Lymphoedema is a condition characterized by the accumulation of lymphatic fluid, leading to swelling, primarily in the arms and legs. It can occur for various reasons, including surgery, radiation therapy, or genetic factors. Managing lymphoedema is crucial for reducing swelling and preventing complications such as infections and tissue damage. Combined Decongestive Therapy is a key component of your Lymphoedema management.
What is Combined Decongestive Therapy (CDT)
Combined Decongestive Therapy (CDT) is a comprehensive treatment approach designed to manage lymphoedema effectively. CDT treatment consists of an application of a series of layers of different materials, which include an initial breathable foam, followed by a series of bandages (usually 3 to 4 layers) of compressive consistency, which may have different lengths and stretches that apply to it. Those layers and materials aim to compress the limb and maintain a specific gradient pressure, higher on the distal side of the limb and weaker at the proximal area, to maintain the lymph fluid movement and induce a decongestive result.
Combined Decongestive Therapy and MLD
Before starting a CDT treatment, along with the lymphoedema management, you are most likely to receive a manual lymphatic drainage session, which aims to create or boost the lymphatic system pathways, where the lymphatic liquid would then be pushed via the compression applied. Along those modalities, skin care and exercise are essential to your lymphoedema management. CDT aims to reduce swelling, improve lymphatic flow, and enhance overall well-being. 
How many sessions would I need to reduce the swelling to an optimal level?
Each individual and each presentation is unique, so based on your presentation, Giovanni would create a treatment plan that would work best for you. On the other hand, a communal ground to all the presentations is that the higher the frequency of the appointments, the better this therapy would work. Initially, Giovanni would highly recommend to book in 3 to 5 sessions for the first week. That would allow a quick reduction of swelling, leading to a secondary management plan.
The more severe the swelling, the longer it could take to manage it. Infections, fibrosis (which is the hardness of the tissue), the number of lymph nodes removed (especially post-cancer surgery), or missing exercise management and an anti-inflammatory diet are all factors that could affect the progress of your presentation. Giovanni can assist you with most of those, and where he can not reach you, he will refer you to another practitioner (like a nutritionist for diet advice).
Why Pharmacy Compression Isn’t Enough
While pharmacy-grade compression garments may seem like a cost-effective solution for managing swelling, they often lack the specificity required for effective lymphoedema treatment. These garments can lead to several issues:
Non-specific Fit: Pharmacy compression products may not provide the correct pressure level needed in targeted areas, leading to inadequate fluid reduction.
Potential Blockage: Inadequate fit can create areas of higher pressure, which might push fluid further up the limb, causing increased swelling in areas that are not adequately compressed.
Increased Risk of Complications: Without proper compression therapy tailored to individual needs, the risk of complications, including infections and further lymphatic blockage, can increase.
At our clinic in Fitzroy North, Melbourne, we emphasize the importance of professionally fitted compression garments, and Giovanni can refer you to clinic that can take measurements for you and deliver a tailored on your need compression garment.
Combined Decongestive Therapy During the Summer
As the temperatures rise, managing lymphoedema can become increasingly challenging. The summer months bring unique issues that can exacerbate swelling:
Atmospheric Pressure Changes: During hot weather, atmospheric pressure decreases, which can lead to increased lymphatic fluid accumulation in the limbs.
Heat and Humidity: Hot and humid days can cause blood vessels to dilate, which may lead to increased swelling. Additionally, sweat and heat can irritate the skin, raising the risk of infections in already vulnerable areas.
To keep swelling under control during the summer, it’s essential to:
Stay Hydrated: Drink plenty of water to help maintain fluid balance.
Wear Proper Compression: Ensure you are using correctly fitted compression garments that are appropriate for summer use. Lightweight and breathable fabrics can make a significant difference. And yes, they are not going to make you feel hotter. A garment wearer has to be comfortable if is not, you will talk to your supplier, and they would be more than happy to assist you with that.
Practice Good Skin Care: Keep the skin clean and moisturized to reduce the risk of infections.
Monitor for Signs of Infection: Be vigilant for any signs of redness, swelling, or increased warmth in the affected areas, and seek prompt medical attention if these occur.
Why CDT is not recommended for the early Lipedema stage
In the early stage of Lipedema, the lymphatic system is not compromised, and CDT therapy, given the nature of this presentation, which is fat accumulation under the skin, could be too aggressive on the skin, which let’s not forget, in a Lipedema presentation would easily bruise. On top of that, as there is an excess of fat accumulation under the skin, the heavy compression applied by CDT to these tissues could compress the dermatome innervations, leading to pain and discomfort. That’s also why lipedema, compared to lymphoedema, can lead to pain when reaching advanced stages.
Conclusion
Lymphoedema is a manageable condition with the right approach. At Melbourne Massage and Treatment in Fitzroy North, Giovanni is committed to providing tailored treatment options, including Combined Decongestive Therapy and appropriately fitted compression garments, to help you effectively manage your symptoms. As we move into the warmer months, staying proactive in your care is crucial to prevent complications and maintain your quality of life. If you have any questions or need support, please get in touch with Giovanni. Your well-being is the priority!
If you are struggling with the management of your lymphoedema, book now your free 15 minutes free consultation with Giovanni, to discuss a treatment plan for your case.
FAQ
Q: What is lymphoedema?
A: Lymphoedema is a condition characterized by the accumulation of lymphatic fluid, leading to swelling, primarily in the arms and legs but it can occur also in the thoracic area or other body parts. It can occur due to various reasons, including surgery, radiation therapy, or genetic factors.
Q: What is Combined Decongestive Therapy (CDT)?
A: CDT is a comprehensive treatment approach designed to manage lymphoedema effectively. It consists of layers of materials, including a breathable foam followed by 3 to 4 layers of compressive bandages, which maintain a specific gradient pressure to promote lymph fluid movement and decongestion.
Q: How does manual lymphatic drainage (MLD) fit into CDT?
A: Before starting CDT, you are likely to receive a manual lymphatic drainage session, which aims to create or boost the lymphatic pathways, allowing the lymphatic fluid to move effectively when compression is applied.
Q: How many CDT sessions will I need?
A: Each individual is unique, but it’s generally recommended to book 3 to 5 sessions in the first week for optimal swelling reduction. The severity of swelling and other factors like infection and tissue hardness will influence the treatment plan.
Q: Why aren’t pharmacy compression garments sufficient for lymphoedema?
A: Pharmacy-grade compression garments often lack the specificity needed for effective treatment. They can lead to inadequate fluid reduction, potential blockage, and an increased risk of complications if they don’t fit properly.
Q: What should I do if I need a properly fitted compression garment?
A: At our clinic, we emphasize the importance of professionally fitted compression garments. Giovanni can refer you to a clinic that can take measurements and provide tailored garments based on your needs.
Q: How does summer affect lymphoedema management?
A: In summer, atmospheric pressure changes and increased heat and humidity can exacerbate swelling. Hot weather may cause blood vessels to dilate, leading to more fluid accumulation and an increased risk of infections.
Q: How can I manage lymphoedema in hot weather?
A: To keep swelling under control during summer, stay hydrated, wear appropriately fitted and breathable compression garments, practice good skin care, and monitor for signs of infection.
Q: What signs should I look for to detect an infection?
A: Be vigilant for any signs of redness, swelling, or increased warmth in the affected areas. If you notice these symptoms, seek prompt medical attention.
Q: How can I contact Giovanni for more information?
A: If you have any questions or need support regarding lymphoedema management, don’t hesitate to contact Giovanni at Melbourne Massage and Treatment in Fitzroy North. Your well-being is a priority.
Giovanni La Rocca
Giovanni moved to Melbourne, Australia, from Italy in 2008 and became a citizen in 2017. He started studying massage therapy in 2016, then completed a Bachelor of Health Science in Clinical Myotherapy in August 2024. During those years, he also specialised in Thai Massage and Manual Lymphatic Drainage for presentations like Lipedema and Lymphoedema. Nowadays, he runs his clinic in Fitzroy North, Melbourne, where he integrates movement therapy into his practice to enhance overall well-being. He also values meditation, having completed several Vipassana courses. Committed to continuous learning, he aims to share his expertise in integrated therapies to help others achieve balance and resilience.