Complete Decongestive Therapy

Educational Resources

The gold standard for lymphedema therapy is a combination of modalities called Complete Decongestive Therapy (CDT). 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.

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Treatment for lipedema is much like that of lymphedema — it is multifaceted and consists of several therapies, the basis of which is CDT (see below). The goals for lipedema therapy are: improving lymphatic flow by manually draining the lymphatic system, either with the assistance of a certified lymphedema therapist (CLT), with the assistance of a lymphatic pump (see below), or by self-drainage techniques, by compression or bandaging, by dry brushing (see below), by deep breathing exercises, and/or by the use of vibration and/or rebounding; reducing inflammation through good nutrition and supplements; assisting and/or improving function through good nutrition and exercise; managing pain through good nutrition, supplements/medication, and exercise; and getting emotional support through support groups, counseling, and connecting with other lipedema patients — a great way to meet other patients is by attending FDRS conferences.

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Kelly Sturm

Complete Decongestive Therapy

Complete Decongestive Therapy (CDT) is comprised of four parts delivered in two phases.

The four parts are: manual lymph drainage (MLD) (see below), compression (bandaging, garments, and aquatics) therapy, meticulous skin and nail care, and decongestive and breathing exercises. 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.

Complete Decongestive Therapy. (n.d.) Physiopedia. https://www.physio-pedia.com/Complete_Decongestive_Therapy_(CDT)

Manual Lymphatic Drainage

Manual Lymph drainage (MLD) is a technique developed by Dr. Emil Vodder and Dr. Estrid Vodder in 1936 in Paris for treatment of swollen lymph nodes. MLD is a light, skin-stretching massage that helps promote the movement of lymphatic fluid out of the swollen limb and is specifically focused on the lymph vessels to help the flow of lymphatic fluid. Therapy is applied to your unaffected areas first, making it possible for the fluid to move out of the affected area, or to “decongest” the region. MLD helps open the remaining functioning lymph collectors and move protein and fluid into them, as well as to help speed up lymph fluid flow through the lymphatics.
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