Chronic oedema is a common problem in the community with at least 100 000 patients suffering in the UK alone, a problem poorly recognized by health professionals. Lymphoedema arising for reasons other than cancer treatment is much more prevalent than generally perceived, yet resources for treatment are mainly cancer-based, leading to inequalities of care.

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This paper describes a randomized controlled crossover study examining the effects of manual lymphatic drainage (MLD) in 31 women with breast cancer‐related lymphoedema. MLD is a type of massage used in combination with skin care, support/compression therapy and exercise in the management of lymphoedema. A modified version of MLD, referred to as simple lymphatic drainage (SLD), is commonly taught as a self‐help measure. There has been limited research into the efficacy of MLD and SLD. The study reported here explores the effects of MLD and SLD on a range of outcome measures. The findings demonstrate that MLD significantly reduces excess limb volume (difference, d=71, 95% CI=16–126, P=0.013) and reduced dermal thickness in the upper arm (d=0.15, 95% CI=0.12–0.29, P =0.03). Quality of life, in terms of emotional function (d=7.2, 95% CI=2.3–12.1, P=0.006), dyspnoea (d=−4.6, 95% CI=−9.1 to −0.15, P=0.04) and sleep disturbance (d =−9.2, 95% CI=−17.4 to −1.0, P=0.03), and a number of altered sensations, such as pain and heaviness, were also significantly improved by MLD. The study provides evidence to support the use of MLD in women with breast cancer‐related lymphoedema. The limitations of the study are outlined and future areas for study are highlighted.

Ultrasound-guided fascia iliaca block increased the frequency of sensory loss in the medial aspect of the thigh. Ultrasound guidance also increased the frequency of femoral and obturator motor block.