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Lymphedema and Risk Reduction Guidelines

March is Lymphedema Awareness month!

Read more about lymphedema and ways to reduce the risk for developing lymphedema.

What is lymphedema?

Lymphedema is an abnormal accumulation of fluid that causes swelling. This most often occurs in the arm(s) and/or leg(s), but can occur elsewhere. This accumulation of fluid happens when the lymphatic system has been damaged or becomes deficient, and the amount of lymph fluid in the affected area exceeds the lymphatic system’s ability to drain it.

Lymphedema usually starts slowly and worsens over time. Once a person has chronic lymphedema, there is no cure. Early detection is extremely important for best results. If you notice even mild changes in the size of your limb, notice jewelry/clothes fitting more tightly on your involved side or even have a sensation of heaviness or fullness, you should contact your physician or therapist. Lymphedema is manageable and many who have it lead full, complete lives.

Lymphedema can be managed by treatment called Complete Decongestive Therapy (CDT). This treatment consists of manual lymphatic drainage (MLD), compression, skin and nail care and exercise. Three factors that are well documented in research that increase risk of developing lymphedema are:

1. Number of lymph nodes removed: the higher the number the greater the risk

2. Radiation treatment to the area: particularly to lymph nodes 3. Obesity

Once you have damage to your lymphatic system, the onset of lymphedema is always going to be a risk. This risk does not decrease over time.


You may have lymphedema if:

  • The area feels full or heavy

  • Your skin feels tight

  • You have less movement or flexibility in the extremity You have difficulty fitting into clothing or jewelry

  • Lymphedema itself is not painful, although some report achiness in the extremity. The swelling may worsen pain from other conditions.

  • Early on, these symptoms may be relieved by elevation or rest.

  • If you notice any of these signs and they persist for 1-2 weeks, call your physician and ask to see a lymphedema therapist. Early diagnosis and treatment of lymphedema improves your prognosis.


Below are guidelines for people who are at risk for or who currently have lymphedema. While there has been no proven way to prevent lymphedema, by following these guidelines you may lower your risk of developing or worsening lymphedema.

1. Try to avoid injuries to the skin.

  • Because the lymphatic system is a part of our immune response, damage to the skin causes increased work for the lymphatic system and can lead to infections.

  • Keep the affected area clean, dry and well-moisturized with use of mild, fragrance- free skin care products. Try to avoid burns from cooking and smoking. Avoid having your cuticles cut.

  • If an injury does occur, wash with soap and water, apply an antibacterial ointment and keep the area clean.

  • Observe for signs of infection (swelling, redness, warm to touch). If you suspect an infection, contact your physician immediately. Try to avoid cuts and scratches from pets, shaving and working outside.

  • When outside protect exposed skin with sunscreen and insect repellent. Try to avoid having injections and blood draws taken from the affected area.

2. Try to avoid extreme temperatures

  • Extreme heat or cold can cause increased blood flow to the area, resulting in increased work for the lymphatic system.

  • Avoid immersing the affected area in water temperatures above 102°F. Avoid prolonged (>15 minutes) exposure to heat, particularly hot tubs and saunas.

  • Avoid exposure to extreme cold or heat, including ice and hot packs.

3. Try to avoid constriction of the area

  • The initial lymph vessels are just under the surface of the skin, so they can be easily constricted and therefore potentially damaged or contribute to restricting lymph flow.

  • Wear a well-fitted bra without underwires; wear a lightweight prosthesis.Be sure jewelry and clothing don’t bind tightly.

  • Try to avoid having your blood pressure taken in the affected extremity.

4. Nutrition is important

There is no proven diet for lymphedema. It is important to maintain a normal, healthy weight. Today most nutritionists recommend a diet low in salt and fat and high in fiber. It is also important to stay well hydrated, so always drink plenty of water.

5. Try to avoid overuse with daily activities/lifestyle

  • Movement and exercise assist the lymphatic system in collecting and moving fluid. However too much or too little activity can cause lymph fluid to accumulate.

  • When you are doing more activity than what is normal for you, do so in moderation, take frequent rest breaks, listen to your body and drink plenty of water.

  • Gradually build up the duration and intensity of any activity or exercise.

  • Try to avoid doing outdoor activities in the heat of the day.

  • If you spend extended periods of time on a computer, take frequent breaks.

  • Household activities that you used to do frequently or for longer durations such as housecleaning, cooking or yard work may now need to be done in smaller sessions.

  • Deep tissue massages can overwork the tissue and increased fluid production in the area. Try to avoid these in the affected area.

6. Air travel

  • Air travel may be an issue for some who are at risk for or who have lymphedema for the following reasons: Decreased air pressure: The decreased air pressure in the cabin of the plane may allow more fluid to collect in the tissues. It has been found to be more of a risk with longer flights at higher altitudes.

  • Inactivity: Get up and move around as able, and move your affected extremity frequently while seated.

  • Dehydration: Drink extra water before, during and after the flight; minimize or avoid salty snacks, caffeine and alcohol. Luggage: Avoid carrying shoulder bags on the affected side, use luggage with wheels when able and seek help when needed.

  • Wearing compression garments on the affected limb(s) during air travel and up to 3 hours after air travel helps to maintain normal tissue pressure to prevent fluid accumulation.

7. Additional guidelines for lower extremity lymphedema

  • Avoid: prolonged sitting and standing, sitting with your legs crossed and walking barefoot. Wear proper, well-fitting footwear.

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