Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
Daily activities and the ability to work or enjoy hobbies may be affected by Lymphoedema. These symptoms may occur very slowly over time or more quickly if there is an infection or injury to the arm or leg.
Lymphoedema is essentially incurable but it can be managed very successfully.
There is no evidence that diuretics help. They may just give you side effects or hypokalaemia.
The treatment that we recommend and practice is Combined Decongestive Therapy (CDT).
Stage 0 : (latent or subclinical )
In this stage the transport capacity of the lymphatic system is reduced, but the remaining lymph vessels are sufficient to manage the flow of lymph, and swelling is not visibly present.
Stage 1 : (spontaneously reversible):
Tissue is still at the “pitting” stage, which means that when pressed by fingertips, the area indents and holds the indentation. Usually, upon waking in the morning, the limb(s) or affected area is normal or almost normal size.
Stage 2 : (spontaneously irreversible):
The tissue now has a spongy consistency and is “non-pitting,” meaning that when pressed by fingertips, the tissue bounces back without any indentation forming). Fibrosis found in Stage 2 Lymphoedema marks the beginning of the hardening of the limbs and increasing size.
Stage 3 : (lymphostatic elephantiasis):
At this stage the swelling is irreversible and usually the limb(s) is/are very large. The tissue is hard (fibrotic) and unresponsive; some patients consider undergoing reconstructive surgery called “debulking” at this stage.
An individual assessment is essential to ascertain suitability for the treatment. The complete treatment plan will include:
Bandages are applied after each MLD treatment to help maintain the reductions achieved with Manual Lymph Drainage and may even cause further reduction. They are short-stretch bandages that resist muscle contraction and are applied with comfortable padding underneath. Bandages are removed when the limb(s) volume is reduced. Thereafter it is replaced with appropriate compression garment.
Skin care is of vital importance and should be stressed to each patient, even those with Stage 1 lymphoedema. The aim of a good skincare routine is to improve and maintain skin integrity by concentrating on:
Lymphedema treatment should be handled by a well-trained therapist. In many places, including Ireland, there are no mandated training standards. Consequently, some therapists lack proper qualifications. To address this, international schools have set best practice standards endorsed by MLD Ireland, which has maintained a therapist register since 2000. Members of MLD Ireland are certified through internationally recognized programs, used by health organizations and insurance companies. All members have completed rigorous training with hands-on experience, examined by lymphoedema specialists, and certified to the highest standards. MLD Ireland does not accept primarily online courses. Therefore, therapists holding a membership certification from the MLD Ireland are properly qualified.
Oedemas caused by Cardiac failure or Renal diseases, Deep vein Thrombosis (blood clot), Cellulitis, active cancer and infection are not suitable for MLD treatment. If there is any doubt, discuss with your therapist, doctor or consultant.
