The current recommended management of chronic lymphedema is Decongestive Lymphatic Therapy (DLT). DLT is a multi-modal treatment that aims to improve lymph drainage through existing lymphatic vessels, to encourage collateral circulation and to maintain volume reduction. DLT is provided by lymphedema therapists and is divided into two treatment phases:
1) An edema reduction phase of approximately 1 week to 1 month that involves manual therapy (e.g. manual lymphatic drainage, fasciatherapy), application of non-elasticized bandages for 24 hours per day, and education in skin care and exercise. Electric pneumatic compression machines may also be used.
2) A maintenance phase where, under the guidance of their lymphedema therapist, patients take charge of their own care. During the day compressive garments are worn to maintain volume reduction. Exercise specific to lymphedema and general overall activity and exercise are recommended. Additional manual therapy and bandaging may be required by those with a more severe stage of lymphedema. Electric pneumatic compression machines may also be used in this stage of treatment.
Research has focused on physical treatments and methods of self-management for this chronic life-long condition. There are some exciting developments on the horizon with scientists investigating possibilities of treatment through medication. Surgical treatments are also available in specialized centres around the world.