Depending on the stage and progression of the lymphedema, various treatment options should be considered. For stage 2 and stage 3 lymphedema, the most common treatment is complete decongestive therapy, which is provided in-clinic by a certified lymphedema therapist (abbreviated as CLT). Therapists who have passed a national standardization examination, in addition to their lymphedema therapist certification, have CLT-LANA behind their name.
The purpose of the complete decongestive therapy is to reduce the limb volume and fibrosis and train the patient with at-home self-treatment skills to ensure maintenance of the condition.
Complete decongestive therapy consists of four parts:
Manual lymphatic drainage:
Manual lymphatic drainage therapy involves gentle, skin stretching massage techniques. The aim is to follow the natural function and pathways of lymphatic system and guide the lymph towards the healthy lymphatic system. Some lymphedema treatment centers apply LymphaTouch® (or PhysioTouch®) device in conjunction with MLD to further support lymphatic drainage. Please, contact us to find out your nearest lymphedema center that uses LymphaTouch®.
Compression Bandaging and Garments
Compression bandaging means applying several layers of bandages with foam to the affected and swollen area, and in this way creating a soft, multilayered compression cast. Bandaging is also known as wrapping. Bandaging can be applied to limbs but also to chest or trunk area, since the short-stretch bandages come in many different sizes.
Compression garments may also be used. The garments come in different sizes and models, including for example compression socks, gloves, pants, tights and sleeves. Certified lymphedema therapist can help with the right compression garment selection
Certified lymphedema therapist may teach patient on how to do manual lymphatic drainage at home on their own. In addition, with compression there are specific exercises that help move lymph from the affected area.
Skin infections, such as cellulitis, are a common problem for lymphedema patients. Proper skin care prevents bacterial and fungal growth that may cause skin infections and is, therefore, a key part of complete decongestive therapy.
After the in-clinic complete decongestive therapy sessions, the patient needs to continue to maintain the lymphedema condition by utilizing various at-home therapies.
Lymphedema treatment at-home
LymphaTouch® negative pressure treatment
LymphaTouch®, also known as PhysioTouch®, is a pain free and easy to use negative pressure device that aims to ease the pain, and give more range of motion for the patient. It can be applied by the patient to support self-treatment of lymphedema and swelling at home. The device is very light weight and portable that travels with the patient.
Compression garments offer a daily care routine for lymphedema patients. Different garment models include for example compression socks, gloves, pants, tights and sleeves in many different sizes. Also, specifically designed night time garments exist.
When choosing the right compression garment or model, the most important thing is to choose a product that has a right size and the right compression level for the treated area. Finding the correct compression level is called fitting and more information on how to find the right fit can be found from the compression garment manufacturer or from your certified lymphedema therapist. As too much compression might also be harmful for the lymphatic system, it is therefore recommended to always order the garments so that they are customized for the patient.
Compression garments are part of the everyday routine for lymphedema patients.
Manual lymphatic drainage at home (Self-MLD)
Certified lymphedema therapist may teach a patient on how to do on their own manual lymphatic drainage at home. You may ask this training from your therapist. The patient may be instructed to do Self-MLD 20 minutes every day.
Lymphedema pumps are a treatment method, where the treated limb is dressed into a cuff. The cuff has a varying number of cells that can be filled with air. The compressor fills one cell at a time, in the distal direction of the limb. The purpose is to push and guide the lymph out of the treated body part.