Barbieux R, Roman M, Penafuerte D Manual lymphatic drainage increases the number of opened lymphatic pathways in patients with lower limb lymphedemas: a sequential research on 80 patients. Lymphology. 2023; 55:(4)155-166

De Vrieze T, Gebruers N, Nevelsteen I Manual lymphatic drainage with or without fluoroscopy guidance did not substantially improve the effect of decongestive lymphatic therapy in people with breast cancer-related lymphoedema (EFforT-BCRL trial): a multicentre randomised trial. J Physiother. 2022; 68:(2)110-122

Kasseroller RG, Brenner E. Effectiveness of manual lymphatic drainage in intensive phase I therapy of breast cancer–related lymphedema—a retrospective analysis. Support Care Cancer. 2024; 34:(5)

Kayıran O, De La Cruz C, Tane K, Soran A. Lymphoedema: from diagnosis to treatment. Turk J Surg. 2017; 33:(2)51-57

Lin Y, Yang Y, Zhang X Manual lymphatic drainage for breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. Clin Breast Cancer. 2022; 22:(5)e664-e673

Mestre S, Calais C, Gaillard G Interest of an auto-adjustable nighttime compression sleeve (MOBIDERM® Autofit) in maintenance phase of upper limb lymphoedema: the MARILYN pilot RCT. Support Care Cancer. 2017; 25:2455-2462

Provencher AM, Giguère-Lemieux E, Croteau E The use of manual lymphatic drainage on clinical presentation of musculoskeletal injuries: a systematic review. Complement Ther Clin Pract. 2021; 45

Thomas M, Coveney E, Pike C Exploring the impact of lymphoedema on individuals and if lymphatic venous anastomosis surgery effects perceptions on quality of life: a qualitative study. Eur J Oncol Nurs. 2020; 44

Whitaker JC. Lymphoedema management at night: views from patients across five countries. Br J Community Nurs. 2016; 21:S22-S30

Xing WT, Duan D, Ye CX Effectiveness of manual lymphatic drainage for breast cancer-related lymphoedema: an overview of systematic reviews and meta-analyses. Eur J Gynaecol Oncol. 2023; 44:(1)1-16

Manual lymphatic drainage: the evidence behind the efficacy

02 February 2024
Volume 29 · Issue 2


Manual lymphatic drainage (MLD), a specific type of massage performed by specialists that aims to enhance the filling and emptying of lymph vessels, is often recommended as an essential part of a successful management strategy for lymphoedema. However, the literature on its efficacy is often contradictory, and its addition may not always be necessary. To ensure optimal understanding of practitioners and benefit to patients, Francesca Ramadan summarises the evidence-based advantages and limitations of MLD.

Lymphoedema is a chronic and progressive disorder resulting from impaired lymphatic system function, triggering an excessive accumulation of lymph fluid in the superficial tissues, which can lead to chronic swelling, localised pain, atrophic skin changes and secondary infections (Whitaker, 2016; Kayıran et al, 2017). Lymphoedema can be primary or secondary in aetiology: the former is related to developmental abnormalities of the lymphatic system, whereas the latter is attributed to the impairment of lymphatic vessels due to an acquired condition, such as trauma, tumour, surgery or infections (Kayıran et al, 2017). To date, there is no cure for lymphoedema, and the condition is associated with impaired quality of life, both in terms of psychosocial and physiological functioning. Pain, skin tightness, heaviness, numbness and reduced range of movement have been reported, as well as altered body image, anxiety and depression (Thomas et al, 2020). Therefore, it is imperative to collaborate with a patient to create and maintain an effective management strategy.

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