Complete Decongestive Physiotherapy (CDP) for Lymphedema

Published: 04th May 2009
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Most doctors agree that the most successful treatment for lymphedema is something called CDP (complete decongestive physiotherapy) or sometimes CDT (complete decongestive treatment). This treatment requires a two step process. First fluid in the lymph system is drained manually by using external massage. Second, the affected areas are wrapped using compression bandages to prevent the swelling from returning. This treatment originated in Germany and was brought to the United States by Dr. Robert Lerner, a former Chief of Surgery at the Brooklyn Jewish Hospital, in the late 1980's.

It is very important that compression garments fit properly. You should ask the physician who treats your lymphedema to help you adjust the fit. Most compression garments are open-toed. Some patients choose to use "toe gloves" to help further reduce the swelling. Toe gloves must also be fitted carefully. They fit over each of the toes individually, except the pinkie toe (so that means you will need a total of 8 garments, 4 for each foot). Patients can also opt to tape toes before putting on the main compression garment. Whatever option you choose, be sure that it does not pinch or rub your foot. People with lymphedema should avoid foot injuries at all costs, and the skin between the toes is particularly vulnerable.

Skin care is an important part of the CDP or CDT regimen. People diagnosed with lymphedema must be extremely cautious when it comes to foot injuries. Their immune system is already compromised, and so even the smallest of scrapes or blisters can lead to serious infection. Calluses, corns, blisters, bunions, hangnails, ingrown toenails and cuts all must be monitored vigilantly. People with lymphedema should never attempt to cut their own cuticles (this is a job for your doctor) or pop a blister.

Small tears in the skin could lead to bigger problems in the future. Wash and dry your feet every day, making sure to wash and dry between the toes. Inspect your feet for injuries, or ask a friend or family member to do it for you. Use a cuticle cream and gently push cuticles back using a blunt instrument. Always use an electric razor when shaving your legs. And finally, invest in a pair of shoes that will not hurt your feet. Athletic shoes or shoes designed for diabetics provide extra protection for the foot. If you have swelling only in one limb, be sure to purchase shoes that properly fit both of your feet - even if that means finding a pair of shoes that includes two different sizes or widths.

Following the CDP regimen requires a change in lifestyle. It both treats your symptoms of lymphedema (swelling in the limbs) and protects against complications in the future (infections, pain and further swelling). You and your doctor must work together in order to give yourself the most complete, effective care possible.

Jane Barron works for,a free online website that helps people find mismatched footwear.If you are looking for different sized shoes, or information useful to polio survivors, people with diabetes foot problems, and people with foot size differences, visit:

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