Do you need a referral for lymphoedema therapy?

Oncology, breast care, rehabilitation or primary care teams can direct you to an appropriately trained physiotherapist or lymphoedema practitioner. Some clinics also accept direct enquiries, but they may request a medical summary before beginning therapy.

Lymphoedema therapy starts with an assessment of the swelling, skin, movement, symptoms and relevant cancer treatment. Care may include education, skin care, suitable movement, compression garments or bandaging, and manual lymphatic drainage when appropriate.

The plan is individual because compression and massage are not suitable in every situation. The practitioner may need medical clarification if swelling is sudden, the cause is uncertain, the skin looks infected, or heart, circulation or clotting concerns could change treatment.

Ask the intended clinic whether it requires a referral and what qualifications its lymphoedema practitioner holds. If a referral is requested, your oncology team or primary care clinician can include the affected area, when swelling began, relevant operations or radiotherapy, current medicines and any previous infections or blood clots.

While waiting, protect the skin, moisturise intact dry skin with a product you tolerate, stay gently active within your abilities and avoid using an unprescribed tight wrap. Bring any existing compression garment to the assessment so its fit and condition can be checked.

Seek same-day medical advice if a swollen area becomes red, hot, increasingly painful or tender, especially with fever, chills or feeling acutely unwell. These features can indicate an infection that needs medical treatment rather than lymphatic massage.

Get urgent help for sudden one-sided limb swelling, chest pain, new breathlessness, fainting, or swelling of the face or throat. A routine therapy appointment should not be used to assess these warning signs.

Ask what is causing the swelling, whether any tests are needed, which type of compression is appropriate and how to care for your skin. Clarify which exercises fit your recovery, whether manual drainage is suitable, how garment fit will be reviewed and whom to contact if symptoms change.