Complete Decongestive Therapy
The gold standard for lymphedema therapy is a combination of modalities called Complete Decongestive Therapy (CDT) , This is the approach at Olympic Sports & Spine (OSS). CDT is endorsed by the International Society for Lymphology, the National Lymphedema Network, the International Lymphedema Framework, and by the committee that advises Medicare and Medicaid on evidenced-based treatment of specific diseases.
CDT is comprised of four parts delivered in two phases.
The four parts are: compression (bandages or garments), manual lymph drainage, meticulous skin and nail care, and exercise. All four parts are present in both phases of treatment. The first phase, the intensive phase, is treatment provided in the clinic by a therapist certified in lymphedema care. The second phase is the life-long, self-management or optimization phase completed at home by the patient or caregivers. Instruction in self-care for lymphedema is provided by the therapist in the transition from the intensive to the optimization phase.
Lymphedema care at Olympic Sports & Spine is characterized by Complete Decongestive Therapy: The recognized “Gold Standard” for lymphedema therapy.
Lymphedema treatment requires specialized compression bandages applied in a highly specific manner; a technique that is modified to best suit each patient. The bandaging helps to move fluid out of the limb or body part and can be surprisingly comfortable to wear (they should not cause pain). The compression bandages also help to soften and reduce fibrosis associated with lymphedema. Once treatment begins, the bandages are worn for 23-24 hours per day. In the optimization phase, compression garments take the place of the compression bandages.
Manual Lymphatic Drainage
MLD is a specialized massage technique that stimulates fluid to move more effectively through the lymphatic system and to bypass impairments in flow. This helps to reduce the accumulation of fluid in the tissues that characterizes lymphedema. MLD is unique in that it is the lone intervention that helps to evacuate stagnant tissue proteins. MLD typically requires 30-45 minutes of work each session. It is a very comfortable massage technique for the patients. When combined with compression bandaging, it forms the core of lymphedema treatment.
Meticulous Skin and Nail Care
Because infection is an ever-present concern for lymphedema patients, daily attention to the skin and nails is needed to prevent infection. Attention to skin care will be a part of each treatment session during phase one of CDT and should be a part of each patient’s daily during phase two.
Exercise for Lymphedema
Exercise generally is a good idea (with a few caveats) for individuals with lymphedema. Patients are encouraged to engage in the exercise of their choice. However, our program calls for remedial exercises which work in concert with the other elements of CDT, especially compression, to help reduce lymphedema. Muscle contractions mobilize fluid, and when combined with compression, augment the results.