Combined Decongestive Therapy


As well as blood circulating in our bodies, we also have a second circulating system, the lymph vessel system. Lymph normally drains back into the blood circulation through a network of
lymph vessels and lymph nodes. This system’s role is to remove excess fluid, bacteria, viruses and waste products from body tissues and the space around the cells. Most of the tissue fluids
return to the heart via the veins. The rest (about 2 litres/day) is transported back to the blood stream via lymphatic vessels.

Primary or Secondary?

Primary occurs without an obvious cause, often present at birth.

Secondary lymphedema can occur as a result of infection, severe injury, burns or any other trauma or surgery that causes damage to the lymphatic nodes or vessels. In North America, this usually occurs as a result of previous radiation and/or surgery of the lymph nodes in the neck, armpit, pelvis or groin. Cancer treatment is the leading cause of lymphedema in Canada.

For cancer patients, lymphedema is usually caused by the removal or damage to lymph nodes from surgery or radiation. As lymph nodes are removed or damaged, it can be more difficult for lymph fluid to flow throughout the body.

Symptoms may include:

  • A full or heavy feeling in the affected limb

  • A feeling of tightness in the skin

  • Less movement or flexibility in the hand, wrist, shoulder or ankle

  • Clothing or jewelry feels tight in one specific area

  • Abnormal swelling in the affected area

Treatment For Lymphedema

The goal of lymphedema treatment is to help reduce and control swelling, prevent it from getting worse and decrease the chance of complications. The most effective form of treatment used by
therapists in North America and Europe is Combined Decongestive Therapy. This includes:


  • Manual Lymph Drainage - a specialized massage to redirect lymph fluid and provide long lasting solutions for people who have lymphedema

  • Compression Therapy - elastic bandaging, compression sleeves, gauntlets or tights

  • Exercise - to promote lymphatic flow by activating muscle and joint pumps

  • Excellent skin care - the use of antibacterial cleansers and pH neutral lotion