Lymphoedema is a chronic condition that affects millions of people worldwide, typically causing swelling in the arms or legs because of a build-up of lymphatic fluid. For those living with lymphoedema, managing symptoms and improving quality of life are top priorities.

There is growing interest in natural therapies that complement conventional approaches. This article explores the causes and effects of lymphoedema, along with natural options like aroma lymphatic massage, diet, exercise, and herbal remedies that can provide relief.

What is Lymphoedema?

Lymphoedema occurs when the lymphatic system, which helps remove waste and toxins from tissues, becomes damaged or blocked. This leads to an abnormal accumulation of lymph fluid, causing swelling, typically in the arms and legs. Primary lymphoedema is a rare genetic disorder, while secondary lymphoedema often arises from surgery, cancer treatments (like lymph node removal or radiation), infections, or trauma.

The Effects of Lymphoedema

Lymphoedema can lead to physical discomfort and emotional distress. The most noticeable symptom is swelling, which can range from mild to severe. Over time, if left untreated, the swelling can become permanent, causing tissue hardening (fibrosis), restricted mobility, and recurrent infections. Those with the condition may also experience pain, skin changes, and a reduced range of motion, affecting daily activities and overall quality of life.

Medical Treatment of Lymphoedema

Medical treatment for lymphoedema typically involves a combination of therapies aimed at reducing swelling and preventing complications. There are no effective drugs that help. Common treatments include:

• Compression therapy: wearing compression garments or bandages to help push lymph fluid out of the affected limb.

• Manual lymphatic drainage (MLD): a specialised massage technique that encourages the movement of lymph fluid.

• Pneumatic compression: using a device that inflates and deflates a sleeve worn around the affected limb to promote lymph flow.

• Surgical interventions: in severe cases, doctors may offer surgical options like lymphaticovenous anastomosis or vascularized lymph node transfer.

Aroma Lymphatic Massage for Lymphoedema

Aroma lymphatic massage is a specialised form of manual lymphatic drainage (MLD) that uses gentle pressure and essential oils to stimulate lymphatic flow and reduce swelling. This technique can help improve circulation, reduce fluid retention, and relieve discomfort associated with lymphoedema. Massage therapists use essential oils like geranium and citrus oils with lymphatic massage for their anti-inflammatory and diuretic properties. They also use rose, thyme, eucalyptus and clove oils to boost circulation and skin elasticity, and reduce inflammation (1).

While there are few scientific studies on aroma lymphatic massage, one study on aroma lymphatic drainage has shown benefits in reducing lymphoedema pain in breast cancer patients (2).

Another study, also on breast cancer patients, found that aroma lymphatic drainage significantly reduced the swelling in the patients’ legs and improved their quality of life (3).

Benefits of a Ketogenic Diet for Lymphoedema

Researchers have explored the benefits of a ketogenic (keto) diet, which emphasises high fat, moderate protein, and low carbohydrate intake, for its potential benefits in managing lymphoedema. The diet promotes the production of ketones, which are used as an alternative energy source by the body. Emerging evidence suggests that ketosis may reduce inflammation and fluid retention, both of which are key factors in lymphoedema.

A study found that a ketogenic diet helped reduce swelling and improved lymphatic function in a mouse model of lymphoedema (4). Another paper outlines the positive effects of a combination of weight management using the keto diet, exercise, stress resilience and sleep on human lymphoedema patients (5).

If you aren’t familiar with the ketogenic diet, I recommend consulting with a nutritionist before starting this diet, especially for those with pre-existing health conditions.

Water-Based Exercise for Lymphoedema

Water-based exercises, such as swimming or aquatic therapy, offer excellent benefits for individuals with lymphoedema. The natural buoyancy of water reduces the strain on joints while providing gentle resistance, promoting muscle strength and lymphatic drainage. Water exercises can also help reduce swelling and improve mobility without putting too much stress on the affected limb.

A review of 8 trials and a clinical study reported that patients who engaged in aquatic exercise experienced significant improvements in swelling, range of motion, pain and overall quality of life (6). The hydrostatic pressure of water aids in lymph flow, making it a highly recommended form of exercise for managing lymphoedema symptoms.

Topical Use of Horse Chestnut Cream for Lymphoedema

Horse chestnut (Aesculus hippocastanum) is known in natural medicine as a remedy for improving circulation and reducing swelling. Used topically, horse chestnut cream helps strengthen blood vessel walls and reduce fluid retention, making it a potentially useful treatment for lymphoedema.

A randomised clinical trial published in The Lancet found that horse chestnut extract significantly reduced swelling in patients with chronic venous insufficiency, a condition closely related to lymphoedema (7). In a study on rats, researchers found that escin gel, an extract from horse chestnut, at a 2% concentration used topically, reduced swelling and skin thickness, and increased lymphatic structures (8).

Use of Cycanchum atratum (Bai Wei) to Increase Lymphangiogenesis

Cycanchum atratum, also known as Bai Wei, is a traditional Chinese herb with properties that may stimulate lymphangiogenesis—the formation of new lymphatic vessels. Increased lymphangiogenesis is crucial in the treatment of lymphoedema, as it promotes the clearance of excess lymph fluid from tissues.

Researchers have found that compounds found in Cycanchum atratum can enhance lymphatic function by stimulating lymphatic vessel formation (9). This suggests that Bai Wei could be a promising herbal therapy for improving lymphatic drainage and reducing the symptoms of lymphoedema.

Bai Wei has been classified as ‘non-toxic’ in The Compendium of BencaoGangmu, which is an encyclopaedia of Chinese Medicine (10).

Traditional Chinese Medicine (TCM) practitioners are the best source of Bai Wei and practitioners who are registered with their professional bodies can advise on its use and provide good quality products. I do not recommend using other sources of TCM medicines, as they are often poor quality and can be potentially dangerous.

Conclusion

Lymphoedema can be a challenging condition to manage, but a combination of medical treatments and natural therapies can provide significant relief. Aroma lymphatic massage, the ketogenic diet, water-based exercise, horse chestnut cream, and herbal remedies like Cycanchum atratum offer promising complementary options.

By incorporating both conventional and natural strategies, individuals with lymphoedema can improve their quality of life and reduce the impact of this condition on their daily activities.

There are many other side effects of cancer treatment. You will find many of them covered in my book, with natural ways to overcome them. All of the remedies suggested show the correct dosages to use, any interactions with other drugs, when they should not be used, and any potential side effects.

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References

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2. Ha YS, Kim JW, Lee JE, et al. Aroma lymphatic massage (aroma lymphatic tressage) for symptom relief in breast cancer patients with Taxane Acute pain syndrome: A randomized controlled crossover trial. European Journal of Integrative Medicine. 2022;54:102167. doi:10.1016/j.eujim.2022.102167

3. Kim JW, Ha YS, Lee JY, et al. The effect of aroma lymphatic tressage for lower extremity edema associated with the taxane chemotherapy in patients with breast cancer: A phase 2 clinical trial. Journal of Clinical Oncology. 2022;40(16_suppl). doi:10.1200/jco.2022.40.16_suppl.e24099

4. Lodewijckx I, Matthys C, Verheijen J, et al. Potential therapeutic effect of a ketogenic diet for the treatment of lymphoedema: Results of an exploratory study. Journal of Human Nutrition and Dietetics. 2024;37(4):885-891. doi:10.1111/jhn.13330

5. Keith L, Erkstam R. Optimizing lymphedema outcomes through lifestyle. OBM Integrative and Complementary Medicine. 2023;08(01):1-13. doi:10.21926/obm.icm.2301016

6. Maccarone MC, Venturini E, Menegatti E, Gianesini S, Masiero S. Water-based exercise for upper and lower limb lymphedema treatment. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2023;11(1):201-209. doi:10.1016/j.jvsv.2022.08.002

7. Diehm C, Trampisch HJ, Lange S, Schmidt C. Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency. The Lancet. 1996;347(8997):292-294. doi:10.1016/s0140-6736(96)90467-5

8. Jeong HH, Kim D, Kim T, et al. The role of escin as a topical agent for lymphedema treatment in a rat model. The International Journal of Lower Extremity Wounds. Published online August 22, 2023. doi:10.1177/15347346231195944

9. Li N, Ruan M, Chen W, et al. An arabinogalactan isolated from Cynanchum atratum promotes lymphangiogenesis and lymphatic vessel remodeling to alleviate secondary lymphedema. International Journal of Biological Macromolecules. 2024;273 Part 2:133061. doi:10.1016/j.ijbiomac.2024.133061

10. Zhang Y, Yang Y, Yan C, et al. A review of the ethnopharmacology, Phytochemistry and pharmacology of Cynanchum atratum. Journal of Ethnopharmacology. 2022;284:114748. doi:10.1016/j.jep.2021.114748