Complete Decongestive Therapy for Lymphedema

An experienced physical therapist, Elizabeth Cendan most recently served in the women's health department at the Rusk Institute of Rehabilitation Medicine at NYU Langone Medical Center. There, Liz Cendan performed complete decongestive therapy for patients diagnosed with lymphedema.

For patients with lymphedema, damaged lymph nodes or vessels cause an abnormal flow of the lymph fluid. This, in turn, leads to chronic swelling and subsequent inflammation of tissue as well as pain and heaviness in the swollen area.

Complete decongestion therapy (CDT) is accepted as a standard first-line treatment for lymphedema. It involves four basic components, the first of which is a manual drainage technique that stimulates the lymphatic system. Outside of these sessions, the patient wears layered foam bandages or specialized, fitted garments to control swelling through compression, the second component of CDT.

The patient helps to support the movement of lymph by performing prescribed exercises, which function as the third component of the CDT regimen. The fourth, skin care, also requires the patient's participation in maintaining clean and well-moisturized skin that is resistant to infection.

The treatment regimen begins with an active phase, also known as the decongestive or intensive phase. This requires daily treatment from trained lymphedema experts and lasts approximately two to three weeks for the average patient. The patient then progresses to the maintenance or self-management phase, an ongoing regimen in which the patient follows individualized instructions that may include self-manual drainage and wearing compression garments daily.