Managing oedema (swelling) in the upper limb (hand or arm) after you have had a brain injury 

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What is this information about?

Oedema is swelling caused by a buildup of fluid in the body’s tissues. If you have oedema in your upper limb (hand or arm), it can be puffy and swollen. This can feel uncomfortable, and you may find it difficult to move your hand and arm. 

The information here describes why oedema happens, what the symptoms of oedema are, and what you can do to help yourself. It also includes a list of places to look for more help and support.

Why have I been given this information?

You have been given this information because you have, or are at risk of having, oedema in your hand and arm. If you follow the advice here, you will be able to recognise the symptoms of oedema and know what to do when it happens.  

How can a brain injury cause oedema?

Usually, muscle and joint movement pump a tissue fluid, called lymph, through the body. 

Brain and spinal surgery can cause weakness in the hand and arm. It happens because of disruptions in your brain, spinal cord, or the nerves that connect to the affected muscles. 

This weakness in the upper limb makes it harder to pump fluid, causing fluid to accumulate (gather) in the hand and arm. 

What are the symptoms and difficulties associated with oedema?

• Fullness and swelling in the hand or arm 
• Pain 
• Decreased movement 
• Numbness 
• Tingling 
• Redness 
• Shiny skin 

What can I do to help?

Positioning 

• When you are in bed or sitting in a chair, position your arm on a cushion with your hand raised. This lets gravity drain the excess fluid away from the hand. If you can, position your arm so it is above the level of your heart. 

Retrograde massage

• Retrograde means backwards. This type of massage helps encourage fluid to move out of your hand and into your arm.  
• Massage your hand using light stroking movements, moving: 
  • From the fingertips to the palm 
  • From fingertips to the back of your hand 
  • Across the wrist towards the forearm 

Where can I look for more information and support?

Who can I contact for further advice?

Please contact your ward’s occupational therapist for further support.