Complete Decongestive Therapy

An overview of lipedema treatment

Lipedema commonly is misdiagnosed as lymphedema. Some patients have a combination of lipedema and lymphedema. Like lymphedema, lipedema is incurable but manageable. For patients with lipedema and lymphedema (lipolymphedema), modified complete decongestive therapy helps reduce and manage lymphatic compromise.

The standard for lymphedema therapy for when there is a presence of swelling is called Complete Decongestive Therapy (CDT). Since the lymphatic system and any impairment to it is unique to each patient, CDT is will vary from patient to patient, including the rigor of therapy and the techniques used. CDT often includes Manual Lymphatic Drainage (MLD) message, wrapping in bandages, compression garment wear, lymphatic breathing/exercises, and an introduction to a self-care routine.

CDT has two phases:

Phase I, the intensive phase, continues until the extremity has decongested or reached a plateau. The therapist provides treatments and educates the patient about all aspects of CDT to prepare him or her for phase II. Phase I can last several weeks to several months depending on severity.

Phase II, the maintenance phase, begins once the extremity has decongested or plateaued. This phase still focuses on CDT; however, the patient, not the therapist, is responsible for all care. The goal is to reduce limb size while enabling the patient to become self-sufficient in managing her care. Although CDT can bring significant improvements in limb size, skin quality and function, patients must remember that phase II continues lifelong.

Chatham, N. & Thomas, L. (2013). Lymphedema and lipedema: What every wound care clinician should know. Wound Care Advisor.
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