1. Where can I go for support?
Most people with lymphoedema have mild to moderate symptoms.
You may need to be referred to a specialist lymphoedema service for advice and treatment. They will assess your swelling and discuss the best way to manage your symptoms. You may need regular guidance from your lymphoedema specialist to help manage your lymphoedema at first.
Your breast care nurse, treatment team or GP can refer you to a specialist lymphoedema service.
The sooner you’re assessed and treated for lymphoedema, the easier it is to control.
The lymphoedema organisations listed at the bottom of this page can also provide information and support.
2. How is lymphoedema managed?
There are various treatments and techniques to manage lymphoedema. These aim to:
- Encourage lymph fluid to move away from the swollen area
- Improve symptoms of lymphoedema
- Stop symptoms getting worse
Managing lymphoedema may involve some, or all, of the following at different times:
- Skincare
- Physical activity and exercise
- Compression garments
- Compression bandages
- Maintaining a healthy weight
- Manual lymphatic drainage (MLD)
- Self lymphatic drainage (SLD)
- Kinesio Taping (an adhesive tape that helps encourage lymphatic drainage)
- Surgery
You may be able to manage some of these yourself, such as skincare, physical activity and exercise, under the guidance of your GP or treatment team. However, you may also have specialist treatment to help manage your lymphoedema.
Skincare
Having excess lymph fluid in areas with fewer lymph nodes can increase the risk of infection in these areas.
An infection can damage the lymphatic system and may make lymphoedema worse.
Having a good skincare routine can help reduce the risk of infection.
Read more about reducing your risk of infection on our lymphoedema page.
Physical activity and exercise
Physical activity is a good way of managing swelling. This is because moving the muscles encourages lymph fluid to move away from the swollen area.
It’s usually possible to carry on doing any exercise and sporting activities you did before you developed lymphoedema. However, you may not be able to perform at the same level as before.
If you want to increase your activity levels or take up a new activity, do it gradually. Stop if you have any discomfort or notice further swelling.
Some people find activities such as running, swimming, cycling, Nordic walking and yoga helpful.
If you use gym equipment, speak to your lymphoedema specialist or treatment team to make sure that it’s safe to do so. Start with light weights until you’ve built up enough strength to use heavier ones without discomfort or increased swelling.
If you have a compression garment, wear this when exercising. If your compression garment is uncomfortable, make an appointment to get the size checked with whoever fitted the garment.
You don’t need to wear compression garments while swimming. Wash your skin after swimming to get rid of chemicals from the pool or salt from the sea.
Deep breathing exercises can also help the movement of lymph fluid. You can find more information and tips on the Cancer Research UK website.
Arm and shoulder exercises
Your lymphoedema specialist, breast care nurse or physiotherapist may give you some specific shoulder, arm or hand exercises to encourage movement and help improve lymph drainage.
You can also try our arm and shoulder exercises for lymphoedema.
Keeping your arm and shoulder moving will help avoid stiffness and prevent further swelling.
You can exercise your arm when you’re walking around by slowly bending and straightening it at the elbow. To relieve pressure and swelling in the hand, try slowly opening and closing your fist as if you’re squeezing a rubber ball. Avoid letting your arm hang down for long periods of time, as this can encourage the lymph fluid to collect. Keep your arm at chest level when resting.
If you’re unsure about what exercises to do, speak to your lymphoedema specialist, breast care nurse or physiotherapist.
Maintaining a healthy weight
It’s important to try to maintain a healthy weight, as this can affect how much your arm swells and how you may respond to treatment.
Eating healthily and doing regular physical activity can help you maintain a healthy body weight.
If you’re concerned about your weight, your GP, treatment team or lymphoedema specialist may be able to advise you on losing weight. Or they may refer you to a dietitian for further advice and support.
Compression garments
Compression garments are designed to encourage lymph fluid to drain away from the affected area. This helps to reduce existing swelling and prevent further swelling.
Your lymphoedema specialist will assess your symptoms to see which size and type of garment is most suited to your needs. This might be:
- A compression sleeve or glove (if the swelling is in your arm or hand)
- A compression bra or vest, similar to a sports bra (if the swelling is in your breast or chest area)
The compression garment may feel uncomfortable at first, but it should be supportive without causing pain or discomfort. If you have any concerns about the garment, contact the lymphoedema specialist who fitted it.
How to put your garment on
The lymphoedema specialist fitting you with the garment should show you how to put it on and take it off.
It’s sometimes difficult to apply compression sleeves, so they should give you an applicator. The Lymphoedema Support Network can also tell you where you can buy applicators.
When using a compression garment:
- Put it on in the morning when there is usually less swelling
- Make sure it doesn’t have any wrinkles and that the fabric is evenly spread
- Never turn the top of the garment over if it seems too long, as this will put too much pressure on one area (you may need a shorter garment instead, so talk to your lymphoedema specialist)
When to wear your garment
The compression garment is most useful when your muscles are working actively. It is least useful during rest.
You can start by wearing it for a few hours each day, then gradually increase the time so you’re eventually wearing it all day. Your lymphoedema specialist will advise you about this.
If you’re struggling with wearing a garment, and your lymphoedema specialist has checked it fits correctly, try wearing it when you’re at your most active. This could be when you’re doing exercise, gardening, housework or physical work. You can then take it off when you’re less active.
Your lymphoedema specialist may suggest wearing your compression garments when flying. This may be more beneficial for long-haul flights (over 4 hours). Regular exercise and self-massage may also help manage any swelling.
Wear your compression bra, if you have been given one, during daytime hours. Your lymphoedema specialist will tell you if it’s suitable to wear it at night if you find it comfortable to do so.
Some compression sleeves are also designed to be worn at night. You can ask your lymphoedema specialist if this would be appropriate for you.
Problems to look out for
Contact your lymphoedema specialist if:
- You have concerns about how your garment fits
- You find it painful to wear your garment
- You notice a change in sensation in your arm or hand (such as numbness or tingling), breast or chest
- You notice a change in colour at the tips of your fingers
- You notice a skin reaction when wearing the garment
- Your skin feels sore or itchy
- You notice swelling in areas the garment doesn’t cover
Replacing your garment
You’ll normally be given 2 compression garments. This is so you can wash 1 while wearing the other. Regular washing according to the care instructions will make the compression garment last longer.
You’ll need to replace compression garments about every 6 months to make sure the compression level remains correct for the amount of swelling you have.
Contact your lymphoedema specialist about getting a replacement garment.
Compression bandages
Compression bandages are used if:
- The swelling makes it difficult for a compression garment to fit your arm correctly
- Your skin has become damaged and sore
Your lymphoedema specialist, or another trained healthcare professional, will put several layers of bandages on your arm. At first these can make your arm seem bigger than normal. They may also feel bulky, so you may need to wear clothes that allow for the extra bulk of the bandages.
You’ll need to go to the lymphoedema clinic regularly to have the bandages changed.
Usually your arm shape will change and the swelling will reduce over 2 to 4 weeks of regular bandaging. Once the swelling has reduced your lymphoedema specialist will then be able to fit a compression garment to control any swelling that remains.
It’s important to exercise and move your arm as much as possible while the bandages are in place. This will improve their effectiveness.
An alternative to compression bandages for your arm and hand are compression wraps. These are foam tubes with Velcro fastenings. Your lymphoedema specialist will let you know if these are suitable for you.
Manual lymphatic drainage (MLD)
Manual lymphatic drainage (MLD) is a specialised type of massage carried out by a trained practitioner. It can be used for any swelling caused by lymphoedema, but it’s usually used when the swelling is severe or difficult to manage. MLD can be particularly useful over areas where compression garments cannot easily be worn, such as the breast or chest.
The MLD therapist uses hand movements to stimulate lymph drainage and move lymph fluid away from areas where it has collected. It’s a slow, rhythmical treatment that takes time to complete.
MLD is usually combined with other compression treatments, such as a compression garment, to achieve a better result. MLD can help to reduce fibrosis, as well as reduce pain and discomfort.
Your lymphoedema specialist can discuss if MLD may be helpful for you. This treatment is available in some NHS hospitals, Macmillan centres or privately. To find out if there is a trained MLD therapist in your area, talk to your lymphoedema specialist.
If you use a private MLD therapist, check they’re registered with MLD UK.
Self lymphatic drainage (SLD)
Your lymphoedema specialist may teach you a simple type of skin massage called self lymphatic drainage (SLD). This is based on the principles of MLD.
If you’ve been taught SLD, your lymphoedema specialist will advise you to do it 1 or more times a day, depending on your condition. You need to do SLD carefully and not change the sequence of the movements you were taught.
If you find it difficult to do SLD yourself, someone else can be taught how to help you with it.
The technique is best done without using oils or cream on the skin to keep good contact between the hand and the skin.
Videos demonstrating SLD is available on the Lymphoedema Support Network YouTube channel.
Kinesio Taping
Kinesio Taping is suitable for some people with lymphoedema. It uses a particular type of adhesive tape that a lymphoedema specialist applies to the skin. They can show you how to replace the tape.
The tape lifts the skin during movement and encourages lymph fluid to move towards other areas and the lymph nodes.
Kinesio Tape is usually used with other forms of lymphoedema treatment. However, it’s sometimes used on its own to manage lymphoedema if it develops in areas such as the breast and chest wall. It can also be used to soften and reduce fibrosis.
3. Other treatments for lymphoedema
The following treatments are sometimes used to manage lymphoedema, but their benefits are less clear.
Surgery
Research is looking at using surgery to treat lymphoedema. Surgery may be considered for some people. However, it’s not yet widely available and may not always be successful.
Lymphatic reconstruction (lymphaticovenous anastomosis (LVA))
Microsurgery (lymphatic reconstruction) for lymphoedema is a relatively new procedure. It’s done under local anaesthetic by plastic surgeons with special training in microsurgery. It aims to join lymph and blood vessels to help the lymphatic system transport more lymph fluid.
Lymph node transfer
Lymph node transfer involves removing healthy lymph nodes from 1 part of the body and transferring them to the armpit area.
Liposuction
This is a surgical procedure where fat is removed from the affected area.
It’s not standard treatment for lymphoedema in the UK. It should not be considered before other therapies, such as exercise, compression bandaging and MLD, have been tried.
Liposuction aims to reduce swelling, improve movement and reduce pain and discomfort. People who have this procedure are advised to wear a life-long compression garment 24 hours a day to keep the swelling down.
Compression pumps
Mechanical compression pumps mimic the effect of MLD by squeezing the swollen arm in a plastic sleeve which inflates and deflates at regular intervals. Pumps are usually used alongside other lymphoedema treatments.
They should never be used without the advice and close supervision of your lymphoedema specialist.
Low-level laser therapy
Research is looking at using a low-energy laser to improve the flow of lymph fluid. Some studies suggest it may be helpful in reducing the amount of swelling, fibrosis and discomfort.
4. Living with lymphoedema
For some people, living with lymphoedema can be harder than coming to terms with a breast cancer diagnosis. You may have a mixture of feelings depending on the degree of swelling and how it affects your daily life.
Having lymphoedema can also affect your self-confidence and body image, including how you feel about intimacy and sex.
You can speak to your breast care nurse, treatment team or lymphoedema specialist if you need support living with lymphoedema.
You can also call our helpline – see below.
We can put you in touch with a trained volunteer who has lymphoedema through our Someone Like Me service, so you can share experiences and get practical and emotional support – also see below.
Or you can chat to other people living with lymphoedema on our forum.
And you can find more information and support from:
