How to Manage Lymphoedema in the Legs

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Lymphoedema is a condition where the accumulation of excessive amounts of protein-rich fluid in the tissue results in swelling of one or more regions of the body. Lymphoedema usually affects the limb(s) although it may also involve the trunk, breast, head and neck or genital area. These body regions are generally associated with lymphatic territories (also called lymphosomes).

Lymphoedema is due to a failure of the lymphatic system and occurs when the demand for lymphatic drainage exceeds the capacity of the lymphatic circulation.

Primary lymphoedema

Primary lymphoedema is characterised by structural problems with the lymphatic system. The vessels may pump sluggishly or there may be insufficient numbers of vessels, or both may occur. Primary lymphoedema may be present before birth (congenital lymphoedema) or may develop during puberty (lymphoedema praecox) or middle age (lymphoedema tarda).

For those people who have a structural problem with the lymphatic system, the risk of developing a secondary lymphoedema overlying it is higher if they have surgery or radiotherapy for cancer treatment or other surgeries.

Secondary lymphoedema

Secondary lymphoedema is caused by obstructions in the lymphatic drainage system. This may be due to surgery, radiotherapy, trauma, lack of movement or an allergy.

How many people are affected by lymphoedema?

According to the US National Library of Medicine primary lymphedema affects 1 in 100,000 individuals and secondary lymphedema is the most common cause of the disease and affects approximately 1 in 1000 Americans.

In Australia, around 300,000 people will experience lymphoedema at any given time. According to the Cancer Council approximately 20% of patients treated for breastmelanoma, gynaecological or prostate cancers will develop lymphoedema.

8 tips to manage lymphoedema in the legs

A patient who was diagnosed with primary lymphoedema (hereditary) over twenty years ago shares his top 8 tips on how to manage lymphoedema in the legs.

Lymphoedema patients should always first consult their GP or healthcare professional.

  1. Contact a lymphoedema clinic/service in your state or territory. These trained professionals will be able to provide tailored advice on how to manage your condition. This includes lymphatic drainage massage and whether you need to wear a compression garment/s. You will need a referral from your GP.  
  2. Self-perform a lymphatic drainage massage each morning. The lymphoedema clinic/service will be able to show you how to perform this correctly.  For more information about a lymphatic drainage massage – visit here.
  3. Use a tapping handheld massager to stimulate circulation in the legs before and after self-performing the lymphatic drainage massage. Please don’t use a percussion/vibration massager or message gun as they are not the right type of handheld massager.
  4. Wear a compression garment on the affected leg/s. Most patients wear these garments during the day. There are some certain circumstances where a patient could wear a looser compression garment at night (older, intact garment) however they should first seek advice from their healthcare professional or local lymphoedema clinic/service. Please note that some patients could develop an ingrown toenail by wearing the closed toe compression garment/s. In these circumstances, they should consider only wearing the open toe garment/s.
  5. Have a lymphatic drainage massage performed by a trained professional at least once every three weeks. Find a qualified healthcare professional trained in lymphatic drainage – a gentle, manual treatment technique. Some trained professionals also combine this type of massage with an acupressure massage. Please do not have a sports massage.
  6. Look after your skin, especially your feet. Avoid cracks in your skin which is where infection can start: Depending on the severity of your swelling, don’t walk around your home without footwear such as slippers, Always wear thongs or something similar in a hotel or public shower, Ensure you always have dry shoes and socks as wet shoes or socks could lead to a cellulitis infection, Use a hairdryer to dry between your toes after a shower, bath or swim, Regularly visit a podiatrist to cut your toenails and carefully remove dead skin and heel callus. GPs can assess patients for a Care Plan where patients will receive subsidised podiatry care.
  7. Learn more about lymphoedema management. It is vital that everyone with a medical condition take an active interest in learning to properly manage their condition. A great starting point for lymphoedema management is There is also a wealth of information online both from here in Australia and internationally.
  8. Recognise the signs of cellulitis and urgently seek medical help. If you have lymphoedema, the build-up of fluid in your tissues makes you more vulnerable to infection. Cellulitis is a bacterial infection of the deep layer of skin (dermis) that often affects people with lymphoedema. 

References Lymphoedema. Retrieved 4/7/2022

Healthline. How to perform a lymphatic drainage massage. Retrieved 4/7/2022

Better Health Channel: Lymphoedema. Retrieved 4/7/2022

Cancer Council: Lymphoedema. Retrieved 4/7/2022