Swelling in your neck or face (lymphoedema)

After radiotherapy to treat a head and neck cancer, you are at risk of getting swelling called lymphoedema in your neck or face.

Lymph fluid

Lymphoedema is pronounced lim-fo-dee-ma. 

Lymph fluid is in all body tissues. It comes from the tiny blood vessels into the body tissues. Usually, it drains back into the bloodstream through channels called lymph vessels. These are part of the lymphatic system.

A build up of lymph fluid in an area of the body can happen if lymph drainage channels or lymph nodes are blocked, removed or damaged. This causes swelling called lymphoedema.

Radiotherapy can cause changes in the lymphatic system in the head and neck area. It's a long-term (chronic) condition. It can’t be cured, but it can usually be well controlled. 

Sometimes the cancer itself can affect your lymphatic system and cause lymphoedema.

What are the symptoms of lymphoedema?

Lymphoedema in the head or neck can also cause symptoms inside your mouth and throat. This may include swelling of your tongue and other parts of your mouth.

Tell your doctor if you:

  • have any swelling or a feeling of fullness or pressure
  • find it difficult to swallow
  • have changes in your voice

Symptoms may develop soon after treatment, or it can take many months or a few years to appear after radiotherapy.

Lymphoedema is easier to control if treated early. It is important that you are referred to a lymphoedema specialist if you have signs of swelling. This is usually a nurse or physiotherapist. 

What to do if you have symptoms

Contact your doctor or specialist nurse if you know you’re at risk of lymphoedema and you have any of the symptoms above. Early treatment can help to control swelling and stop it getting worse. Your doctor or nurse can refer you to a lymphoedema specialist.

The Lymphoedema Support Network can tell you how to get lymphoedema care within the NHS.

The British Lymphology Society has a directory of lymphoedema services.

Types of treatment for lymphoedema

The main treatments for lymphoedema are

  • skin care – keeping skin in the swollen area clean, dry and moisturised and preventing injury and infection
  • exercise – to keep lymph flowing through the lymphatic system and help you to maintain a healthy weight
  • reducing swelling – specialised skin massage called manual lymphatic drainage (MLD) is the main treatment. It's not usually possible to do bandaging in the head and neck area. There are light compression garments for the head.

Manual lymphatic drainage (MLD) is a specialised massage that encourages the flow of lymph. 

You shouldn't wear anything around your neck.

Exercises for lymphoedema

Using your head, neck and shoulder muscles may help to reduce swelling. Your physiotherapist or specialist nurse will usually go through these exercises with you. 

These exercises shouldn't be painful. You might have a feeling of stretching as you do them, this is normal. Stop doing the exercises if you have any pain and, if it doesn't get better contact your doctor.

Try to do some exercises every day once or twice a day. It is better to do some every day even if you need to reduce how many you do. Aim to do between 5 and 10 of each exercise.

Do the exercises slowly and gently, don't rush them. You can rest between exercises. It might help to do them in front of the mirror so you can check that your shoulders are back and relaxed. 

Neck exercises

  • Head turns - turn your head to look over your shoulder as far as you can, hold for 2 seconds. Slowly go back to the start position. Repeat on the other side. Keep your shoulders still while doing this exercise.
  • Head tilt - tilt your head towards one shoulder until you feel a stretch on the opposite side. Hold for 2 seconds then straighten up. Repeat on the other side. Keep your shoulders still while you're doing this exercise.
  • Chin to chest - bend your neck down as far as you comfortably can so your chin is on your chest, hold for 2 seconds and then slowly bring your head back up so you are looking forward again.

Shoulder exercises

  • Shoulders up and down - relax your shoulders, bring them up to your ears, relax then drop them back down. Repeat.
  • Shoulder rotation - rotate your shoulder forward, then rotate them backwards.

Mouth exercises

  • Open and close your mouth.
  • Blow kisses, blow out imaginary candles.
  • Smile - an exaggerated one
  • Say the vowels in an exaggerated way - a, e, i, o, u.
  • Chew sugar free gum but only if you don't have any swallowing problems.

Jaw exercises

  • Side to side - slide your lower jaw one way and then the other.
  • Jaw forward - push your lower jaw forward then relax and repeat it.
  • Lymphedema: A concise compedium of theory and practice 
    B Lee and others, 
    Springer International Publishing, 2018

  • Head and neck cancer: Treatment, rehabilitation and outcomes (2nd edition)
    E Ward and C Van As-Brooks
    Plural Publishing, 2014

  • The Royal Marsden Hospital Manual of Clinical Nursing Procedures (9th Edition)
    Lisa Dougherty and Sara Lister
    Wiley-Blackwell, 2015

Last reviewed: 
10 Nov 2020
Next review due: 
10 Nov 2023

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