What is lymphatic drainage?
Lymphatic drainage is used to treat lymphoedema. Lymphoedema occurs when the lymphatic drainage is disturbed as a result of a chronic, inflammatory disease of the interstitium (space between cells, tissues and organs), causing fluid to accumulate in the tissue. This can be recognized by a clearly visible swelling. Lymphoedema often occurs in the limbs, but lymphoedema can also develop in the face.
Lymphoedema can be congenital (primary lymphoedema). Much more frequently, however, they are caused by another disease. Such secondary lymphoedema is usually caused by cancer. For the treating therapist, all lymphoedema is therefore suspected to be cancerous until the opposite is proven.
In the initial phase of lymphoedema treatment, patients should receive lymphatic drainage once or twice a day. This can be done on an outpatient or inpatient basis. Complex physical decongestive therapy” has a total of four basic procedures for lymphoedema:
- Compression therapy using bandages
- Decongestive movement exercises
- Skin care
- Manual lymph drainage
Legs and arms are preferentially affected by lymphoedema and can therefore be treated well with lymphatic drainage. However, the face and trunk can also be treated with this procedure.
When is lymphatic drainage carried out?
Edema therapy is often used for the following conditions:
- Chronic lymphoedema
- Chronic venous insufficiency (often visible in the form of “varicose veins”)
- Post-operative swelling
Lymphatic drainage can also be beneficial for other diseases, although the therapeutic value is lower. These include
- Chronic polyarthritis
- CRPS (complex regional pain syndrome, formerly Sudeck’s disease)
- Swelling after hemiplegia (hemiparesis) following a stroke
- Headaches
There are also other, non-disease-related areas of application for lymphatic drainage: pregnancy, for example, can lead to oedema in women, which mainly occurs in the evening and after long periods of standing. This does not necessarily require treatment, but can be very stressful for a pregnant woman. Lymphatic drainage can then help. Cellulite is another area of application. However, there is no clear scientific evidence of the effect of lymphatic drainage in this case.
When is lymphatic drainage not advisable?
Lymphatic drainage should not be used for certain medical conditions. These include
- malignant tumors
- acute inflammation
- severe cardiac insufficiency (decompensated cardiac insufficiency grade III-IV)
- cardiac arrhythmia
- very low blood pressure (hypotension, below 100/60 mmHg)
- Acute deep thrombosis of the leg veins
- Unclear skin changes (erysipelas)
What does lymphatic drainage do?
Lymphatic drainage is intended to stimulate the lymph vessels and encourage the increased removal of lymph fluid. Increased blood circulation or activation of pain receptors in the skin is not the aim of lymphatic drainage. “Massage” in its classic form, on the other hand, works via both mechanisms.
The therapist achieves the special effect of lymphatic drainage through circular movements. The following four basic movements are particularly important:
- standing circle
- pumping grip
- scooping grip
- twist grip
These handles are always used. Depending on the cause of the edema, so-called “supplementary grips” are then added.
After the treatment, the corresponding part of the body is wrapped (“compression therapy”). This prevents the oedema from forming again after the manual lymphatic drainage has finished. Lymphatic drainage should be carried out by a specially trained physiotherapist.
Lymphatic drainage of the head and neck region
Lymphatic drainage of the extremities and trunk
The extremities are also often the starting point for lymphatic drainage: the arm and leg are quite frequently affected by lymphoedema. For example, radiation therapy for breast cancer or lymph node removal in the armpit can lead to edema in the arm.
Treatment on the arms begins in the armpit area before working over the upper arm to the hand. Here too, the basic techniques may be supplemented with additional techniques. On the legs, lymphatic drainage begins at the groin (knees and buttocks can be treated with special grips).
What are the risks of lymphatic drainage?
If lymphatic drainage is carried out properly by a trained therapist and certain medical conditions have been ruled out in advance, there are generally no risks.
What do I need to consider after lymphatic drainage?
No special behavior is necessary after lymphatic drainage. However, you can do something to prevent lymphoedema from recurring so quickly:
- Clothing: Be careful not to wear tight or constricting clothing, which makes lymph drainage even more difficult. The same applies to watches, jewelry and footwear.
- Household: Wear gloves when doing housework or gardening! Elevate your legs regularly to improve lymph drainage.
- Leisure time: When exercising, you should limit yourself to “light” movements (walking, Nordic walking, swimming, etc.). Avoid prolonged sunbathing, going to the sauna or solarium – this will damage your skin!
Lymphatic drainage is generally an effective and safe method of treating lymphoedema that is well tolerated.
