Complete Decongestive Therapy

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The gold standard for treating both lymphedema and lipedema 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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CDT is comprised of four parts delivered in two phases. The four parts are:

Manual lymph drainage (MLD)
— Compression, which includes bandaging and compression garments plus aquatics therapy
— Meticulous skin and nail care
— 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.

Treatment for lipedema is much like that of lymphedema — it is multifaceted and consists of several therapies, the basis of which is complete decongestive therapy. For more information, see the article Goals for Lipedema Care.

Complete decongestive therapy. (n.d.) Physiopedia.


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