Complete Decongestive Therapy

Currently, the gold standard for the treatment of Lymphedema is Complete Decongestive Therapy by a Certified Lymphedema Therapist. This form of treatment is low risk with nearly no complications to the patient. With good patient compliance, the patient can experience significant reduction in swelling and symptoms.

There is no cure for lymphedema, however, it can often be treated successfully and managed to reduce or eliminate symptoms. The earlier the treatment program starts the better the prognosis for the individual.

The certified lymphedema therapists at the Lymphedema Therapy Center of New Jersey, offers one-on-one treatment and education that are tailored to meet each patient’s specific needs. 

Complete Decongestive Therapy (CDT) shows good long-term results in both primary and secondary lymphedema; it consists of two phases and the  following combined modalities: 

Manual Lymph Drainage (MLD)

This gentle manual treatment technique increases the activity of certain  lymph vessels and manually moves interstitial fluid. Applied correctly, a series of MLD treatments  decreases the volume of the affected extremity to a normal or near normal size and is applied daily in he  first phase of the therapy.

Compression Therapy

The elastic fibers in the skin are damaged in lymphedema. In order to prevent  reaccumulation of fluid it is necessary to apply sufficient compression to the affected extremity.  Compression therapy also improves the function of the muscle pumps, helps to reduce fibrotic tissue and  promotes venous and lymphatic return.  

In the first phase of CDT, compression therapy is achieved with the application of special short-stretch  bandages. These bandage materials are used between MLD treatments and prevent the reaccumulation of  lymph fluid, which has been removed from the extremity during the MLD session. Once the extremity is  decongested, the patient wears compression garments during the day. In some cases it may be necessary for  the patient to additionally apply bandages during nighttime.

In order to achieve best results, specially  trained personnel should take measurements for these elastic support garments; incorrectly fitted sleeves or  stockings will have negative effects. The type of garments (round or flat-knit style) and the compression  class depends on many factors such as the patients' age and the severity of the swelling.

For upper  extremity lymphedema, compression classes I (20-30 mm/Hg) or II (30-40 mm/Hg); for lymphedema of the  lower extremities, compression classes II, III (40 - 50 mm/Hg) or IV (>50 mm/Hg) are suitable.

In some  cases it may be necessary to apply compression class III to an upper extremity or an even greater  compression than class IV to a lower extremity lymphedema. This can be achieved by wearing two  stockings on top of each other, or by the application of bandages on top of a stocking.  To have the maximum effect, garments must be worn every day and replaced after six months.

Exercises

A customized exercise program is designed by the therapist for each patient. These decongestive  exercises aid the effects of the joint and muscle pumps and should be performed by the patient wearing the  compression bandage or garment. Vigorous movements or exercises causing pain must be avoided.  Exercises should be performed slowly and with both, the affected and non-affected extremity.

Skin care

The skin in lymphedema is very susceptible to infections and usually dry. A low-pH lotion, free  of alcohol and fragrances should be used to maintain the moisture of the skin and to avoid infections. You  should consult your physician if there are any fungal infections present in your affected extremity.