Compression Therapy for Lymphedema
By John C. Andrich, MLD/CDT
Chrysalis Wellness Resources, Dartmouth , N.S.
Bandaging and compression garments are an essential part of the program called Complete Decongestive Therapy for the management of Lymphedema. Compression garments are often prescribed by doctors recognizing lymphedema, but the benefits of bandaging are not as understood or accepted for many reasons. One most common reason is the work and expense involved in learning from a certified lymphedema therapist the proper techniques.
This short article is meant to encourage those dealing with their lymphedema to take a closer look at the complete picture involving compression therapy for lymphedema care. Bandaging helps reduce swelling in the affected limb during the initial treatment program called manual lymph drainage/ complete decongative therapy. The skilled and certified therapist helps the lymphedema patient reduce the swelling considerably within the first 10 – 15 treatments, and the bandaging techniques are introduced, so that the patient can effectively learn to self-bandage at home.
After the swelling in the limb is significantly reduced, the patient is referred to a specially trained garment fitter and the new garment fitted to the reduced size of the limb. If the garment is fitted without proper limb reduction, the garment itself will do its work, the limb will reduce somewhat, and from then on be too loose and essentially ineffective. Having the garment fitted after the limb is properly and effectively reduced in size will ensure maximum effect and lifespan of the compression garment.
Each component of compression therapy, the bandages and the garment are designed to give different kinds of compression, both of which are essential for long-term successful lymhpedema management. The bandages are short stretch material which form a “soft cast” environment for the overstretched skin and help reduce refilling once the limb had been successfully reduced in volume. The garments on the other hand, are more elastic and give with each movement, but “spring back” and add compression when the limb is at rest. The bandages are most often used in the evening at home, during the exercises designed to increase healthy lymphatic flow, and overnight, while the garment is designed for the daytime where the sleek and unobtrusive fitting is easier to handle under clothing.
Over the course of months and years, the tissue that was gradually “flooded” from the slowly developing lymhpedema, becomes thicker, almost sponge-like, and actually begins to attract more fluid. This vicious cycle of fluid imbalance in the tissue is effectively and completely eliminated only when the sponge like tissue is safely broken down and reduced to it’s previous healthy state.
Compression therapy, both proper bandaging and compression garments break up and reduce accumulated deposits in the connective tissue because they give the limb different types of compression each day. One or the other alone is not enough and results in an incomplete, frustrating experience where the relentless effects of lymphedema often lead to heaviness, reduced mobility, and tissue hardening.
Certified lymphedema therapists spend many years developing the skills to bandage swollen limbs and to effectively coach lymphedema patients to self -bandage. These therapists also carry and supply the best quality bandages designed specifically for this purpose. As each lymphedema is individual, it is important to develop these skills with personal coaching.
I encourage those who want to progress and advance in their own lymphedema self-management program to learn and master these bandaging skills for efficient and long-term swelling reduction of their affected limb.
For a list of certified lymhpedema therapists, please contact:
Massage Therapy Association of Nova Scotia
P.O. Box 9410, Station A,
6009 Quinpool Rd., Suite 801
Halifax, N.S.B3K 5S3
Suggested further reading: http://www.nortonschool.com/compression