The Benefits of Lymphatic Drainage

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Lymphatic drainage is a manual technique used to stimulate the flow of lymph (a clear fluid that circulates through the body via the lymphatic system) to relieve swelling and improve health. Among its many functions, lymph helps isolate disease-causing pathogens and returns captured fats and protein back into the bloodstream.

Because the lymphatic system plays a central role in the body's immune system, proponents of lymphatic drainage suggest that this form of therapeutic massage can help treat a variety of health conditions.

Also Known As

  • Decongestive lymphatic therapy (DLT)
  • Lymphatic drainage massage
  • Lymphatic massage
  • Manual drainage massage
  • Manual lymph drainage (MLD)
Woman receiving lymphatic massage
Eliza Snow / E+ / Getty Images

Types of Lymphatic Drainage

There are four types of lymphatic drainage used by doctors, physical therapists, and massage therapists, named after the people who developed them:

  • Vodder: A foundational technique using a variety of sweeping hand motions, depending on the part of the body being treated
  • Földi: An extension of the Vodder technique in which circular hand motions are interspersed with moments of relaxation
  • Casley-Smith: A technique that also involves circular hand motions, albeit with the sides and palms of the hands
  • Leduc: A technique in which hands motions are said to "entice" (collect) lymph before directing its reabsorption into the larger lymphatic system

Each of the techniques are based on the same principles, namely the use of gentle movements to stretch the skin in the direction of the lymphatic flow, starting at the part of the limb closest to the torso and moving outward.

A lymphatic drainage procedure generally lasts for 45 to 60 minutes.

Uses

Lymphatic drainage was initially developed in the 1930s by Danish physicians Emil and Estrid Vodder as a treatment for lymphedema (a condition marked by the buildup of lymph in soft tissues, often as the result of infection, injury, cancer treatment, surgery, or genetic disorders affecting the lymphatic system).

Lymphedema can manifest with a range of symptoms, including tissue swelling, skin discoloration, and pain, weakness, and heaviness in a leg or arm.

Lymphatic drainage is also sometimes used to treat peripheral edema, the generalized swelling of tissues in the arms or legs not inherently associated with the lymphatic system.

Lymphatic drainage is a technique thought to treat a wide variety of health conditions characterized by tissue swelling, including:

Lymphatic drainage is also used at spas as a pseudo-therapeutic technique to treat acne, cellulite, and eczema (although there is little to no evidence that it can treat any of these conditions).

Benefits

Studies show that lymphatic drainage may be beneficial in the treatment of a number of health problems, some more than others.

Lymphedema

In an analysis published in the Cochrane Database of Systematic Reviews in 2015, researchers evaluated six previously published trials involving the use of lymphatic drainage on women experiencing lymphedema following breast cancer surgery.

According to the review, manual lymphatic drainage is safe and may enhance the benefits of compression bandages in treating post-mastectomy lymphedema in women with mild to moderate symptoms.

The finding were supported by a 2015 study published in the Journal of Pain and Symptom Management in which lymphatic drainage (involving two weeks of intensive treatment and six months of maintenance) was considered comparable to compression bandaging and exercise in women with post-mastectomy lymphedema.

Orthopedics

The same results were not seen in studies investigating the use of lymphatic drainage in people undergoing orthopedic surgery or recovery from an orthopedic injury.

A 2016 study published in the Archives of Physical Medicine and Rehabilitation evaluated the benefits of post-surgical rehabilitation with or without lymphatic drainage in adults recovering from total knee replacement surgery.

Compared to people who underwent standard rehabilitation alone, researchers could find no difference in pain, tissue swelling, range of motion, knee function, and gait between the two groups.

Because the swelling is not directly related to the lymphatic system (but is rather caused by post-surgical inflammation that increases the permeability of blood vessels), it is unclear how effective lymphatic drainage is in treating any orthopedic condition.

Rheumatoid Arthritis

In people with rheumatoid arthritis, the circulation of lymph is enhanced in the early stages of the disease but becomes increasingly impaired as the disease progresses and erodes the joints. It is in this latter stage that tissue swelling is common, along with joint pain, changes in skin color, and the loss of joint function.

It has been posited that lymphatic drainage could help relieve these later-stage symptoms, but, to date, there has been little evidence that doing so provides anything more than the temporary relief of symptoms similar to other massage techniques.

Chronic Venous Insufficiency

Chronic venous insufficiency (CVI) is a condition in which the walls or valves in the veins of the legs are not working effectively, making it hard for blood to return to the heart from the legs. Lymphatic drainage has been proposed as a conservative treatment of CVI, and there is some evidence of its benefits.

According to a 2017 study in the journal Physiotherapy, the use of lymphatic drainage in 57 adults with CVI increased the velocity of blood flow in the femoral artery and other blood vessels of the leg immediately following the massage.

It was unclear, however, how lasting these effects are or if the ongoing use of lymphatic drainage is able to sustain relief of peripheral pain and swelling compared to no treatment. Further research is needed.

Fibromyalgia

Lymphatic drainage may benefit people with fibromyalgia, suggests a 2015 review of studies published in Manual Therapy. Fibromyalgia, characterized by the inflammation of nerves in the skin, often manifests with tissue swelling and skin discoloration.

According to a review of 10 previously published studies, lymphatic drainage was found to be better than connective tissue massage in treating stiffness, depression, and quality of life in people with fibromyalgia but not as effective as a myofascial release in relieving fibromyalgia pain.

The findings were limited by the small size and generally poor quality of the studies and could neither offer explanations as to why lymphatic drainage is useful nor determine if the reported benefits were physiologic or simply perceived.

Side Effects and Precautions

Lymphatic drainage is non-invasive and generally considered safe. Because it is focused on soft to moderate stretching of the skin, it doesn't cause the discomfort associated with deep tissue massage or sports massage.

With that said, women who undergo lymphatic drainage to treat post-mastectomy lymphedema are more likely to experience short-term swelling and redness in the early stages of treatment.

As a rule, pain should never accompany lymphatic drainage. If there is pain, it may be the sign of an underlying condition for which massage may be detrimental, such as local infection or deep vein thrombosis (DVT).

If any pain is experienced during lymphatic drainage, stop the procedure immediately and speak with your doctor or health care provider.

Lymphatic drainage is typically avoided in people with the following health conditions:

If you are considering lymphatic drainage for the treatment of a diagnosed condition, speak with your health provider first.

A Word From Verywell

If you have symptoms of lymphedema, speak with your health care provider to determine the cause of the swelling and pain. While you may assume that lymphedema is the cause, only the appropriate lab and imaging tests can confirm the condition.

If you do decide to pursue lymphatic drainage for a diagnosed health condition, only seek treatment from a qualified practitioner. Some physical therapists, physicians, nurses, and massage therapists are trained and certified to practice lymphatic drainage. Estheticians and spa therapists usually are not.

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