Although lymphoedema is a chronic (long-term) condition without a cure, it can be well-managed with Complete Decongestive Therapy (CDT). This means that non-surgical treatments such as compression therapy, lymphatic drainage, exercise, skin care, and self-management are usually sufficient to treat the signs and symptoms. Lymphoedema surgery, such as lymph node transfer, might be appropriate in some cases.
What it takes to cope with lymphoedema
What is complete decongestive therapy?
Complete Decongestive Therapy (CDT), sometimes also referred to as Complex Decongestive Therapy, is the gold standard for management of lymphoedema. As the name suggests, the main aim is to decongest, to reduce swelling and moreover to improve skin condition and mobility. CDT consist of two phases:
- Phase I – Decongestion: Intensive treatment phase which usually lasts 2-4 weeks. In case of a mild lymphoedema this phase might not be necessary, and the patient could go straight into Phase II
- Phase II – Maintenance and Optimization: In this phase the goal is to gain long-term control over your lymphoedema by maintaining and maximizing the achievements of Phase I. Depending on the course and severity of your condition, it might be necessary to go back into Phase I from time to time.
Both phases consist of several elements.
Elements of complete decongestive therapy
Compression Therapy is the cornerstone of both phases, though in Phase I the compression needs to be more adaptable as the swelling will be reduced significantly over time. Therefore short-stretch bandages, often as part of a multi-layer bandage system, or adaptive wrap systems are used. In Phase II usually flat-knit garments maintain the achieved success.
Lymphatic drainage further supports the effect of compression therapy. It is a specific massage technique with gentle, skin-stretching movements applied by a therapist and then called Manual Lymphatic Drainage (MLD). It could also be learned by the patient and self-applied, which is rather the case in Phase II of CDT. This is then referred to as Simple/Self Lymphatic Drainage (SLD).
Exercise is an element of both phases, too. In lymphoedema treatment it is necessary to maintain and improve mobility as well as to increase the lymphatic flow. In Phase I this is usually supported by a therapist, while in Phase II your active role is required more.
Skin Care and Self-Management are essential in both phases of CDT. With lymphoedema you are more prone to local infections and even small skin injuries can cause bacterial infections which might further worsen your condition. Taking good care of your skin is only one element of Self-Management. It also means that you take a leading role in your condition and that you gain a deep understanding of lymphoedema in general. This will support you in working with your healthcare professional in partnership and on eye level.
