1st September 2025

Welcome to this special edition of the PhysioPod® UK Newsmagazine.

In this issue, we're focusing specifically on secondary head and neck lymphoedema (HNL) following cancer treatment – a condition that can severely impact daily activities and significantly affect quality of life.

The British Lymphology Society say in their Lymph Facts document that "Cancers in the head and neck account for approximately 3-5% of all cancers and as many as 90% of patients treated for head and neck cancers report some degree of lymphoedema" [source]. This is backed by many studies around the world and was also seen in the experiences of Sue Hansard, retired Specialist Lymphoedema Nurse, who noted in her  article on LinkedIn that all of her patients who have surgery and radiotherapy for these cancers developed HNL.

HNL is most likely to develop immediately following surgery and radiotherapy, with patients often reporting persistent swelling that is both externally apparent and internally felt as post-operative swelling subsides.

HNL can affect a wide range of delicate and intricate areas, including the oral cavity, trachea, face, ears (including the ear canal and inner ear), eyelids, nose, scalp, and neck. Given this high prevalence and immediate onset, a critical message for optimal patient outcomes is that early identification and referral to specialist lymphoedema services are vital, as the longer the delay, the more limited the possibilities of improvement and the greater the risk of reduced quality of life.

Best practice for managing HNL involves a proactive rehabilitative approach with multidisciplinary input, encompassing not only lymphoedema specialist care but also physiotherapy, speech and language therapy, occupational therapy, and counselling support.

HNL can severely impact daily activities and significantly affect quality of life.

The National Health Service (NHS) currently faces limitations in its approach to treatment in this area, highlighting a clear unmet need for truly effective treatment options.

DEEP OSCILLATION® is an internationally patented, effective technology solution to address this situation and it is our primary goal to demonstrate that by adopting its wider use, (it is already successfully utilised in many NHS Lymphoedema clinics and by private Lymphoedema Practitioners), the NHS can deliver better treatment and achieve long-term cost savings.

This edition will share what patients and practitioners say about the effects of Deep Oscillation in treatment, reflecting the many individuals who have gone on to invest in their own units after receiving initial NHS or private treatment. This, we believe, is a testament to its benefits.

A new survey will reach your inbox soon in order to collate more information, and we encourage you to complete and share it with HCPs and patients in your community. This survey is for ALL individuals living with HNL and the HCPs responsible for their care, regardless of whether deep oscillation is in the treatment protocol or not, so we can evaulate the difference it is making.

With your help, we hope to make genuine progress in improving head and neck lymphoedema treatment.

We greatly appreciate your help in advance.

Corinne's brave journey with head and neck cancer led to severe secondary lymphoedema and fibrosis following extensive surgery and radiotherapy, leaving her with significant discomfort, restricted movement, and challenges with speech and swallowing. After exhausting conventional options, Corinne found a "game-changer" in Deep Oscillation therapy, introduced by her specialist lymphoedema nurse.

Non-invasive Deep Oscillation treatment dramatically softened fibrotic tissue, reduced swelling and pain, and restored movement to her face and neck, leading to clearer speech and easier swallowing. So profound were the improvements that Corinne invested in her own Deep Oscillation unit, empowering her to take control of her lifelong condition and significantly enhance her overall quality of life. Discover Corinne's full, inspiring story and see the remarkable difference this innovative therapy made.

READ FULL STORY

Head and neck surgery can be life-changing, but for many, the journey to recovery is fraught with challenging and often debilitating side effects. Patients frequently face profound difficulties, from oral hygiene issues and swallowing problems that cause anxiety and impact daily nutrition to communication struggles that can lead to social isolation. The extensive nature of these surgeries often results in lymphatic impairment, causing disfiguring facial and neck swelling, pain, and a higher risk of infection. Furthermore, patients may experience impaired hearing, severe headaches, and persistent musculoskeletal stiffness, limiting their mobility and exacerbating feelings of depression and anxiety.

However, for those navigating this complex landscape, a non-invasive therapy called Deep Oscillation is offering a significant glimmer of hope. This unique treatment works deeply within the tissues to reduce swelling and fibrosis, enhance mobility, alleviate pain, and improve skin health. It’s proving to be a valuable adjunct in managing the intricate problems associated with head and neck lymphoedema, helping patients regain confidence, improve speech and swallowing, and significantly enhance their overall quality of life. Discover how this innovative approach is transforming recovery and empowering patients to take control of their well-being.

READ CHRISTINE'S ARTICLE ON CLINICAL CONSIDERATIONS

 

Living with secondary lymphoedema of the head and neck presents significant challenges, as illustrated by the case of Mr A, a 67-year-old man who suffered from constant pain, impaired speech, and recurrent cellulitis infections following extensive cancer treatment. Despite trying various conventional therapies, his quality of life remained severely affected. However, a multi-faceted approach that prominently included Deep Oscillation therapy administered by Lymphoedema Practitioner Christine Talbot led to remarkable improvements. Mr A experienced substantial relief from pain and pressure, and he regained his full facial animation, sense of taste, and the ability to speak without impediment. Treatment using Deep Oscillation facilitated the resolution of severe swelling, resulting in no further episodes of cellulitis. The facial oedema was significantly reduced, leading to decreased excess salivation and easier swallowing. This enhancement in his quality of life instilled enough confidence in him to attend Men's Sheds group and to begin visiting local areas with his wife once again.
 

READ FULL CASE STUDY WITH IMAGES

Head and neck cancers (HNC) have risen by 35% in the UK since the 1990s [1], with notable increases also observed in Ireland, rates in females have increased by more than a tenth (12%), and rates in males have increased by around a seventh (15%) (2017-2019) in 5 years. [2] 

Improved survival rates are linked to multidisciplinary care and targeted therapies, leading to more patients needing management of complications, especially lymphoedema.

Improved survival rates are linked to multidisciplinary care and targeted therapies, leading to more patients needing management of complications, especially lymphoedema.

Therapists now see higher numbers of HNC survivors presenting with post-treatment issues like pain, scarring, lymphoedema, facial nerve damage, hearing loss, fibrosis, mucositis, xerostomia, dysphagia, fatigue, immunosuppression, and neuropathy. Early intervention is crucial for enhancing quality of life.

Treatment of HNC patients is diverse, considering the various levels of surgery involved and adjunct therapies like radiotherapy (RT) and chemotherapy. Considering this, almost every patient requires a specifically tailored treatment plan. The use of Deep Oscillation therapy (DOT) along with Manual Lymph Drainage (MLD) therapy is most used in Ireland to treat this cohort of patients.

Deep Oscillation Therapy is highly effective in managing post-radiation fibrosis. Treatment frequency settings typically range from high frequency (80 Hz to 200 Hz) to low frequency (5–25 Hz), adjusted according to the severity and extent of fibrosis. During the treatment of fibrosis, DOT is incorporated in conjunction with traditional Dr Vodder Manual Lymph Drainage techniques. DOT enhances conventional Manual Lymphatic Drainage (MLD) methods, resulting in more rapid and improved outcomes.

Scars located in areas of fibrotic tissue can complicate recovery, where radiation therapy has increased skin damage and sensitivity. Nevertheless, mobilisation of the scar tissue is essential, and DOT (160 Hz for 15 minutes, then reducing to 60 Hz for a further 15 minutes) is used alongside specialised scar mobilisation techniques to facilitate this process. Patients with head and neck cancer (HNC) commonly experience pain and discomfort; the combination of MLD and DOT has been shown to provide significant pain relief. For individuals exhibiting less fibrosis but substantial lymphoedema (LE), the application of DOT (80 Hz for 15 -30 mins) with MLD yields faster reduction in swelling compared to MLD alone.

References

1. Cancer Research UK, Head and Neck Cancer Statistics, 2025.

• Airway Obstruction: Severe swelling can lead to compromised breathing and breathing difficulties, which may be lethal in extreme circumstances.

• Dysphagia (Difficulty Swallowing): This condition impairs swallowing, potentially resulting in nutritional difficulties. Patients may also experience odynophagia, or painful swallowing.

• Facial and Neck Disfigurement: Lymphoedema can cause asymmetry of the face or neck, leading to cosmetic disfigurement, facial deformity, or an abnormal facial appearance, which significantly affects how someone looks.

• Pain and Discomfort: Common symptoms include pain or discomfort, which may also manifest as headaches. This pain can arise from swelling, fibrosis, or nerve compression.

• Limited Mobility: There can be a decrease in range of motion, particularly in the cervical spine (neck), leading to limited neck mobility, restricted neck range of motion, and difficulty moving the neck, head, and jaw. This hampers daily activities and reduces quality of life.

• Skin Issues: Cellulitis or Skin Infections: Patients face an elevated risk of persistent cellulitis or skin infections, which are often linked to lymphoedema. Skin Breakdown or Ulceration: Swelling can cause skin damage, leading to skin breakdown or ulceration, sometimes with oozing or bleeding from lesions. Fibrosis and scarring exacerbate this risk.

• Psychological and Emotional Effects: The visible disfigurement, functional limitations, and ongoing medical issues can result in social disengagement, anxiety, emotional distress, increased social isolation, and reduced self-esteem.

• Ocular Difficulties: Severe eyelid lymphoedema can cause difficulty regaining normal ocular aperture (ability to open eyes), potentially leading to vision problems or even effective blindness in extreme cases.

• Speech Difficulties: Individuals may experience modified speech or difficulty speaking, signifying a functional impairment that can impact social interactions and overall quality of life.

 

By Catherine Groom
Specialist Lymphoedema Practitioner

"Integrating Deep Oscillation in our NHS lymphoedema clinic has dramatically enhanced the treatment outcomes for head and neck cancer patients suffering from lymphoedema. The enhanced effect achieved through the therapist's hands reduces treatment times, which in turn allows for the treatment of more patients and a reduction in waiting lists.

Deep Oscillation acts as a powerful adjunct that can transform the effectiveness of the overall lymphoedema management plan. By effectively mobilising fluids and proteins in tissues, it significantly reduces the build-up of cellular debris and proteins, which is crucial, because this directly reduces the risk of cellulitis and the formation of fibrosis in affected areas.

This comprehensive approach not only manages swelling and discomfort but also proactively addresses cellulitis, one of the most serious complications of lymphoedema."

READ FULL ARTICLE

"Concluding Observations

The patient’s therapeutic response to Deep Oscillation Therapy has been exceptional, producing outcomes that are objectively measurable and functionally transformative. Oedema reduction has been sustained, with soft tissue remodelling resulting in restored anatomical contours and enhanced mobility. Fibrotic and scar tissue changes are palpably evident, with complete resolution of mechanical restrictions that once impeded functional movement and daily living tasks.

Pain and discomfort have been alleviated to a clinically negligible level, supporting improved postural alignment and movement efficiency. Skin health and resilience have improved to the extent that the patient now presents with a considerably reduced dermatological risk profile.

Functionally, the enhanced drainage efficiency facilitated by Deep Oscillation Therapy has accelerated lymph relocation and improved airway, speech, and swallowing performance. These gains have been complemented by profound psychosocial benefits, including increased confidence, social participation, and emotional well-being.

In entirety, the results of this intervention demonstrate that Deep Oscillation Therapy is a highly effective, non-invasive, and patient-centred adjunctive treatment for complex head and neck lymphoedema. It has delivered substantial and clinically meaningful improvements across all key domains—structural, functional, and psychosocial—supporting both immediate and sustained recovery."

READ CASE STUDY

Two years ago I was diagnosed with stage two throat cancer. After three operations on my neck and throat and the removal of 150 nodes, I’m today cancer-free, but not without my wounds. 

Immediately post-surgery, it was clear I now had lymphatic issues and was diagnosed with moderate lymphoedema.

I was eventually referred for treatment, and after assessment and waiting list times, I was given nine treatments with the Oscillator. Within six treatments, I felt like a different person. My neck was free of this bulk, and the movement increased by 50% at least. It literally changed my life, and I was so sad and fearful that I was going to be left this way. 

Every three to four months, they would ask to see me again, but they didn’t want to use the machine on me, as I didn’t have one at home, so they wanted to teach me at-home techniques that I could use daily. Nothing at all compares to be honest, but what choice did I have but to keep doing my daily massages? 

My neck is never the same for two days; with any lifting/carrying, it immediately struggles and gets very hard. I asked for more treatments with the machine, and they gave me two more; it was apparent that I needed to invest, as this was life-changing. 

Most recently my neck had been strange again, and a new lump appeared. After 10 weeks and more cancer checks, I’m pleased to say I was clear again.

I contacted PhysioPod, who have been excellent, and I am now the owner of my own device. The machine has now helped move the fluid that appeared on my collarbone.

It’s very easy to use at home, and it’s there for when I need it. I am so glad I have invested, as my neck will never heal, but this allows me to manage my neck and gives me 100% improvement. 

It has literally been a solution to what I thought was my new normal. 

Thank you,

David McConnachie"

Patient Background:

The patient was a 26-year-old woman.

She had undergone surgery for a 5 cm tumour in her head.

She had undergone three surgeries in total.

Treatment with Deep Oscillation began one year after she finished chemotherapy.

VIEW CASE STUDY WITH IMAGES

"My experience of using Deep Oscillation in the treatment of Lymphoedema is excellent, both used alongside manual lymphatic drainage therapy and when used in self-treatment. I had a lot of Lymphoedema in my neck and tongue, as I had all my nodes removed in my neck after surgery in my tongue and neck for cancer. My level of needs is complex and so I drive 45 minutes each way, twice a week to be treated in the hands of Lumi Worsfold who is a very skilled MLD DLT Lymphoedema practitioner. The swelling is so much better; I now have a good jaw-line, my speech is clear and my swallowing is excellent. Both my Surgeon and Oncologist have been very pleasantly surprised to see these remarkable results.

I have been so impressed with Lumi's treatment with Deep Oscillation, that I also purchased a Deep Oscillation Personal Sports to use when I am not going to Lumi, and especially when I am traveling and am not able to have my bi weekly treatment. I am happy to say that I am beginning to manage and contain the Lymphoedema with the personal unit"

Patient identity withheld

READ FULL REPORT

 

“The lady underwent transoral laser surgery to remove a cancerous tumour from her right tonsil, followed by an ear-to-ear neck dissection to remove cancerous lymph nodes in March 2014. Six weeks after the operation, she underwent daily radiotherapy, which concluded in early June. During August, her neck started to swell and became very uncomfortable and painful. She saw me in mid-September for MLD and DEEP OSCILLATION®. After the first treatment session, her tongue swelling had reduced, and she had more tongue movement, which in turn had made eating easier. She has improved further after regular, initially frequent treatment sessions.”

 

As a  Lymphoedema Practitioner, I encountered many challenging cases, particularly those involving severe sclerodermatic changes resulting from radiotherapy, which can significantly impede lymphatic drainage. These changes can affect various areas, including the cheeks, chin, neck, and even the ears, making treatment quite difficult.

In these complex situations, I found that Deep Oscillation Therapy (DOT) can significantly enhance the effects of Manual Lymphatic Drainage (MLD). I've observed faster softening of submental/submandibular oedema compared to using MLD alone.

Beyond DOT, I also incorporated other supportive therapies into my treatment plans: kinesiology taping and compression garments for some patients to help maintain symptom reduction and improve their condition between treatments.

Furthermore, I always emphasised the importance of patient education and participation in exercises. I consistently taught my patients exercises to improve head, neck, and shoulder mobility, as well as facial exercises. These exercises further enhance the effects of DOT, and I consider them essential for all patients with head and neck lymphoedema.

"My experience of using Deep Oscillation in the treatment of Lymphoedema is excellent, both used alongside manual lymphatic drainage therapy and when used in self-treatment. I had a lot of Lymphoedema in my neck and tongue, as I had all my nodes removed in my neck after surgery in my tongue and neck for cancer. My level of needs is complex and so I drive 45 minutes each way, twice a week to be treated in the hands of Lumi Worsfold who is a very skilled MLD DLT Lymphoedema practitioner. The swelling is so much better; I now have a good jaw-line, my speech is clear and my swallowing is excellent. Both my Surgeon and Oncologist have been very pleasantly surprised to see these remarkable results.

I have been so impressed with Lumi's treatment with Deep Oscillation, that I also purchased a Deep Oscillation Personal Sports to use when I am not going to Lumi, and especially when I am traveling and am not able to have my bi weekly treatment. I am happy to say that I am beginning to manage and contain the Lymphoedema with the personal unit and self-lymphatic drainage massage which Lumi has taught me"

Patient Identity Withheld

DEEP OSCILLATION® creates a pulsed electrostatic field, which is built up in the client's body region to be treated and the therapist’s hand or applicator which is also used in self treatment.. Its frequency changes between 5 - 250 Hz, according to the selected indication. Due to the movement of the applicator or the special gloves of the therapist, a vibrating or pumping effect with deep impact is induced in the client's tissue.

What is the sensation of Deep Oscillation for client and therapist?

Client feels a gentle, pleasant, deep relaxing vibration in the tissues. Therapist feels the same gentle vibration in their own hands whilst massaging, without applying any pressure.

"In June 2011, fourteen years ago, Physiopod supplied a Hivamat Deep Oscillation machine to a Hospice in a neighbouring county. I was asked whether I would be agreeable in setting up and showing the Hospice staff how to use this machine. I had been using my Hivamat since the end of November 2009.

I explained all aspects of the machine and how to prepare for treatment, whereupon a lovely elderly gentleman with severe head and neck lymphoedema was presented for me to demonstrate deep oscillation.

He had severe facial oedema with a marked left-sided drop of his face, his left eye was hooded, his mouth drooped significantly downwards in comparison to his right side, and he had an enlarged, flaccid submental, submandibular pouch obscuring a normal neck.

It became evident to us all at the transformation of this gentleman’s face as I worked accordingly with the machine using both gloved hands and the applicator head. His hooded eye was lifting, improving his ability to see, his left mouth raised so his articulation from when he had arrived was more pronounced, and the sloppy lymph-filled pouch receded.

Clearly, in a short space of time, deep oscillation had penetrated engorgement and improved areas that would have been impossible with the normal surface, feather touch technique.

This was my first experience of treating a head and neck patient and my first experience of treating with deep oscillation. Since then I always treat head and neck cases with deep oscillation as the evidence was self-evident in 2011."

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PhysioPod® UK Limited are looking forward once again to meeting new and existing LSN Members and providing information and small tasters of DEEP OSCILLATION therapy.

The Lymphoedema Support Network (LSN) is a UK-based registered charity serving as the national support organization for individuals affected by lymphoedema. Established in 1991, the LSN provides crucial information and support to patients, promotes self-management, and advocates for improved care through education, awareness campaigns, and research contributions. Relying on public generosity, the LSN also offers various ways for people to donate and get involved in supporting their work.