Home Treatment of Lymphedema

Living with lymphedema is a significant challenge, but not an impossible task. Lymphedema usually involves swelling and fluid accumulation in the extremities, particularly the legs and hands. Although the disease is currently incurable, with treatment it can be managed, and your quality of life can be greatly improved. The most important thing you must understand: lymphedema is not a condition that can be sufficiently addressed with a short hospital treatment once a year. The key to successful treatment is daily, consistent attention and home therapy.

Why is home treatment important?

The answer is simple: lymph is constantly produced in your body with every heartbeat. If your lymphatic system is damaged, this fluid cannot drain properly and accumulates in tissues, causing swelling.

This is a continuous, uninterrupted process that cannot be resolved long-term with just a few days of intensive treatment.

Imagine it like a constantly dripping faucet – no matter how many times you mop up the spilled water once, if you don't attend to it regularly, it will keep accumulating again and again.

The situation is more severe if there is not only a problem with your lymphatic system. Concurrent venous insufficiency (chronic venous insufficiency) can contribute to worsening lymphedema and general lymphatic circulation disorders.

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Treatment in hospital or at home?

Medical treatment naturally plays an important role in managing lymphedema, especially in more severe cases.

Intensive hospital or clinic courses can help quickly reduce significant swelling. However, 360 days of the year depend on how your condition progresses at home. You are the only one who can prevent the deterioration of your condition and the need for repeated hospital treatments.

Complementary treatments helping each other

During therapy, it is important to understand that individual treatment methods do not replace but complement each other. The more methods you apply simultaneously, the more effectively you can combat the swelling. Read this article: Multimodal treatment – what does it mean?

For example, using compression stockings alone may result in about 5% improvement. Adding regular physical exercise can gain an additional 10%. Proper diet and weight loss can add another 10%. The joint application of various treatments therefore significantly increases the therapy’s effectiveness.

Comprehensive decongestive therapy – the doctors’ recommendation

Decongestive therapy is a multi-component compression treatment.

Manual lymphatic drainage.

This is a specialized, gentle therapeutic technique performed by a trained therapist to stimulate lymphatic system function, promoting the removal of excess fluid from the affected area.
Often referred to as lymphatic massage, but medically the accepted term is lymphatic drainage. Lymphatic drainage is a specific, very gentle technique that acts specifically on the lymphatic vessels near the skin surface. This differs from classical massages that target deeper muscles and tissues. The term “massage” can be misleading because lymphatic drainage does not use strong pressure or intense movements.
While traditional massage typically aims to relax muscles, relieve tension, or improve blood circulation, lymphatic drainage focuses specifically on stimulating lymph flow. The technique is therefore much gentler, following slow, rhythmic patterns.

Compression therapy.

Use of compression bandages or garments (elastic stockings, gloves) to reduce swelling and prevent further fluid accumulation.
Bandaging is especially recommended for those who move less. The bandage should be tighter at the hand or foot and gradually loosen as you move upward. This helps proper lymph flow direction.
Compression stockings are special garments that apply consistent pressure on the limb. They are useful both at rest and during movement but especially important during exercise. The combination of exercise and compression stockings is much more effective than either alone. Always select the right size and compression level with professional help.

Exercise.

It is a known fact that the main driver of lymph circulation is the muscle pump, i.e., muscle contraction and relaxation. It pumps lymph and blood. Low-intensity movements (walking, swimming, cycling, yoga, gymnastics) promote lymph flow and improve mobility.

Skin and nail care.

These are preventative measures to reduce infection risks (e.g., cellulitis) in the affected area.

Education and self-treatment.

Since lymphedema is incurable, it is essential for patients to understand and learn that daily self-care is necessary to suppress symptoms. Without this, the edema returns. Education aims to teach patients how to independently manage their condition, for example with self-massage, applying compression, and monitoring complications.

Decongestive therapy with manual lymphatic drainage was developed in the early 1900s by Dr. Emil Vodder and his wife, Estrid Vodder. The Vodder method was the first scientifically accepted technique for supporting lymph flow and is included in lymphedema treatment protocols.

In the 1960s, in Germany, enhanced lymphatic drainage was combined with other treatments such as compression therapy, skin care, and specific exercises to create the complex decongestive therapy still used today in hospitals and clinics.

With technological progress, new devices such as pneumatic compression units (commonly known as compression therapy units) have emerged, but these slowly integrate into medical protocols, often due to information gaps.

New therapeutic options

There are many physiotherapeutic devices proven to improve circulation which can help reduce lymphedema to some extent.

Mechanical compression therapy (click here for detailed info)

One of the most effective edema-reducing methods. Pneumatic compression devices inflate air chambers in connected cuffs, applying pressure to tissues. A well-set device inflates the air chambers sequentially from bottom to top, promoting lymph and blood flow upward. This method supports not only lymph circulation but also venous flow and reduces thrombosis risk.

Muscle Stimulation

Muscle contractions triggered by electrical impulses improve circulation similarly to walking, the most natural driver of lymph flow, reducing edema.
Muscle stimulators can aid swelling reduction in all severities of lymphedema. In mild edema, EMS can replace the compression therapy unit. In moderate and severe cases, EMS and compression therapy devices enhance each other’s effect.
Globus electrotherapy devices provide special 3S sequential stimulation programs for limb edema reduction. I wrote in detail about them and suitable devices in this article.

Softlaser therapy

Softlaser therapy stimulates microcirculation and contributes to edema reduction. The higher the laser class of a device, the stronger its effect on lymphatic circulation. Significant lymphedema reduction effects come from class 3 and 4 laser devices. Physical therapy clinic lasers have the most notable effect.
For edema reduction, I recommend class 3 softlasers, for example, the Personal-Laser L400 or the Energy-Laser L500 Pro device.

Magnet therapy

Stimulates microcirculation, contributing to swelling reduction.

Bemer therapy

Bemer is a unique procedure. Bemer treatment = physical circulatory therapy. It significantly improves blood circulation and contributes to enhanced lymph circulation. Its edema-reducing effect is proven.

These methods can be effective individually but achieve the best results when combined with traditional treatments.

Lymphedema management through lifestyle

Lifestyle modifications are just as important as physical treatments.

Regular exercise is fundamental for lymph circulation. Muscle contraction acts as a natural pump aiding lymph flow.

Low-intensity aerobic exercises are most suitable for lymphedema sufferers: walking, cycling, swimming, water aerobics are excellent choices. Yoga exercises are also recommended. Exercise should last at least 40-50 minutes to be effective.

Nutrition is also a key factor. Although there is no specific diet that helps all lymphatic patients equally, following certain nutritional principles can significantly improve your condition. Reducing intake of inflammation-promoting foods like processed carbohydrates (bread, pasta, pastries, sweets, snacks, sodas, fruit juices), gluten, and excessive animal proteins can help mitigate symptoms. This is especially important if you have an autoimmune disease, as inflammatory processes can worsen lymph flow.

Weight control is also essential in lymphedema treatment. Overweight can worsen the condition through multiple mechanisms. Increased fat tissue puts pressure on lymph vessels and nodes, obstructing lymph flow. Obesity often associates with chronic inflammation, causing further damage to the lymphatic system. Weight loss can therefore considerably improve symptoms.

Factors influencing lymphedema

Among environmental factors, temperature plays a particularly important role. Heat can worsen lymphedema in several ways. High temperatures dilate blood vessels, increasing blood flow to the skin and limbs. This results in more fluid moving into tissues, exacerbating edema. Heat also relaxes muscles, reducing the effectiveness of the muscle pump. Therefore, avoid sunbathing, sauna use, and excessively hot baths.

Pay attention to medication effects as well. Many drugs can cause increased edema as a side effect, such as some blood pressure meds, contraceptives, steroids, and other anti-inflammatories. If you notice edema onset or worsening associated with starting a medication, definitely consult your doctor about potential alternatives.

Key to successful treatment

The key to successful treatment is consistency and regularity. Lymph is constantly produced, so treatments must be tailored to your individual refill time. For some, treatment every two days suffices; others may need it more frequently, even multiple times daily.

The important part is not to wait until swelling causes pain or discomfort.

You must understand that lymphedema treatment is a lifelong process. Initially, this may sound daunting, but if you accept and make regular treatment part of your life, the disease will not significantly affect your daily life. Neglecting treatment will lead to gradual deterioration, eventually severely limiting your quality of life.

Lymphedema treatment is therefore a complex process based on multiple pillars in which you play the main role. Using combined therapeutic methods and lifestyle changes significantly improves your condition and minimizes symptoms. Remember: while the disease is incurable, with proper attention and treatment you can live a full, active life.

Common misconceptions about treatment

Lymphedema and diuretics

Using diuretics is generally not recommended for lymphedema because they do not address the root cause and may even worsen symptoms.

Diuretics stimulate kidney function, increasing urine production and excretion. The kidney removes water from blood vessels. Lymph is not in the blood vessels but in lymphatic vessels and mostly in tissues, so diuretics "cannot reach" it.

Diuretics reduce fluid volume in blood vessels, leading to lymph thickening and electrolyte imbalance, worsening edema.

“Only therapist-performed treatments are allowed; machine therapy is not good”

Lymph therapists often prohibit patients from using compression therapy units (regardless of edema stage). They say only manual drainage can "open the lymph gates." What's the truth?

Manual lymph drainage is currently the main method recommended in hospitals and clinics for stimulating lymph circulation and reducing swelling. Manual therapy can treat deeper tissues and fibrosis, which machines allegedly cannot.

I consider this approach harmful because:

• Most patients are not severely ill. Fortunately, only a small fraction of patients progress to the severe, fibrotic stage. So, most do not need "deep" lymphatic relaxation.
• Therapist-performed treatments are very costly. Since only 10 free treatments are reimbursable annually, patients must purchase additional sessions for the other 355 days.
  Checking a lymph therapist's price list shows a lymphatic drainage session costs about 10,000 HUF, and this is just a single session. Annually, costs may reach hundreds of thousands to millions of HUF, making regular therapy unaffordable for most.
• Access difficulties: Few therapists are available, especially in smaller towns or rural areas. Patients simply cannot easily access treatment. Appointments are given not when needed, but when the therapist is available.
• Time constraints: Patients cannot reconcile their lifestyle with regular treatments in distant clinics. It is unrealistic to travel multiple times weekly to a faraway office, which would hinder work and normal family life.

Home-use pneumatic compression devices (commonly called compression therapy units), though not fully replacing manual lymph drainage, can effectively treat mild to moderate lymphedema, which constitutes most cases.

Owning your own device allows daily use, which is especially important because lymphedema can only be reduced with continuous, regular treatment. A compression therapy unit costs about 150,000 to 300,000 HUF once but will serve for 8-10 years without additional expenses. This is far less than manual therapy costs (if a therapist is available near you).

Overall, lymphatic drainage in mild to moderate cases can be substituted by a quality compression therapy unit. Regular visits to a lymph therapist every few months remain important as conditions may change and therapy must be adjusted.

“Can a woman with lymphedema take contraceptives?”

Lymphedema means fluid accumulation between tissues. Most contraceptive pills contain estrogen hormones, which are known to cause fluid retention! The higher the estrogen content, the more so.
Theoretically, estrogen-containing pills can increase water retention and hinder lymphedema therapy success.

Note that today's contraceptives have about 70-80% less estrogen than those 10-15 years ago.

There are other options: try non-estrogen contraceptives! Progesterone-based ones do not or much less retain water and pose minimal risk of worsening symptoms.

Consult your gynecologist for choosing the appropriate medication.

A "practical" advice: not only contraceptives but other drugs can increase water retention and edema.

If your doctor prescribes a new drug, start measuring limb circumference (ankle-calf-thigh on the leg), preferably morning and evening, from the day before starting the drug.
From a carefully kept chart, it will be clear after a few days if a drug increases edema. Stop it and try another.

If after 3-4 weeks no swelling increases, the drug may be suitable. This “testing” is risk-free and safe.

Why must treatment be continuous?

The key to successful lymphedema treatment is understanding that lymph is produced with every heartbeat – unstoppable as long as your heart beats! This is perfectly normal.

Lymphedema is not yet curable today. Swelling can be reduced to near normal with regular treatment.

Treatment reduces swelling, but it accumulates again by the next session. Treatments must be timed according to individual refill rates. If your lymph refills every two days, treatment every other day may suffice. If filling occurs in hours, treatment needs to be frequent.

It's a big mistake to wait until swelling is tight, painful, cracked, or ulcerated! The longer swelling is left untreated, the harder it becomes to clear.

Videos about lymphedema

You can find my videos about lymphedema on my YouTube channel. Watch them too.