Lymphatic Drainage Massage: What It Is And How To Perform It (2024)

Lymphatic drainage massage, also known as manual lymphatic drainage (MLD), is a type of massage used to reduce swelling caused by fluid buildup.

The lymphatic system acts as the body’s sewerage system. Consisting of a network of lymph nodes, ducts and vessels, it carries fluid—which contains proteins, salts, water and white blood cells—throughout the body to the blood. As part of the immune system, lymph nodes help filter out foreign substances (like infections) before that fluid enters the central venous system.

In conditions where the lymphatic system is not working properly, fluid builds up, causing the area to swell. Lymphatic drainage massage moves the fluid to where the lymphatic system is working properly, so the fluid can be removed and the swelling goes down.

Lymphedema: The main health condition lymphatic drainage massage treats is lymphedema. Lymphedema is a severe and debilitating condition where excess protein-rich fluid accumulates in the space between cells within tissues.

Post-surgical swelling: Massage can help reduce swelling and promote healing after surgical procedures, says Sergio Alvarez, M.D., a plastic surgeon at Mia Aesthetics in Miami. A well-trained massage therapist should perform a lymphatic drainage massage effectively while avoiding disruptions to your surgical site and healing incision, he explains.

Edema: Edema is the accumulation of fluid in the body tissues. It can occur for a number of reasons including pregnancy, injury or certain medical conditions (such as heart failure or kidney disease), shares Melody Weber, a registered massage therapist and owner of livingoodproducts.com in Naples, Florida.

Sinus congestion: Lymphatic drainage massage specifically applied to the sinuses can also help relieve congestion and promote drainage in the sinus passages, adds Weber.

Rheumatoid arthritis: Rheumatoid arthritis is an inflammatory condition that causes joint pain and swelling. Lymphatic drainage massage can be used to treat rheumatoid arthritis, according to Dr. Alvarez.

Lipedema: Lipedema is a chronic condition where fat and connective tissue accumulates in the legs, hips, buttocks and occasionally arms. It’s more common in women and can be painful. Standard of care for lipedema in the U.S. includes lymphatic drainage massage, which helps stimulate lymphatic flow and reduces swelling.

Fibromyalgia: According to a 2015 systematic review and meta-analysis in Manual Therapy, lymphatic drainage massage was superior to connective tissue massage for managing stiffness, depression and quality of life for people with fibromyalgia^[1]Yuan SL, Matsutani LA, Marques AP. Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis. Man Ther. 2015; 20(2):257-64. .

Chronic venous insufficiency: Chronic venous insufficiency is a common condition that involves edema in the lower extremities, skin changes and discomfort. A small randomized controlled trial of 41 people with chronic venous insufficiency found that lymphatic drainage massage reduced symptom severity, edema and pain in people with chronic venous insufficiency^[2]dos Santos Crisóstomo RS, Costa DS, de Luz Belo Martins C, Fernandes TI, Armada-da-Silva PA. Influence of manual lymphatic drainage on health-related quality of life and symptoms of chronic venous insufficiency: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2015;96(2):283-91. .

There are several benefits of lymphatic drainage massage, including the following.

Reduction of Swelling and Inflammation

Lymphatic drainage massage stimulates lymphatic flow, which can help reduce swelling and edema, explains Weber.

A systematic review looking at the efficacy and safety of lymphatic drainage massage to treat breast cancer-related lymphedema found that it may offer additional benefit over compression bandaging alone for swelling reduction. It also found that people with mild-to-moderate breast cancer-related lymphedema saw more benefit from lymphatic drainage massage combined with compression bandaging than people with moderate-to-severe breast cancer related lymphedema (but additional research is warranted)^[3]Ezzo J, et al. Manual lymphatic drainage for lymphedema following breast cancer treatment. Cochrane Database of Systematic Reviews. 2015;5:CD003475. .

Enhanced Immune System Function

One of the main functions of the lymphatic system is the removal of microorganisms and other foreign particles. The lymphatic system contains specialized immune cells, called lymphocytes, that destroy harmful microorganisms. Since a normally-functioning lymphatic flow is required for these processes, impaired lymphatic drainage could lead to an accumulation of inflammatory substances in the fluid between cells.

Lymphatic drainage massage can support the body’s immune response by helping remove toxins and waste materials, according to Weber.

Relaxation and Stress Relief

“The gently, rhythmic stokes of lymphatic drainage massage promote relaxation and can help reduce stress and anxiety,” says Weber.

A randomized controlled trial of 50 women with fibromyalgia found that lymphatic drainage massage was superior to connective tissue massage for reducing symptoms of anxiety. However, studies with longer-term follow up are needed^[4]Ekici G, Bakar Y, Akbayrak T, Yuksel I. Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial. Journal of Manipulative and Physiological Therapeutics. 2009;32(2):127-33. .

“Lymphatic massage is applied without the use of oil or lotion,” explains Angela Johnson, a licensed massage therapist and founder of Deep Tissue Diva LLC in Blue Ash, Ohio. “Very gentle pressure (about the weight of a nickel) is used to manually move the lymph fluid toward the center of the body. This can feel similar to gently stretching the skin,” says Johnson.

A lymphatic drainage massage starts close to the midline of the body. The massage therapist will gently work their way down while continuously stroking in the direction of the body’s center, explains Johnson. “This is done at a slower pace than traditional massage modalities,” she adds. “The massage therapist can often gauge the appropriate rhythm for lymphatic massage. It is important to tailor each massage to the individual client, as opposed to following a routine,” Johnson notes.

If lymphatic drainage massage is used to treat post-surgical swelling, many individuals receive two to three treatments per week for about six weeks after their surgery, says Dr. Alvarez.

Some people may also wish to perform lymphatic drainage massage on themselves. “If you can reach the area comfortably, you can absolutely perform lymphatic massage on yourself,” says Dr. Alvarez. However, it’s important to ask your doctor or massage therapist to show you how to do it properly, as doing it the wrong way can do more harm than good, he adds.

Lymphatic drainage massage is generally considered safe, says Weber. However, there are some risks and side effects to be aware of.

Increased urine output: “The body eliminates excess lymph by way of kidney filtration,” explains Johnson. “This often results in the urge to use the restroom almost immediately at the conclusion of the massage session.” Johnson recommends drinking plenty of fluids the day of the massage session.

Fatigue or drowsiness: Some individuals may feel tired or relaxed after the massage. This is a normal response, assures Weber.

Temporary increase in symptoms: In some cases, existing symptoms, such as headaches, nausea and fatigue, may temporarily worsen before improving, says Johnson. This occurs because the body is adjusting to the increased lymphatic flow, explains Weber.

You should avoid getting a lymphatic drainage massage if you have an infection, heart condition, blood clots or kidney failure, says Dr. Alvarez.

To determine if lymphatic drainage massage is right for you, Weber recommends you consider the following:

• Consult with a health care professional: If you have a specific medical condition or concern, it’s best to consult with a health care provider who can evaluate your individual needs.

• Understand the benefits: Researching and understanding the potential benefits of lymphatic drainage massage can help you decide whether it aligns with your health goals.

• Personal preferences: Some people may prefer more gentle, relaxing massage techniques, while others may seek more targeted therapies, such as lymphatic drainage massage.

“It’s important to note that while lymphatic drainage massage can be beneficial for many individuals, it may not be suitable for everyone,” says Weber. “It’s always best to consult with a qualified massage therapist or health care professional to discuss any specific concerns or conditions before starting any new treatment.”