Lymphoedema & Lipoedema

Lymphoedema is swelling of a body part (e.g. arm, leg, breast, etc.) due to insufficiency of the lymphatic system. The lymphatic system is in charge of recycling the fluids and waste products in our body. It also filters the bodily fluids to get rid of harmful particles such as bacteria.

Insufficiency of the lymphatic system can be congenital, or caused by damage during trauma or cancer treatment etc. For example, breast cancer treatment may require surgical removal of lymph nodes in the armpit on the affected side. This may reduce the capacity of the lymphatic system to drain the fluids in the affected arm, and cause swelling.

Symptoms of lymphoedema include:

- swelling in the affected body part (usually an arm or a leg)

- feeling of heaviness, tightness and pain in the affected arm or leg

- stiffness in joint movement in the affected arm or leg

- skin changes such as thickening of the skin in the affected arm or leg

- slow wound healing in the affected arm or leg

Patients with lymphoedema are also twice as likely to develop cellulitis, which is infection of the skin. Patients will then require antibiotic treatment, or even hospitalization.

Once lymphoedema reaches stage 2, it is a life-long condition. However, symptoms can still be reduced significantly with treatment. This improvement then needs to be maintained with patients' self-management in the long run.

Lymphoedema is classified into four stages, namely stage 0, stage 1, stage 2 (early/late), and stage 3. 

In stage 0, patients may not display any signs or symptoms of lymphoedema, although insufficiency exists in the lymphatic system, for example due to previous cancer treatment. Small increase in fluid level in the affected body part can be identified when tested with equipment. This stage may persist for months or years before symptoms start to develop.

In stage 1 lymphoedema, swelling becomes more noticeable, and can be detected through circumference measurement of the limb. Swelling usually goes away with elevation of the affected body part.

In stage 2 lymphoedema, fibrosis starts to develop in the swollen area, gradually hardening the tissue. Swelling no longer goes away with elevation.

In stage 3 lymphoedema, fibrosis is prominent. The swollen area becomes hard. Changes of the skin become more prominent. The shape of the limb may be altered.

A combination of various treatment methods are used in treatment of lymphoedema. They include skin care, manual lymphatic drainage, bandaging, compression garments, exercises, and Kinesio taping. We also use Deep Oscillation Treatment (DOT) to enhance the effect of manual lymphatic drainage. The treatment program is customized according to each patient's stage of lymphoedema, general health, lifestyle, and budget. 

Lymphoedema should be ideally identified and treated at stage 0 or stage 1, although one may not experience severe symptoms at this stage. From stage 2, there will be some degree of irreversibility, as the damage to the lymphatic system is more extensive. But symptoms can still be improved tremendously with treatment.

Early diagnosis and treatment help to prevent serious complications in the long run, such as recurrent cellulitis, and reduced mobility. 

We work with surgeons and oncologist in Singapore to identify patients at risk of developing lymphoedema. Through education programs and regular screening, we are dedicated to prevention and early diagnosis and treatment of the condition.

Some measures to prevent lymphoedema after breast cancer include:

- Doing scar massage and stretching exercises after surgery

- Using the affected limb as normally as tolerated

- Doing regular exercises

- Maintaining a healthy weight

Our therapist visits you at your home for your treatment sessions. On the first session, the therapist will assess your condition, measure the circumference of the affected and unaffected limbs, and discuss with you to draw up a treatment plan that meets your needs. We do not provide any packages as each individual's needs are different, and treatment plan may be adjusted to meet your changing needs. 

Lipoedema and lymphoedema are completely different conditions, although they share similar treatment methods. Lipoedema is characterized by disproportional but symmetrical distribution of fat in the limbs. It exists almost exclusively in women. It may present with or without pain. Manual lymphatic drainage and compression garment can be used to relieve pain related to lipoedema. 

As more and more surgical approaches have been developed for lipoedema, we also work with surgeons to provide post-operative care.

- Our therapist is a certified lymphoedema therapist who is passionate and skillful in lymphoedema and lipoedema prevention and treatment.

- Our therapist has more than 14 years of experience in musculoskeletal health to help you manage pain effectively.

- We are equipped with a lymph scanner to accurately diagnose and monitor lymphoedema and lipoedema.

- We are equipped with Deep Oscillation Treatment (DOT) to fasten up your recovery!

- We source the best compression garments worldwide to assist with your recovery!

- We visit you at your place anywhere in Singapore

- Competitive rates - in fact, comparable to a visit to a physiotherapy clinic!

- We work together with established surgeons in Singapore!