Understanding Lymphoedema
Diagnosis and staging
Your lymphoedema practitioner or another health professional will ask about your medical history, and check the level of swelling and any pitting, thickening or damage to the skin. The size of the affected limb will be compared to the other limb, and any differences will be assessed.
This is done in different ways:
- using a tape measure to measure the distance around the limb (circumference)
- using a device with a painless, low-frequency electric charge (bioimpedance spectroscopy) to calculate the amount of fluid
- using a high-frequency, low-power electromagnetic wave to measure the water content of the tissues
- taking photos of more difficult to measure areas, such as the head, neck, trunk, breast and genitals
- using a doppler ultrasound to rule out a blood clot
- less commonly, using magnetic resonance imaging (MRI), computerised tomography (CT) or an ultrasound to show extra fluid or fat in tissues or tissue changes
- using special imaging procedures – such as lymphoscintigraphy or indocyanine green (ICG) fluorescent lymphography – to see if there are problems with lymph fluid flow.
If lymphoedema is diagnosed, it will be staged from 0 (least severe) to 3 (most severe). All stages of lymphoedema need ongoing treatment and care.
Who will provide treatment?
Lymphoedema usually requires care from a range of health professionals including a qualified lymphoedema practitioner, doctors and allied health professionals (e.g. dietitian, exercise physiologist).
Lymphoedema practitioners – may be an occupational therapist, physiotherapist, massage therapist (may be called a myotherapist), podiatrist, speech therapist or nurse with specialist training in managing lymphoedema. Lymphoedema practitioners assess people with lymphoedema, develop treatment plans, prescribe compression garments, and provide ongoing treatment and care. They may work as part of a lymphoedema service in a public or private hospital or in private practice.
Doctors – your general practitioner (GP), surgeon or oncologist may diagnose the condition, coordinate your treatment plan and refer you to a lymphoedema practitioner. If you develop a skin infection (cellulitis), your GP will help to manage this.
How to find a lymphoedema practitioner
You can ask your GP or specialist to refer you to a lymphoedema practitioner for assessment, or you may find a practitioner yourself. The Australasian Lymphology Association has an online register of lymphoedema practitioners. If you live in a rural or regional area, you may need to travel to visit a lymphoedema practitioner or some clinics provide telehealth consultations.
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This information is reviewed by
This information was last reviewed September 2023 by the following expert content reviewers: health professionals and people affected by lymphoedema. It was reviewed by: A/Prof Louise Koelmeyer, Director, Australian Lymphoedema Education, Research and Treatment (ALERT) Program, and Associate Professor, Macquarie University, NSW; Prof John Boyages AM, Founding Director and Honorary Professor at the ALERT Program, Macquarie University, NSW; Dr Nicola Fearn, Occupational Therapist and Accredited Lymphoedema Therapist, The Lymphoedema Clinic Wollongong, and Senior Research Officer, St Vincent’s Hospital Sydney, NSW; Jennifer Gilbert, Clinical Nurse Consultant – Lymphoedema, Icon Cancer Centre, Chermside, QLD; Megan Howard, Senior Physiotherapist and Lymphoedema Physiotherapist, Peter MacCallum Cancer Centre, VIC; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Dr Amanda Pigott, Clinical Specialist Occupational Therapy, Princess Alexandra Hospital, QLD; Prof Neil Piller, Director, Lymphoedema.