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Management of Lymphoedema

A Complete Guide to Complete Decongestive Therapy (CDT)

What Is Complete Decongestive Therapy?

Complete Decongestive Therapy (CDT) is used to reduce the lymph volume in the arm or leg. While each treatment plan is tailored to the individual, all CDT programs include three essential phases. 

Treatment Timeline

Typical duration: 2–4 weeks of intensive therapy to reach plateau in swelling reduction.

CDT Phases

Phase 1: Intensive – Oedema Reduction 

This phase focuses on actively reducing swelling and improving lymphatic flow.

  • Manual Lymph Drainage (MLD)
  • Multilayer compression bandaging
  • Individually tailored exercises
  • Skin & nail care
  • Patient self-care education

Week one – 4 MLD & CDT treatments – 1.5 hours

Week two – 2 MLD & CDT treatments – 1 hour

Note: Bandages are worn continuously, except during MLD sessions. Bandages are ordered via the GP.


Phase 2: Maintenance – Stabilisation & Optimisation (weekly 1 treatment for 4 weeks)

After decongestion plateaus, patients transition to daily management.

  • Self-drainage techniques replace professional MLD
  • Compression garments worn during the day
  • Bandaging applied at night
  • Continued skin & nail care
  • Regular exercises

Therapists will measure for made-to-order compression garments during this phase. Compression can be ordered via your GP.

Week three, four, five  - 1 MLD treatment  45 min treatment          

 

Phase 3: Follow-Up (As Needed)

This phase mirrors Phase 1 and is scheduled according to symptom recurrence or seasonal needs.

Components of CDT

Manual Lymph Drainage (MLD)

MLD is a specialised massage technique using gentle, rhythmical movements to stimulate lymph flow. It redirects fluid from obstructed areas to healthy nodes, decreasing congestion and improving circulation.

MLD is most effective when combined with bandaging, skin care, and exercise.

Multilayer Bandaging

Applied post-MLD during the intensive phase, multilayer bandages:

  • Prevent fluid reaccumulation
  • Reduce tissue fibrosis
  • Help reshape the affected limb

Treatment options:

General treatment plan: 

Most clients who have been diagnosed with Lymphoedema / Lipoedema via the hospital, are looking for additional treatment and advise to manage their condition. 

Month one - two treatments to soften the tissue, advice, self treatment, exercise