Fluoroscopy-Guided Manual Lymphatic Drainage

Lymphoedema is a long-term condition that causes swelling in the body’s tissues, most often in the arms or legs. It occurs when the lymphatic system doesn’t work properly and is unable to drain lymph fluid efficiently. As fluid builds up, it leads to swelling, heaviness, discomfort, and sometimes skin changes or infections.

The lymphatic system is part of your immune system and helps remove waste, toxins, and extra fluid from the body. It includes a network of lymph vessels and lymph nodes that carry lymph — a clear fluid containing proteins, white blood cells, and waste products — back into the bloodstream.

When this system is damaged or underdeveloped, lymph can’t drain as it should. That’s when lymphoedema develops.

Lymphoedema is generally classified into two main types: primary and secondary.

Primary lymphoedema is caused by a problem with how the lymphatic system has developed. It may be due to missing or underdeveloped lymph vessels or nodes. These changes can be inherited or happen during development in the womb.

Primary lymphoedema can appear at any age — at birth, during puberty, or later in adulthood. The timing often depends on how severely the lymphatic system is affected.

Common signs include:

• Swelling in one or both legs (occasionally arms)
• Skin tightness or heaviness
• Reduced flexibility in joints
• Hardening or thickening of the skin over time

Primary lymphoedema is a lifelong condition, but with early diagnosis and proper care, symptoms can often be managed well.

Secondary lymphoedema is much more common and happens when the lymphatic system is damaged or blocked by another condition or treatment. It can develop months or even years after the initial cause.

Common causes include:

• Surgery involving lymph node removal (e.g. cancer surgery)
• Radiotherapy
• Infection (such as cellulitis)
• Trauma or injury
• Reduced mobility or venous disease

Secondary lymphoedema can affect the arms, legs, chest, face, or other parts of the body, depending on where the lymphatic damage occurs.

Signs are similar to those of primary lymphoedema but usually appear on one side of the body, especially after surgery or cancer treatment. Without treatment, the swelling can worsen and lead to skin thickening, infections, and reduced function.

While lymphoedema can’t be cured, it can be managed. Treatment focuses on reducing swelling, maintenance, and improving diet and exercise. It can feel like a lot of effort, but it all helps to improve your quality of life.

• Manual lymphatic drainage (MLD)
• Compression garments or bandaging
• Exercise and movement
• Good skin care
• Self-management techniques

Early diagnosis and tailored care are key. If you notice swelling or changes that don’t go away, it’s important to speak to your GP or District Nurse for a formal diagnosis.