless of your condition, it is possible to lead a fulfilling and meaningful life if you have the right supports and guidance. However, before we can discuss this further let’s do a quick recap about lymphoedema for those who may not be familiar with the condition.
What is lymphoedema?
Lymphoedema is a chronic condition that develops when the body has a reduced ability to transport fluid back from affected tissues due to damage, dysfunction or deformity of the lymphatic system. It can be classified into stages (0-3) depending on the extent of someone’s signs and symptoms. When left untreated, lymphoedema can cause significant disability, morbidity and even mortality which is why awareness about lymphoedema is so vital. Lymphoedema can be classified as either primary (born with lymphatic deformity) or secondary lymphoedema meaning it has been caused by some form of damage or dysfunction of the lymphatic system.
Many things can damage or cause dysfunction of the lymphatic system, with the main causes being:
- Cancers: for example lymphoma, pressure from large tumours on lymphatic structures, metastatic cancers (spread in lymphatic system), lymph node cancers.
- Infections: commonly cellulitis, tuberculosis, filariasis (transmitted by mosquito bites in tropical areas), fungal and lymphangitis can damage the delicate lymphatic vessels.
- Trauma and tissue damage: surgery, fractures, burns, circumferential scarring (scarring running around a limb) as well as radiotherapy or surgery to lymph vessels or lymph nodes can cause damage to the lymphatic system and reduce its ability to move fluid away from the tissues.
- Immobility/ dependency: long periods of sitting, morbid obesity and paralysis of a limb can reduce the ability of the body to pump lymph/fluid back to the circulation.
- Venous disease: varicose veins, post thrombotic syndrome (swelling following deep vein thrombosis), venous ulcers can all lead to lymphoedema if not well managed.
- Inflammation: for example, rheumatoid arthritis, eczema/dermatitis, myxoedema (endocrine disease) can impact on lymphatic function.
- Self-harm/bodily mutilation: can disrupt lymphatic flow by damaging fragile lymphatic vessels under the skin as well as causing scars.
Lymphoedema can develop immediately after lymphatic damage or may develop years later so it is important to be aware of warning signs that the lymphatic system is not effectively doing its job. These signs may include:
- swelling, which might come and go in the affected body part. You might notice that clothes, shoes or jewellery seem tighter than usual
- a feeling of heaviness, fullness or tightness in the affected body part
- aching and discomfort in the affected body part
- less movement in an affected arm or leg
- repeated skin infections
- skin may feel tougher or thicker
- pitting of the skin (gently pushing on the skin leaves an indentation)
The good news is that a plethora of research has been released to show that lymphoedema, when identified and treated early, can be prevented from progressing and its impact on ones life can be minimised. For this reason, it is essential that we educate our health care workers and our community to flag what signs and symptoms to recognise and also what steps to take if you think you, a client or a loved one may be developing lymphoedema.
So, what is the secret to living well with lymphoedema?
The secret to living well with lymphoedema is the following 4 actions, act, treat, move and support. Each one of these actions is essential to address lymphoedema in a hollistic way. Let’s take a closer look at what we mean by each.
Act!
If there is a chance you have lymphoedema, or you have been diagnosed with lymphoedema and are experiencing some symptom changes, do not wait before taking action – early intervention and treatment is key to prevent deterioration and progression of your condition. Contact your GP or an accredited lymphoedema practitioner to book an assessment to determine what is causing your symptoms. If you are at risk of lymphoedema (due to risk factors mentioned above), ensure you know what symptoms to look out for, knowledge is key to being able to act quickly.
Treat
Work with your accredited lymphoedema practitioner to develop a plan that can help you manage your condition, Treatment must include prescription of self-management strategies that fit with your lifestyle to allow you to take control over your lymphoedema. There are so many treatment options and different compression styles to meet individual preferences and conditions so if your current treatment plan is not working for you speak up and reach out. If you have lymphoedema, ensure you also have an action plan in place with your GP for early treatment of cellulitis to prevent deterioration of your lymphoedema.
Move
Keep physically active every day with some form of regime, be it a formal exercise program or incidental movement during you daily life. Movement helps to move fluid by the muscle pump effect as well as by encouraging deeper breaths which pump lymph fluid back into the circulation. Movement is also vital to maintain a healthy heart, lungs, maintain a healthy body weight and good mental health which are essential to living well with any chronic condition.
Support
Find your community so that you have support in your journey. Living with a chronic condition can feel overwhelming and isolating at times so surround yourself with people who can support you when you need it. Consider joining ‘living with lymphoedema’ or you state lymphoedema Facebook support group (e.g., Lymphoedema Support Group of NSW Inc.) to meet others who are going through similar experiences to you. Also consider speaking with your health practitioner and participating in group activities for support. Every individual is different but the most important thing is to find a support that works for you.
Lymphoedema may be a chronic, incurable condition but that should not stop you leading a healthy, fulfilling life if you follow these 4 actions. If ever you feel lost or overwhelmed with your condition, reach out and we will help to support you. If you think you may have lymphoedema or your lymphoedema symptoms are changing, you can book a consult online at Calm & Connection Physiotherapy [here] or find an accredited lymphoedema practitioner in your area via find an ALA Accredited Practitioner.
Until next time, be kind to yourself.
Jenny Romanczukiewicz
Physiotherapist
ALA accredited lymphoedema practitioner