When treating patients with lymphedema, specially trained physical and occupational therapists, medical doctors, registered nurses, chiropractors and massage therapists may be able to offer lymphedema therapy, including Complete Decongestive Therapy (CDT).
To be able to provide lymphedema therapy these medical health professionals must have a current, unrestricted license as well as complete an additional 135 hours of training. This allows the medical professional with the lymphedema certification to provide all services for treatment including developing treatment plans and providing treatment.
What is Lymphedema Therapy?
The complete package of treatment options considered for lymphedema therapy will vary from patient to patient. It includes several different aspects of management of the condition including:
1. The use of manual lymphatic drainage or MLD
2. Compression garments
3. Bandaging
4. Exercise
5. Patient self-care
For many people with Stage or Grade 1 lymphedema, where there is only light swelling of the area and no change in the tissue, MLD may be all that is required. Once the swelling goes beyond this stage and is affecting an entire limb and the tissue, including the presence of fibrotic tissue, the more complete CDT is typically ]recommended.
The Goals
Each component of CDT has a different purpose or a different impact on the body. The most important component is the manual massage or MLD. This technique provides the correct amount of pressure on the skin in specific patterns to facilitate the flow of lymph into the area and assist in the stimulation of the lymphatic system. The movements also assist in directing the flow of the lymph along the natural pathways of the body.
Short-stretch compression bandages and compression garments are worn after MLD and between sessions. They are usually worn on the appropriate areas of the body around the clock, but they are removed for bathing and for sessions with the therapist.
At the same time during the lymphedema therapy the therapist will work with the patient to teach exercises to use used between therapeutic sessions. These exercises will also be designed to stimulate the lymph system and to aid with the reduction of swelling.
Finally, patient self-care will also be involved in the lymphedema therapy. This allows the therapist to provide specific information based on the needs and requirements of each patient. Self-care support can include skin and nail care as well as signs of complications requiring immediate medical support, providing the patient with the knowledge they need to continue to manage the condition.
