Lymphoedema is chronic swelling that occurs when the lymphatic system cannot transport tissue fluid away, either because the lymph vessels are congenitally underdeveloped (primary lymphoedema) or because they have been damaged by surgery, radiotherapy, infection or injury (secondary lymphoedema). The most common forms in Sweden are arm or breast lymphoedema after breast cancer treatment and leg lymphoedema after gynaecological or prostate cancer. Lymphoedema does not go away on its own, but it can almost always be brought under control with treatment through healthcare: compression, manual lymphatic drainage, exercise and skin care, led by a lymphoedema therapist. This page explains the symptoms, how treatment works, what you can do yourself and, since we sell massage cups, why cupping at home is not the right tool for lymphoedema without a therapist's guidance. For ordinary, passing swelling (heavy legs after a long day), Fluid retention in the body is the right guide.
Symptoms of lymphoedema
- Swelling in an arm, a leg, a hand or foot, the chest or (more rarely) the face or genitals, usually on the side that was treated or operated on.
- Heaviness, tight skin, tension; clothes, rings and watches feel tighter on one side.
- Early: the swelling comes and goes, a fingertip press leaves a dent (pitting oedema) and it reduces overnight.
- Later: the skin becomes firmer, the swelling remains in the morning and the skin fold at the base of the toes or fingers cannot be pinched up (Stemmer's sign).
- Repeated skin infections (erysipelas/cellulitis) in the swollen limb.
Swelling that starts within a few years of cancer surgery with lymph node removal or radiotherapy should always be assessed by healthcare, even if it is small. The earlier treatment starts, the better it works.
Causes
| Type | Cause | Common with |
|---|---|---|
| Primary lymphoedema | Congenital abnormality of lymph vessels or nodes | Often starts in the teens or early adulthood, usually in the legs |
| Secondary lymphoedema | Lymph nodes removed or irradiated, infection, trauma, chronic venous insufficiency, severe obesity | After breast cancer (arm), gynaecological cancer, prostate cancer and melanoma (leg), after repeated erysipelas infections |
Lipoedema (symmetrical, tender fat accumulation on legs and arms) is a different condition often confused with lymphoedema, and the two can occur together. Assessment determines which it is.
How lymphoedema is treated
The GP or oncology clinic refers to a lymphoedema therapist, usually a physiotherapist or nurse with further training in lymphoedema care. The treatment is called complete decongestive therapy and has four parts used together:
- Compression. The most important part. Often bandaging first to reduce volume, then a made-to-measure compression stocking or sleeve worn daily, for life. Compression garments are prescribed by the therapist.
- Manual lymphatic drainage (MLD). Light, rhythmic massage that guides fluid towards healthy lymph pathways, performed by the therapist and sometimes taught as self-treatment. Used above all in the intensive phase and for fibrosis.
- Movement and exercise. The muscle pump is the lymph's motor. Exercising with compression on is safe and recommended, including progressive strength training.
- Skin care. Daily moisturising, prompt treatment of wounds and cracks, to prevent erysipelas, which worsens the oedema.
In some cases pneumatic compression (pressotherapy) is used as a complement, and for pronounced oedema surgery (liposuction of fibrotic tissue, lymph vessel transfer) may be considered at a specialist clinic. Lymphoedema treatment is healthcare, not wellness.
What you can do yourself
- Wear the compression garment as prescribed, even when the swelling feels small.
- Move every day: walking, swimming, cycling, light strength training with the garment on. Deep belly breathing helps the lymph in the trunk.
- Look after the skin: moisturise, avoid cuts, insect bites, sunburn and tight clothes on the affected side; wear gloves for gardening.
- Keep your weight in check; overweight increases the load on the lymphatic system.
- Learn the light self-drainage the therapist shows you, and stick to it.
- Seek care the same day for redness, warmth, fever and rapidly increasing swelling: it may be erysipelas requiring antibiotics.
Cupping and lymphoedema
We are often asked whether massage cups can be used with lymphoedema. Our answer: not on your own on the affected limb. The negative pressure draws fluid into the area and can increase the swelling, and the skin in a lymphoedema is more vulnerable to injury and infection. Some lymphoedema therapists use very light cupping as a tool to soften fibrotic tissue within a treatment, but that is their assessment and technique. Cupping on healthy body parts (for example tight shoulders when you have arm lymphoedema on the other side) is fine, but avoid the trunk on that side and the area around removed lymph nodes. Talk to your lymphoedema therapist before cupping at all. The full list of when to avoid cupping: When to avoid cupping.
Lymphoedema, ordinary swelling or lipoedema?
| Ordinary swelling (oedema) | Lymphoedema | Lipoedema | |
|---|---|---|---|
| Where | Both feet/ankles, face in the morning | Usually one side, including hand/foot and toes/fingers | Symmetrical on legs (and arms), feet usually spared |
| Course | Comes and goes with the day, heat, salt, menstruation | Persists, slowly worsens without treatment | Constant, does not respond to dieting |
| Feel | Heavy, eases with legs up | Tight, heavy, skin becoming firmer | Tender to pressure, bruises easily |
| What helps | Movement, legs up, light lymphatic massage, see fluid retention | Lymphoedema therapist: compression, MLD, exercise, skin care | Assessment through healthcare, compression, exercise, sometimes surgery |
Sources and further reading
- 1177 Vårdguiden (Swedish): search "lymfödem" for symptoms, treatment and when to seek care.
- The Swedish Oedema Association (Svenska Ödemförbundet) and the Swedish Breast Cancer Association have information on therapists and compression.
- On the lymphatic system in general: The lymphatic system – how it works. On lymphatic massage as self-care for healthy people: What is lymphatic massage?
Frequently asked questions about lymphoedema
Can lymphoedema go away?
Lymphoedema is chronic, but with early and regular treatment the swelling can be greatly reduced and kept stable. Many people live with well-controlled lymphoedema without it limiting everyday life.
Does lymphatic massage help lymphoedema?
Manual lymphatic drainage is part of the treatment, but only together with compression and performed or taught by a lymphoedema therapist. Ordinary lymphatic massage at a salon does not replace treatment.
Can I exercise with lymphoedema?
Yes, exercise is recommended, including progressive strength training, preferably with the compression garment on. Discuss the plan with your therapist.
Can I use massage cups if I have lymphoedema?
Not on your own on the affected limb. On other parts of the body it is fine, but check with your lymphoedema therapist first.
Where do I turn?
To your GP, or to the clinic that treated your cancer, for a referral to a lymphoedema therapist. For redness and fever in the swollen limb: urgent care the same day.
Written by Curam. Last updated 17 October 2026. This is general information and does not replace medical care. Lymphoedema and unexplained swelling must always be assessed and treated through healthcare (GP, lymphoedema therapist). Curam sells massage cups for self-care, not medical treatment.
