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Dr Aoife McGarvey is a physiotherapist. Read more about her research on physiotherapy after neck dissection and helping lymphoedema

Physiotherapy and Lymphoedema


​It’s normal to have some physical limitations during cancer treatment and for several weeks after surgery. Side effects from head and neck cancer treatment can lead to nerve injuries, neck and shoulder pain, lymphoedema, and deconditioning.

For many people these issues may persist beyond cancer treatment, and impact on ability to return to work and other activities.

A whole range of head and neck cancer survivors see a physiotherapist, from those who have had neck dissection surgery that may have nerve-related shoulder dysfunction, to those who have received chemo-radiation therapy with head and neck lymphoedema.

Physiotherapy can help with neck tightness, shoulder pain, head and neck lymphoedema, and reduced body strength and fitness.

The earlier you seek a referral to see a physiotherapist if you notice any of these problems, the greater the chance of improvement and recovery.

What is Lymphoedema?

Lymphoedema is swelling in the head or neck that can happen after treatment for Head and Neck Cancer.

What Causes Lymphoedema?

Lymph nodes are small glands found around our body that help to filter out bacteria and drain fluid out of your body. Lymphoedema happens when lymph nodes in the neck are not working properly, causing fluid to build up in the area. This may happen because:

  • lymph nodes were removed during surgery
  • lymph nodes were damaged during radiotherapy
  • cancer has caused a blockage in the lymph nodes and vessels in your neck.

You are more likely to get lymphoedema if you have both surgery and radiation therapy, and if both sides of your neck are treated.

Symptoms of Head and Neck Lymphoedema

Head and neck lymphoedema is highly visible and can affect a person's appearance and body image. Symptoms may include:

  • swollen eyes, face, lips, neck or chin
  • feeling heavy or tight in your neck or face
  • trouble moving your neck or jaw
  • difficulty swallowing, speaking or breathing

How is Lymphoedema Treated?

Treatment for lymphoedema aims to reduce the swelling and prevent it from getting worse. Treatments for lymphoedema may include:

  • massage designed to drain fluid from the affected area. This is called manual lymphatic drainage
  • exercises to help with head and neck movement
  • compression bandages to help reduce swelling
  • skin care to prevent infection in the swollen skin.

If you have lymphoedema, you may have one or more of these treatments.

Where Can I Find Support?

You should always tell your doctor if you notice swelling in your face or neck. They can arrange for you to have tests to find out the cause.

Your doctor may recommend that you get help from a health professional who has expertise in treating lymphoedema, such as a lymphoedema nurse or physiotherapist.

A nurse or physiotherapist with special expertise in treating lymphoedema can:

  • massage the head and neck area using manual lymphatic drainage to reduce swelling
  • show you some exercises to help drain fluid in the head and neck area
  • give you advice on how to care for and prevent infection in the swollen skin.

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