Massage (manual lymphatic drainage) treatment for lymphoedema
This page tells you about specialist massage to reduce lymphoedema swelling. There is information about
Manual lymphatic drainage (MLD) is a specialised type of massage for lymphoedema which helps to reduce swelling. You can have MLD for lymphoedema anywhere in the body. Only someone with specialist training should carry out MLD.
The aim of the massage is to move lymph fluid from the swollen area into an area where the lymphatic system is working normally. To do this the person massaging you first massages and clears the area they want the fluid to drain into. When you have the massage you feel a gentle pressure. It is not a deep massage. The amount of swelling you have and how well MLD is working will affect how often you have it and how long for.
Simple lymphatic drainage (SLD) is massage that you are taught how to do yourself. You massage twice a day, for about 20 minutes each time. You only apply light pressure, as your lymphoedema specialist taught you.
In some situations you should not have or do self massage, for example, when you have an infection. Your lymphoedema specialist will tell you whether you can or can’t have massage. Always check with your specialist if you are not sure.
You can view and print the quick guides for all the pages in the Treating lymphoedema section.
A specialised type of massage called manual lymphatic drainage (MLD) helps to reduce swelling. You can have this for lymphoedema anywhere in the body. Only someone with specialist training should carry out this kind of massage.
Manual lymphatic drainage is an intensive treatment that you may have daily for a few weeks.
Immediately after your massage each day you may have compression bandaging, which is also called multilayered lymphoedema bandaging (MLLB). The bandaging helps to reduce swelling and stop it coming back. The combination of massage and bandaging is called intensive lymphoedema treatment. Some people have the intensive treatment for 2 to 3 weeks. Bandaging is not possible in some areas of the body, for example, in your head and neck area.
Once the swelling has gone down, you can wear a compression garment to help stop it coming back. The garment may need to be made to measure. There is information about compression garments in this section.
Manual lymphatic drainage is also called MLD. This is a special type of massage that reduces swelling from lymphoedema. There are different types of manual lymphatic drainage (MLD) including Vodder, Leduc, Földi and Casley-Smith. You should only have MLD from someone who has been trained in one of these types.
The aim of the massage is to move fluid from the swollen area into an area where the lymphatic system is working normally. To do this the person massaging you first massages and clears the area they want the fluid to drain into. It might seem strange to have them massage your chest and neck if you have lymphoedema in your arm. But it means that the fluid has somewhere to drain to when they massage your arm.
You usually lie down to have massage. But if you have lymphoedema in your head and neck, you sit up.
When you have the massage you feel a gentle pressure. It is not a deep massage. If it is too deep it won’t work because it flattens the small lymph vessels so that the fluid can’t drain. The movements are slow and rhythmic so the lymph vessels open up.
You may have MLD daily from Monday to Friday, or 3 times a week, for about 3 weeks. The number of treatments varies depending on the type of MLD you have and what you need. Your specialist will also take into account the amount of swelling you have.
After the massage the specialist may bandage the area. They use a specialist bandaging technique called multi layered lymphoedema bandaging. If it is not possible to use bandages, you may wear a compression garment.
Your lymphoedema specialist will regularly check how well your treatment is working. They will assess whether the tissues are softening and how much the swelling is going down. Once the swelling stops reducing, they will give you another compression garment to wear.
Remember that you are the person who will notice changes first and you need to talk to your specialist about how your treatment is working. Managing lymphoedema is very much about you and the specialist working together.
Simple lymphatic drainage (SLD) means that you learn how to do the massage yourself. It is sometimes called self massage. A specialist needs to teach you how to do this. You may be taught to only massage in the areas where you don’t have lymphoedema. This frees up space for the lymph fluid to drain into from the swollen area.
You don’t massage the area where you have swelling. Massaging the swollen area is difficult to do. You will be shown how to massage the surrounding areas and can ask questions if anything is not clear.
You massage twice a day, for about 20 minutes each time. Only apply light pressure, as your lymphoedema specialist taught you.
There are some situations when you should not have massage or do self massage. Your lymphoedema specialist will tell you whether you can or can’t. Always check with them if you are not sure. You may not be able to have MLD or SLD if you have any of the following
- An infection or inflammation in the swollen area
- A blood clot
- Heart problems
- Active cancer in the area
If you are uncertain about having MLD or doing SLD, talk to your doctor or lymphoedema specialist.
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