Lymphoedema management can be optimised but requires ongoing maintenance to remain effective. Typically, management is divided into two phases: the intensive decongestive phase and the maintenance phase.
The intensive decongestive phase focuses on reducing swelling and generally involves 2–3 weekly appointments for 3–4 weeks. During this phase, treatments may include bandaging, education on lymphatic drainage, exercises, and possibly complementary therapies to support swelling reduction. Alternatively, some patients may opt for self-management using wrap-style garments at home. Once the swelling is reduced to an acceptable level patients move to the maintenance phase. measurements are taken for a maintenance garment.
The maintenance phase emphasizes consistent skin care, simple exercises, self-lymphatic massage, and the regular use of compression garments. Manual Lymphatic Drainage (MLD), a specialised massage technique can also be incorporated during this phase as a way to “top up” maintenance efforts. While some individuals may not require a decongestive phase, others may experience a cycle of decongestion and maintenance depending on the severity and nature of their oedema.
For patients with Lipoedema, a decongestive phase is typically unnecessary, as compression cannot reduce the fat tissues. Instead, the focus is on education about the condition, measurement, and provision well fitting compression garments to support the tissues, prevent it getting worse and improve mobility.