What is lymphatic drainage?

Muscle weakness (paresis) can lead to lymphoedema. Lymphoedema is the accumulation of tissue fluid (lymph) in the interstitial space of the arms and legs. The accumulation of lymph fluid is caused by an imbalance in the blood flow to a region of the body. The inflow of blood into an extremity occurs through arterial blood vessels that have a musculature in the vessel wall (“pulse”). The inflow of blood is caused by the pulse and the increased vascular pressure (compared to the veins) within the arteries. Blood is transported out of the extremities via veins, which in turn have a weakly developed vascular wall musculature. The blood is transported away by the surrounding arm and leg muscles. The veins are actually located in close proximity to the muscles. The muscle movements cause the neighboring veins to be compressed and squeezed out towards the body. This connection between veins and muscles is known as the “vein-muscle pump”.

In the case of motor dysfunction (due to the paralysis of the muscles), there is also a reduction in the venous-muscle pump. As a result, more blood is transported into the limb than can be removed via the reduced muscle-venous pump. This imbalance results in lymphoedema, which leads to significant swelling of the hands, feet, forearms or lower legs. Lymphatic drainage is a form of physical decongestion therapy that moves the lymph fluid towards the trunk, thereby reducing lymphoedema.

Using special hand movements, the physiotherapist causes the lymph vessels to move on their own (manual lymphatic drainage). The massage (drainage) is performed once or several times a week and the therapeutic effect usually lasts for 24 hours. Compression bandages are also applied to prolong the drainage effect. In addition to manual lymphatic drainage, compression bandages or compression stockings are also used. Compression bandages are wrapped around the affected arms and legs. The compression supports the removal of lymphatic fluid. In the case of severe lymphoedema, compression therapy is started with a bandage and then continued with the fitting of compression stockings.

Lymphatic drainage is necessary because the presence of lymphoedema (in addition to the painful swelling) is associated with particular risks. Injury to an extremity with lymphoedema must be prevented, as the ability to heal wounds and defend against infection is reduced by the swelling of the extremity. Lymphatic drainage is mainly performed by physiotherapists and is often part of physiotherapy, which consists of physiotherapy, massage, heat therapy and lymphatic drainage. Like other forms of physiotherapy, lymphatic drainage is prescribed by a doctor on a prescription and carried out in a physiotherapy practice.