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Joachim Zuther, Lymphedema Specialist. Read more
Solaris
MediUSA

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Do’s and Don’ts for Lymphedema of the Arm

 

Certain activities may trigger the onset of lymphedema, or may exacerbate the symptoms of existing lymphedema. Individuals affected by primary or secondary lymphedema and those at risk for developing it (everyone who has undergone lymph node excision and/or radiation treatments) should observe the following precautions. The “Do’s” and “Don’ts” below are based on decades of experience and knowledge of clinical experts in the field of lymphedema management.

Skin Care

  • Keep your skin meticulously clean and check frequently for any cracks, infections or rashes
  • Moisturize your skin daily, especially after taking a shower or bath
  • Use appropriate ointments or lotions
  • Dry your skin thoroughly with a soft towel following a shower or bath; do not scrub
  • If you undergo radiation therapy, apply the ointments recommended by your physician to any radiation redness on your skin and avoid direct exposure to sunlight
  • Avoid cosmetics that irritate the skin

Clothing – Jewelry – Compression Sleeve – Prosthesis

  • Avoid clothing that is too tight, for example bras and sleeves that restrict; you should use a comfortable bra with wide and padded shoulder straps
  • Do not wear tight jewelry and avoid elastic bands around your wrist
  • Wear your compression sleeve all day, and if necessary apply your bandages at night. Use rubber gloves when you put on your compression sleeve. See your therapist at least every six months (or sooner) to check the condition of the garment
  • Discuss with your doctor and/or therapist, what kind of external breast prosthesis is appropriate in your case (heavier silicone or lighter foam)

Avoid any Injuries to the Skin

  • Shaving: use an electric razor to remove hair from your armpit or chest; do not use razor blades
  • Nail care: you should keep your fingernails cut short; avoid the use of scissors for cutting your fingernails; do not cut the cuticles. Avoid artificial nails
  • Should you smoke, do not extinguish the cigarette with your affected hand
  • Wear gloves when gardening and playing with your pets (scratches)
  • Mosquito bites: wear insect repellants, avoid mosquito infested areas
  • Injections: do not allow injections in the swollen arm or the arm at risk. Do not allow blood to be drawn from the affected arm or the arm at risk. Have it drawn from the other arm, or if both arms are affected, from the lower extremity (certain contraindications may exist)
  • Avoid blood pressure to be taken on the affected arm or the arm at risk. Have the clinician use the other arm, or if both arms are affected, an oversize pressure cuff may be used on the thigh or calf to measure the blood pressure. If you can’t avoid the blood pressure to be taken on the arm, make sure that the cuff is inflated only 10mm/Hg above the systolic pressure (this is the point at which the pulse stops) and that only manual equipment is used – automated equipment inflates generally to a very high pressure, which is held for a prolonged period
  • To take care of minor injuries, always carry an alcohol swab, topical antibiotic and a bandaid with you
  • No piercing or tattoos on the arm, back or chest

Avoid Heat

  • Avoid hot showers
  • Avoid hot packs and/or ice packs on your arm, back and chest
  • Avoid saunas, hot tubs and whirlpools. Do not sit too close to a fire place
  • Avoid traditional massage on the arm, chest and upper back area. Note: Manual lymph drainage is not considered to be a form of massage
  • Avoid sunburn – while in the sun, use sunscreen, cover the arm with appropriate clothing or a dry towel

Exercises

  • Discuss proper exercises and activities with your therapist
  • Avoid movements that overstrain. Should you experience discomfort in your arm, reduce the exercise activity and elevate your arm
  • Avoid heavy lifting

Nutrition

  • Obesity may have a negative effect on your swelling; maintain your ideal body weight
  • There is no special diet for lymphedema. Keep your diet well balanced. Most nutritionists recommend a low-salt and low-fat diet, high in fiber
  • Eating too little protein in the hope to have a positive effect on lymphedema (high-protein edema) is not recommended and may cause serious health problems. Reducing the protein intake will not reduce the protein component in lymphedema

Travel

  • Avoid mosquito-infested regions
  • Wear an additional bandage on top of your compression sleeve when traveling by car, train or air. Incorporate frequent stops, or get up from your seat frequently, elevate your arm(s) as often as possible

See your Doctor if you:

  • Have any signs of an infection, such as fever, chills, red and hot skin
  • Notice any itching, rash, fungal infections, or any other unusual changes on the skin
  • Experience pain, or an increase in swelling in your fingers, hand, arm or chest

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29 comments to Do’s and Don’ts for Lymphedema of the Arm

  • Thank you for the reminders of the do’s and don’ts , I remind my clients all the time and even give them written copies of the do’s and don’ts they really appreciate that I take the time with them and I am concerned about their Health. Thank you for the information you give, it helps alot.
    Cheryl Atkinson, LMT, CLT, CNA
    Sun Coast Massage Therapy

  • Regina

    I have had Lymphedema in my right arm for 20 years. Only ever had one infection that put me in the hospital for four days. I am doing fine. Lets fine something that will cure this situation.

  • Mary Ann

    thanks for the reminder. I will be getting ready to travel for the holidays, and it is always good to have my garments updated and ready for use.

  • Christine

    Any tips for breast lymphoedema??

  • Clinita Lynch, MHS, OTR/L-CLT

    Thank you for putting this in print again as a reminder to all of our patients; helping them realize we are not being alarmist as therapist, just trying to help.

  • Colette

    Thank you for complete list. My surgeon gave me this info 20 years ago, but years later I forgot & had an attack of cellulitis & terrible swelling of the hand & arm. Thanks to my physical therapist who used manual lymph drainage & bands, I am now okay. The travel precautions and exposure to heat I did not know. This all helps so much. Thank you!

  • Joan Blair

    No mention was made about how much weight can be lifted with the affected arm. My dr. wants me to go to the YMCA for exercise and could not tell me just how much weight I could lift on the machines. It has been 5 years since my surgery for breast cancer and removal of 12 lymph nodes in the arm. I would appreciate a comment please.

  • Since lymphedema, when left without treatment, can cause a wide range of additional problems – some quite dangerous – it is necessary for people to seek treatment.So you should be aware of the solutions.Read More

  • The do and don’t that is given in this blog is really effective and helpful for lymphedema patient and I want to tell my friend about this blog how is facing lymphedema problem.
    Source:calf compression sleeve

  • Keith

    Has any research been done regarding the cause or onset of early lymphedema from Lovenox (blood thinner) or other required injections in the abdomen? My wife had many abdominal lymph nodes removed during surgery and did not have any swelling or signs of lymphedema until starting Lovenox injections in the abdomen. The abdomen was the only place left after using up the arm and legs. These injections are daily and leave lumps or bruises as well.

  • Jaye

    I had no idea that artificial nails would pose a problem. I have lymphedema in my wrist on the side l had lymph nodes removed. It just came from nowhere! I was fine, then one night I awoke to excruciating pain in my wrist. I can barely move it! It actually feels broken. I am currently seeing an occupational therapist for lymphedema.The pain is still here! Some days it is not as SEVERE. I do get artificial nails. I’m wondering if that has ANYTHING to do with it!!

  • Lilith Nix

    Good info. I will pass this along to my medical team including my physical therapists. I have also read we aren’t supposed to lift heavy things or take diuretics.

  • selena

    I’m a breast cancer survivor since 10/2005 2 months later I found out I have lymphedema in my left arm. Its been about 4 to 5 years since I had physical therapy for my lymphedema. I was able to keep it under control with no problem. November/2013 I was involved in a car accident. A rollover accident we landed upside down once we stopped rolling. The seatbelt left my left breast bruised & aching. After a ultrasound they found scar tissue was causing the discomfort & now I’m back at physical therapy. Is it possible this accident exacerbated my problems I’m having now with my lymphedema? I was doing great with no problems til this accident. I’m so worried Thank you for your help

  • Rosemary

    Dear Angela.
    I too have primary lymph edema that showed up when I was 20. I exercise a lot too but need a lot of compression and it gets very swollen. Where is the site of your blockage?
    Thanks rosemary

  • Tammy Griffin

    All at one time i got shingles;lymph edema set in plus i had a dislocated disc in my neck.I felt like i was dieing.I’m now dealing with the lymph edema which is a result of 34 lym. nodes being took out.Is this something that will affect me for the rest of my life or is it due to the radation??

  • Mindy Henson

    I have primary lymphedema in both arms due to the swelling of lymph nodes from sarcoidosis. Compression garments cut off circulation at the wrists and upper arms. I have been measured many times but can’t get a proper fit. Any suggestions?

    • Joachim Zuther

      You should be measured by a therapist who was trained and certified in lymphedema management. Please click on the “Find a Therapist” tab on the menu bar on tp of this page in order to locate a therapist in your area.

  • Tina Mueller

    I was diagnosed with breast cancer in March 2014. I had two lumpectomies on left, 4 nodes left side, and 1 node right side during bilateral masectomy. I had the exchange to implants, have nipple surgery scheduled, and was looking forward to finishing with nipple tattoos. After reading this article, I am concerned with the tattoos. Why would doctors recommend this if it puts us at risk for lymphedema?
    I have not had any symptoms and can’t imagine the implications should I be diagnosed (I am a dance teacher). Have any studies correlated the onset of lymphedema with nipple tattoos? Thank you.

  • Tina Mueller

    Thank you. Good to hear!! I really want to look as I did before diagnosis…or as close as I can get.
    I recently read about dry brushing the skin to aid the lymphatic system. Is this something you would recommend?

  • Susan

    ^Regarding Keith’s comment about Lovenox, I was hospitalized for 8 days and getting twice daily blood thinner injections in the abdomen. I started having abdominal lymphedema shortly after I was discharged. I thought there was a correlation, but obviously there is no way to prove it. At the time I didn’t know it was lymphedema, so after multiple tests and 3 different doctors with 3 different answers, I finally figured out what it was. I still have a hard time convincing the doctors it is lymphedema.
    I am fortunate to have a couple of amazing therapists that help me keep my lymphedema under control. I don’t know what I would do without them.

  • Tina

    It is frustrating to see that we should not use ice/heat & to avoid regular masssge. In addition to lymphedema in my arm from a mastectomy… I also have arthritis & severe back/neck pain issues.

  • STEPHANIE

    I am affected in both hands and arms and I need to receive a shingles injection. Is there another area in which this injection can be administered? No one has been able to answer this question. The offices I have called only give the injection in the arm. I am very afraid of taking it in my arm even though it is only in the epidermis. Thank you!

  • Nancy W

    I would never recommend using an electric shaver to shave the hair in the armpit area. I tried that and the shaver chewed up my skin far worse than a razor would’ve. I now use a lotion-based chemical hair remover which works really well.

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