Choosing a Lymphedema Therapist
Finding qualified lymphedema therapists that is a part of your healthcare plan and suits your needs can be challenging and confusing for many new patients. As a resource, the NLN lists affiliate clinics and therapists on our website. While the NLN can neither endorse services nor provide accreditation for these services, substantial effort is directed toward verification of accurate, up-to-date information.
When choosing to see a lymphedema therapist, it is wise to check their credentials and qualifications. Important notes are discussed below.
1. Is your therapist qualified to treat lymphedema?
First and foremost, it is important to know that your therapist is properly trained to treat lymphedema. While there are currently no government-recognized national standards for treatment or training in the United States, we generally follow guidelines established by the Lymphology Association of North America (LANA). http://www.clt-lana.org/faqs/default.asp
According to LANA guidelines, a minimum of 135 hours of intensive training is required to be considered qualified.
Lymphedema therapists come to this field from a variety of backgrounds, including nursing (RN), physical and occupational therapy (PT and OT), and massage therapy (MT), among others. While the traditional training programs for these careers provide some background for treatment of lymphatic disorders, therapists require additional training in programs devoted to the education of lymphedema therapists. Since the care of lymphedema is quite complex, more training generally translates into better care. For more information on training for lymphedema therapists, please see:
2. Where was my therapist trained?
Beyond training hours, a therapist should be trained at a reputable training program. A good training program should incorporate approximately 1/3 of the training in theoretical instruction, including anatomy and physiology of the lymphatic system, and 2/3 significant "hands-on" mentoring be provided to the trainees. We make every attempt to make sure that these minimal requirements are met by NLN Affiliate Training School. While not a complete list, the NLN training school page
3. Independent Therapist or Treatment Facility?
Excellence of care is the goal for both treatment facilities and independent therapists. Depending on your location, you may have the ability to choose between multiple treatment providers. For others, the availability of a qualified therapist is limited. Independent Therapists and treatment facilities offer different advantages. We highlight some differences below.
The standard of lymphedema treatment is complete decongestive lymphatic therapy (CDT), which is comprised of several elements: 1) manual lymphatic massage 2) skin care 3) bandaging 4) exercises and 5) instruction in self-care. We feel that it is a minimal requirement that any treatment resource for lymphedema provide each element of this care to patients.
Additional attributes characterize a treatment resource as a lymphedema center (vs. an independent therapist): to receive this designation, we feel that the organization should provide continuity of care (you should always have the ability to communicate with your therapist[s] about the status of your lymphedema and the potential need for reassessment or a change in therapy) and at least two (2) of the following attributes:
Direct onsite supervision/administration by an MD;
Garment fitting services (certified fitter on staff or refer to qualified, certified outside source);
A support group;
Onsite podiatric services by a licensed DPM;
Physical and/or occupational therapy.
Therapeutic providers that certify such additional services have been designated as lymphedema treatment centers in our resource listings.
Independent lymphedema therapists also are required to provide all the basic elements of decongestive therapy (see above), as well as garment fitting (either by the therapist, who is certified, or by referral to a qualified, certified outside source) to be listed in our resource listings.