Complete Decongestive Therapy (CDT) is a modality that is used to manage Lymphedema effectively. A CDT / Lymphedema Therapist's goal is to combine a series of treatments to help reduce the swelling, decrease the risk of infection, prevent hardening of the tissue and improve quality of life for the patient.
What is Lymphedema?
Lymphedema is an abnormal accumulation of protein rich fluid that causes swelling, most often in the arms or legs and occasionally in the trunk. The condition develops when lymph vessels or lymph nodes are impaired, damaged, or removed.
There are two types of lymphedema: primary and secondary.
Primary lymphedema is rare and is caused by the absence of certain lymph vessels at birth, or abnormalities in the lymphatic vessels.
Secondary lymphedema occurs as a result of a blockage or interruption that alters the flow of lymph through the lymphatic system and can develop from an infection, malignancy, surgery, scar tissue formation, trauma, deep vein thrombosis (blood clot in a vein), radiation, or other cancer treatment.
Signs and symptoms of Lymphedema
▪ Heaviness or tightness in limb or trunk
▪ Aching in Limb
▪ Restricted range of motion
▪ If an arm is affected, fingers may feel puffy and rings may feel tight
Treatment for Lymphedema
Lymphedema is a disease and unfortunately there is no cure due to the permanent damage to or absence of lymphatic components. However, Complete Decongestive Therapy (CDT) is a modality that is used to manage Lymphedema effectively.
CDT consists of 5 components -
▪ Compression Bandaging
▪ Skin and Nail Care
▪ Instruction in Self Care
Manual Lymphatic Drainage is a light massage therapy technique in which the skin is moved in certain directions based on the structure of the lymphatic system. MLD techniques are designed to increase the movement of lymph and interstitial fluid from a compromised to uncompromised part of the body.
Compression Bandaging improves the efficiency of joint and muscle pumps, breaks down fibrotic tissue which can form as a result of long standing fluid build up, and prevent fluid building up again in an area which has been treated with MLD.
Exercise increases muscle pump activity, which in turn, increases the movement of lymphatic fluid and is often performed with compression bandaging or a compression garment.
Skin and Nail Care is very important in reducing the risk of infection to the affected body part. A compromised lymphatic system means infections can be easily contracted. Skin should be kept supple, clean and insect bites, burns and cuts should be avoided
Instruction in Self Care is vital in the maintenance of Lymphedema. It enables the patient to take part in their own care by understanding the importance of skin care, self bandaging, exercise and self MLD and knowing when to attend follow up visits.
Benefits of Lymphedema Rehabilitation
▪ Decrease swelling and pain
▪ Help regain Range of Motion
▪ Decrease possibility of infection
▪ Learn self care techniques to control swelling, including the use of compression garments