background image
20th October 2017 

Lymphoedema And Complementary Therapies In SW London

Treating Lymphoedema with (CDT) and Manual Lymphatic Drainage (MLD)

What is it Lymphoedema?

Lymphoedema is swelling that develops because of a build-up of fluid in the body’s tissues. This happens when the lymphatic system, which normally drains the fluid away, isn't working properly. It can occur in any part of the body, but is most likely to affect an arm or a leg.
Lymphoedema develops when lymph nodes or vessels are damaged or blocked. Lymph fluid is unable to pass through the nodes and vessels. Because the fluid can’t drain away in a normal way, the lymphatic system becomes overloaded and fluid builds up between the tissues and causes swelling.
Lymphoedema is a chronic swelling. That means it is a condition that never goes away because the causes can’t be reversed. However, it can be reduced in most people, and the swelling can often be kept to a minimum, particularly when it’s diagnosed early. Learning how to manage it yourself is a major part of treatment.

There are two main types of Lymphoedema:
Primary lymphoedema – caused by faulty genes affecting the development of the lymphatic system; it can develop at any age, but usually occurs in early adulthood
Secondary Lymphoedema – caused by damage to the lymphatic system or problems with the movement and drainage of fluid in the lymphatic system, often due to an infection, injury, cancer treatment, inflammation of the limb or a lack of limb movement

How Do We Treat Lymphoedema?

Decongestive Lymphatic therapy (DLT) is recommended treatment for lymphoedema
There are four components to DLT:

1) Compression bandages and garments
If you have lymphoedema, you will have special bandages or garments (such as sleeves, gloves, stockings or tights) fitted over any affected limbs. These will support the affected muscles during exercise and encourage them to move fluid out of the affected limb.
These may also be applied after a session of MLD, to prevent fluid accumulating in the limb again. This use of compression bandages and garments is known as multilayer lymphoedema bandaging.
Velcro wraps may be used instead of bandages and have the advantage that the person with lymphoedema can apply them themselves.
You will be taught how to correctly apply your own bandages and compression garments, so you can continue to use them during the maintenance period.

2) Skin care
Taking good care of your skin is important, because it will reduce your risk of developing an infection, such as cellulitis.
Read our page on preventing lymphoedema for more skin care advice.

3) Exercises
Your lymphoedema care team will help devise an exercise and movement plan designed to strengthen and stimulate the muscles to improve lymph drainage . They will also help you to lose weight, if you are overweight. This will be tailored to your requirements and ability.
Your plan may involve specific limb exercises, as well as gentle activities that involve the whole body, such as swimming, cycling and walking.

4) Manual lymphatic drainage (MLD)
specialised massages called manual lymphatic drainage (MLD) carried out by a specialist therapist – to move fluid from the swollen areas into working lymph nodes, where it can be drained.
Unlike the blood circulation system, there is no central pump, such as the heart, to move fluid around the lymphatic system. Instead, the lymphatic system uses the massaging effect of surrounding muscles to move the fluid.
Your lymphoedema therapist will also teach you a range of simpler massage techniques that you or your carer can use during the maintenance phase of treatment, to help keep the swelling down. These self-massage techniques are known as simple lymphatic drainage (SLD).

DLT usually begins with an intensive phase of therapy, during which you may receive daily treatment for several weeks to help reduce the volume of the affected body part.
This is followed by the second phase, known as the maintenance phase. During this, you will be encouraged to take over your own care by carrying out simple self-massage techniques, wearing compression garments and continuing to exercise. This phase of treatment aims to maintain the reduced size of the affected body part.
You may then have reviews every few months to check how your treatment is progressing.