7 Contraindication of MLD in Lymphoedema treatment
In our previous blog, we talked about what lymphoedema is, the general aspects of this condition and how MLD helps to treat it. Today, on the other hand, we want to share with you the contraindications of using MLD. In other words, when not to use it or wait for your general practitioner’s permission before starting your lymphatic drainage treatment. Let’s have a quick view of these contraindications!
1.Infection
Lymphedema patients are more prone to infections due to the swelling and skin changes that can lead to open sores and cracks, providing entry points for bacteria, so manual techniques are avoided during infection treatment, here three reasons why:
- In patients with an active infection, MLD or other lymphedema treatments can not be performed. The reason why is because MLD increases lymph and blood flow and it could allow infectious pathogens to disseminate and spread the infection through their body.
- As infections need antibiotics to treat them, MLD should be avoided because it might interfere with the efficacy of your meds. Lymphatic drainage increases the expelling rate of medication, lowering the needed concentration.
- Massage in swollen nodes could be painful for lymphoedema patients, that is another reason to avoid MLD during infection treatment.
Note: Lymphedema treatments should only be performed once any underlying infections have fully resolved.
2.Cancer
Lymphoedema is a common side effect of cancer (specially breast cancer or those where lymphatic nodes are removed) and cancer treatments, but don´t worry! Cancer itself is not a contraindication for lymphoedema. On the other hand, some types of cancer and cancer treatments significantly increase the risk of developing lymphoedema.
It is key that your lymphatic drainage therapist carefully manage the lymphatic system during cancer treatment to reduce the risk and impact of this chronic condition. I t is key for you to know that, before booking your appointment, the permission of your oncologist or GP will be required.
3.Thrombosis and DVT (Deep Vein Thrombosis)
Lymphatic drainage on areas with Thrombosis (blood clot) or DVT could push the clot into the bloodstream and where it could break off, causing a life-threatening embolism (artery obstruction).
Symptoms of thrombosis:
- warmth sensation,
- tenderness,
- redness,
- pain over a vein
If any of these signs are present, lymphatic drainage should be avoided in that area until the clot has resolved and your GP authorizes the treatment. What I recommend to my patients with conditions affecting blood and lymphatic flow (obstructions) is to postpone MLD until the underlying circulatory issue is addressed, I can share more info if needed.
4.Other contraindications are:
5.Acute inflammation: Manual Lymphatic Drainage may exacerbate acute inflammatory conditions, so it is generally avoided till the inflammation is reduced.
6.Cardiac edema: If a patient has edema due to heart failure or another cardiac condition, MLD may not be appropriate without proper medical supervision.
7.Malignant diseases (when cancer is active): In some cases of active cancer or malignancy, MLD may not be recommended without consulting your oncologist.
In short, Manual lymphatic drainage is a key part of lymphoedema treatment, however, as we explored in this blog, there are few contraindications that only need time to be resolved or the authorization of your GP before booking your first appointment. Last, but not least, always look for the best and experienced Manual Lymphatic Therapist. Remember your general well being is in her hands.
We hope this information was useful. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill and Islington. We are always glad to help. If you like this blog, please share!
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652571/
https://pubmed.ncbi.nlm.nih.gov/16737666/
https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571332/
