Treatment and MLD (Manual Lymphatic Drainage)

What can be done about lymphoedema?

There are two forms of treatment, the medical (non-surgical) and surgical forms. Surgery is only indicated with severe cases and even after surgery it is important to continue with the many aspects of medical treatment.

What medical therapies are there?

Manual lymphatic drainage (MLD) is a specialised form of therapy which is gentle and rhythmic. It is a technique which was developed in Europe in the 1930s by Emil Vodder. The method has now been adapted by medical professionals around the world to treat lymphoedema and there are a number of schools of MLD (including Asdonk and Földi in Germany, Casley-Smith in Australia, LeDuc in Belgium and Vodder in Austria). The aim is to encourage protein reabsorption and stimulate lymphatic flow to improve drainage away from congested areas.

How does MLD work?  

Manual lymphatic drainage (MLD) is a specialised form of therapy which is designed to improve the functions of the lymphatic system. The specific movements used in MLD treatments allow the superficial lymph vessels to reabsorb excess fluid, metabolic waste, large protein molecules and foreign substances from the tissues.
The lymphatic fluid is then encouraged to empty into the deep lymphatic vessels and filtered through series of lymph nodes along its route before it is returned to the blood circulatory system in the neck area.

Who benefits from MLD?

All patients with lymphoedema or at risk of developing it (for example after breast cancer surgery or after radiotherapy to the pelvis) can benefit from MLD.

What kind of treatment protocols are used?

1.Intensive Therapy comprises
a)a course of 10 to 15 MLD treatments over a period of 2 to 3 weeks. b)exercises
c)compression hosiery
This is followed by maintenance therapy.

2.Complex decongestive therapy involves 2 to 4 weeks of
a)Multilayer bandaging
b)pneumatic compression therapy
c)manual lymphatic drainage
d)exercises
This is followed by maintenance therapy.

3.Maintenance therapy comprises
a)exercise
b)manual lymphatic drainage
c)self lymphatic drainage
d)compression hosiery
e)skin and nail care and careful chiropody
f)occasionally prophylactic antibiotics can reduce the number of episodes of cellulitis

What are the benefits of treating lymphoedema?

Apart from the relief or reduction in swelling and therefore improved comfort and quality of life, there is evidence that treatment also reduces the number of infective episodes and cellulitis. In addition, the skin and subcutaneous tissues often feel much softer after MLD.