What Is Lymphatic Drainage Massage—And How Do You Do It?

Lymphatic drainage massage, also called manual lymphatic drainage (MLD), is a gentle body massage that helps move a fluid called lymph through the body. Using manual, light pressure helps the lymph vessels contract and move built-up fluid through the lymphatic system. This technique helps treat side effects of lymphedema—like arms and legs swelling—caused by lymph build-up, which can happen when the lymphatic system isn't working properly.

Your lymphatic system is a network of thin tubes called lymph vessels that connect to hundreds of lymph nodes throughout the body. Lymph, or lymphatic fluid, is left behind after blood circulates to your tissues and organs. Usually, lymph moves through lymph vessels to your lymph nodes. The lymph nodes filter out harmful bacteria, abnormal cells, and waste. Any excess lymph then drains back to the bloodstream via lymph vessels.

However, lymph node damage or conditions like lymphedema can disrupt the lymphatic system and cause lymph fluid to stop draining and build up. This lack of lymphatic drainage causes swelling, typically in the arms and legs, called lymphedema. If left untreated, lymphedema can cause life-threatening infections.

Here's how lymphatic drainage massage works and how it may benefit your health.

How To Do a Lymphatic Drainage Massage

A certified lymphedema therapist (CLT) typically performs lymphatic drainage massage. These trained specialists include physical therapists, occupational therapists, nurses, and massage therapists. If you are diagnosed with lymphedema, your healthcare provider will often refer you to one of these specialists for manual lymphatic drainage sessions. 

A CDT can also teach you how to properly perform a lymphatic massage at home. Lymphatic drainage massage done at home or by a CDT includes two main phases: 

• Clearing: Moving lymph through your tissues. 
• Reabsorption: Moving lymph to your lymph nodes.

When treating lymphedema or lymphatic drainage issues, manual lymphatic drainage usually takes about 15-30 minutes and involves the following steps: 

1. The person receiving the massage lies down on their back and starts a deep breathing exercise. (At-home massage may be done standing up.)
2. Starting in areas without blocked lymph nodes or lymphedema, the CLT slowly and gently runs their hands over the skin to stretch the surface toward the lymph nodes. 
3. Stretching techniques may include cupping motions, strokes, and rhythmic pressure.
4. After finishing a pass over the skin, the CLT briefly pauses to let the skin return to its original shape.
5. The CLT will repeat the same massage and pause sequence in different areas to move lymph through the lymph networks and lymph nodes. They will work their way to the areas with the most lymph blockage, like the arms and legs. 

Lymphatic drainage massage is often one piece of complete decongestive therapy (CDT)—a treatment to reduce lymphedema and swelling. CDT also includes:

• Wearing compression bandages or sleeves
• Performing exercises to help promote drainage
• Treating skin conditions caused by swelling 

Benefits of a Lymphatic Drainage Massage

The main benefit of lymphatic drainage massage is reducing swelling caused by lymphedema. While less common, lymphatic drainage massage may also help treat stiffness, swelling, and other side effects unrelated to lymphedema.

It May Help Reduce Lymphedema Swelling

Lymphedema is common in folks undergoing breast cancer treatments that remove or damage the lymph nodes. While rare, someone can also be born with lymphatic system dysfunction and develop lymphedema. Lymphatic drainage massage may help reduce swelling associated with lymphedema by manually moving lymph through the lymphatic system. However, researchers have found this massage technique is more effective when combined with other CDT practices, like compression. Research is also limited, so there is still some debate on the effectiveness of manual lymphatic drainage as a lymphedema treatment.

According to a 2020 review of 12 randomized controlled trials, lymphatic drainage massage did not significantly prevent or treat lymphedema after folks had surgery to treat breast cancer. However, a 2015 research review of breast cancer-related lymphedema found combo lymphatic drainage massage and compression bandage treatment was more effective in reducing swelling than massage alone.

It May Relieve Stiffness and Pain

While research is limited, lymphatic massage may help relieve stiffness, swelling, or joint pain related to conditions like rheumatoid arthritis (RA). Research has also found that folks with RA often don't have a properly functioning lymphatic system, which may be why lymphatic drainage massage helps RA symptoms.

A small 2015 review also found that people with fibromyalgia—a condition that causes widespread pain and fatigue—reported better quality of life from pain and anxiety reduction following lymphatic drainage massage. Still, more research is needed to prove lymphatic massage is an effective fibromyalgia treatment.

It May Improve Blood Flow 

People with chronic venous insufficiency (CVI)—when damaged leg veins don't properly move blood to the heart—may also benefit from lymphatic drainage massage. According to a small 2017 study, manual lymphatic drainage performed on the legs helped improve blood flow in deep veins and veins close to the skin's surface. Additional research has found lymphatic drainage massage helped relieve CVI-related swelling and pain due to a lack of blood flow.  

Research has also found manual lymphatic drainage techniques may help reduce lipedema-related fat and increase blood flow to surrounding tissues. Lipedema is a connective tissue condition that causes irregular fat build-up only on the lower extremities—like the legs, thigh, and butt. Females are more likely to have lipedema, which can damage the lower body's lymphatic vessels and cause swelling.

It May Help Reduce Cellulite

Lymphatic drainage massage has also resurfaced as a trendy cosmetic massage to reduce cellulite and improve muscle tone. However, no concrete evidence proves that lymphatic massage can reduce cellulite or make you look more toned long-term. It's also worth noting that many studies on lymphatic drainage massage and cellulite could be better quality.

A 2022 study found lymphatic massage techniques helped reduce cellulite in folks following thigh liposuction. However, the study only compared folks who already received liposuction and did not include folks who did not have a cosmetic procedure. Studies also don't include large groups of people and are often set in unrealistic situations. For example, a 2012 study that found lymphatic massage helped reduce cellulite only included 10 women. These women also had 4-hour daily therapeutic sessions that included lymphatic drainage massage. 

Risks of Lymphatic Drainage Massage

Lymphatic drainage massage is typically considered safe and low-risk. However, lymphatic drainage is not safe for people with health conditions that can move lymphatic fluid back to the heart or kidneys, including:

• Heart conditions
• Liver or kidney conditions
• Blood clots
• Stroke

People with an active infection should also avoid manual lymphatic drainage.

The massage should not hurt or leave bruising since it uses extremely light pressure and is not a deep tissue massage. However, if you do experience any pain during your lymphatic drainage massage, tell your CDT or healthcare provider immediately.  

A Quick Review

Lymphatic drainage massage helps move lymphatic fluid through the body if it becomes built up in the lymphatic system. This massage technique involves gently applying pressure toward the lymph nodes to manually clear lymphatic fluid through the lymph vessels and reabsorb fluid through the lymph nodes. Usually, a certified lymphatic therapist performs lymphatic massage, but they can also teach folks to do it at home.

Lymphatic drainage massage is typically used to relieve swelling caused by lymphedema and is more effective when used with other complete decongestive therapy (CDT) techniques like bandages and exercises. While not as well researched, lymphatic massage may also help treat joint pain and swelling related to other conditions like rheumatoid arthritis and fibromyalgia.