Treatment for Lymphedema: Complete Decongestive Therapy (CDT)

Andrea Branas, MSE, MPT, CLT & Joy Cohn, PT, DPT, CLT
Good Shepherd Penn Partners
Last Modified: December 12, 2011

Lymphedema occurs as a result of damage to the lymph nodes or lymph vessels.

The lymph vessels run very close to the blood vessels in our bodies and move fluid from the body through the lymph nodes and then into the blood. Lymph nodes work as filters to fight infection and help regulate swelling.

lymphatic-system-ben#613900

Lymphedema is chronic swelling that happens when the lymph is not moving properly. This can happen when lymph nodes are removed due to cancer. Lymph nodes can also be removed in other non-cancer surgeries. Lymph nodes and vessels can also be damaged with radiation therapy for cancer or through an injury to a body part.

Some people are born with poorly working lymph systems.

Some people have damaged leg veins or a history of blood clots. These people can also develop lymphedema due to back up of blood and fluid in the small vessels of the body.

Lymphedema results in chronic swelling that leads to tissue inflammation and scarring. The swollen body part feels harder to touch and is heavier than the non-swollen side.

How Is Lymphedema Treated?

The best treatment for lymphedema is complete decongestive therapy (CDT).

What is Complete Decongestive Therapy (CDT)?

Complete decongestive therapy (CDT) has 4 parts:

Manual Lymphatic Drainage (MLD)
A light skin stretching technique that stimulates the lymphatic system
Compression
Layered bandaging with foam or specially fitted garments that support the swollen area to control swelling.
Exercises
With compression, special exercises will help to pump lymph out of the swollen area.
Skin Care
Keeping the skin clean and moisturized will help to prevent infections that often can happen with lymphedema.

How Long Does Treatment Last?

There are two phases of treatment:

Active Phase

Lasts 2 to 12 weeks depending on the amount of swelling and tissue firmness.
Complete decongestive therapy for one-hour sessions, 4 to 5 days per week.
Bandages with foam are worn 23 hours per day.

Maintenance Phase

In order to prevent the area from swelling constant attention is needed.
Elastic compression garments that fit like a second skin are worn during the day.
Often bandages with foam are worn at night to decrease daily daytime swelling.
Exercises are done while wearing compression.
Self manual lymphatic drainage is done for 20 minutes per day.

How Can I Begin Complete Decongestive Therapy?

Complete decongestive therapy can begin once you have a written prescription from your doctor. The prescription is good for 30 days after it is written.
It is important to see a physical or occupational therapist that has passed a special training course to treat lymphedema. You will see the initials CLT, certified lymphedema therapist behind their name. Therapists who have passed a national certification test have CLT-LANA behind their name.
How do I find a certified therapist? If you need to find a qualified lymphedema therapist in your area, you can consult the websites below. These schools train qualified certified lymphedema therapists (CLT). Lymphedema therapists with CLT-LANA following their name have passed a national standardized examination.