What is the current advice for the use of needles, exercise, flights and heat for persons with lymphoedema? There is so much conflicting advice that persons with lymphoedema are met with confusion in the management and care of their lymphoedemous limbs. This section is about giving YOU the resources to make an informed choice.
Current preventative advice and recommendations involve heat, exercise and avoiding needles into the ipsilateral arm (UK Lymph, 2002; National Cancer Institute). The Lymphoedema Framework policy guidelines (4.4.2 & 4.4.3) state that needling should be avoided in lymphoedemous limbs or limbs prone to lymphoedema. However, Acupuncture is not contraindicated (Filshie and Hester, 2006, p175). The use of acupuncture is the same as for all Non Accidental Skin Puncture (NASP) interventions – the affected area (lymphoedematous limb) should be avoided (Tavares, 2003; Filshie and Hester, 2006; Lymphoedema Framework, 2006). Available literature and some organisations will counsel persons with lymphoedema to avoid acupuncture (UK Lymph.com, 2002; O’Connor, 2008; Hansard, 2010) even when the evidence into ‘avoiding’ acupuncture and lymphoedema is severely lacking (Cemal et al., 2011; McLaughlin, 2012). The historical source of this recommendation is probably attributed to Halstead (1921) who hypothesized that post- surgical infections was the underlying cause of swelling following breast cancer surgery. It is recommended that all needles (intravenous, acupuncture) avoid the affected limb.
Cemal, Y., Pusic, A., Mehrara, B., (2012). Preventative measures for lymphedema: Separating fact from fiction. American college of surgeons. 213 (4), 543-551.
Filshie, J.,and Hester, J., (2006). Guidelines for providing acupuncture treatment for cancer patients – a peer reviewed sample policy document. Acupuncture Medicine. 24 (4),172-182.
Halsted, W, W., (1921). Swelling of arm after operations for cancer of breast: elephantiasis chirurgica: its cause and prevention. Bull Johns Hopkins Hospital. 32,309–313.
Hansard, S., (2010). Lymphoedema and complementary therapy – How to make an informed choice. Lymphline: Newsletter of the lymphoedema support network. Summer 7-9
Lymphoedema Framework (2006). Best practice for the management of lymphoedema. London: MEP Ltd
McLaughlin, S, A., (2012). Lymphedema: Separating fact from fiction. Oncology 26 (3), 242-249
O’connor, P., (2008). Acupuncture treatment and lymphoedema. Available online www.lymphoedemapeople.com/thesite/lymphoedema_acupuncture_treatment.htm.
UKlymph.com (2002). Alternative therapies. Available online at www.uklymph/tr.alternativetherapies.php
Winge, C., Mattiasson, A, C., Schultz. I., (2010). After axillary surgery for breast cancer–is it safe to take blood samples or give intravenous infusions? Journal of Clinical Nursing. 19 (9–10),1270–1274.