What Is Lymphatic Drainage Massage, and Do You Need It?

Lymphatic drainage massage has been in use for decades, but it wasn't until a few years ago that the practice went mainstream — thanks, primarily, to its huge celebrity and influencer following.

Here's the catch: The lymphatic massages you see on Instagram and TikTok that tout skin and anti-bloating benefits aren't necessarily what you'd receive from a certified physical or massage therapist.

A ‌true‌ lymphatic drainage massage is usually given to someone who has lymphedema — i.e., painful swelling in the body, according to the Cleveland Clinic.

This isn't exactly obvious, though, from a quick glance online. Today, techniques like jade rolling and gua sha are sometimes compared to lymphatic drainage massage (and they're totally different, for the record).

Here's a breakdown of what lymphatic massage really is, and who is — and isn't — a good candidate for it.

Before you can understand what lymphatic drainage massage is, you'll need a quick primer on the lymphatic system itself.

In a nutshell: The lymphatic system is part of your immune system, with a network of lymph vessels, nodes and ducts that help filter waste out of your body, according to the Cleveland Clinic.

Waste (like fats, proteins, salts, glucose, minerals and bacteria) is moved through your lymph vessels in a fluid called — you guessed it — lymph, says Nasreen Starner, OTR/L, an occupational therapist at the Cleveland Clinic, who performs this massage regularly.

Dr. Starner says lymph is then dropped off at lymph nodes (small, bean-shaped structures located all over the body, but usually checked by a doctor in the neck, armpits and groin) throughout your body, where it's filtered to separate waste.

Eventually, waste is pushed to the kidneys or liver through the blood. Then, it's urinated or pushed out through stool, she says.

Problem is, if your lymphatic system has been weakened — due to lymph node removal after cancer surgery, or damaged lymph vessels from chemotherapy or radiation, for example — fluid can build up in certain areas of the body, causing swelling and pain, Starner says.

This is where lymphatic drainage massage comes in.

Lymphatic drainage massage is a medical technique used to "move waste products out of the lymphatic system and body that can't filter out on their own," Starner says. This technique is also called manual lymphatic massage.

During this massage, a physical therapist performs a skin stretching technique that targets the lymph vessels, which moves fluid to lymph nodes that are still functioning (i.e., able to filter out waste).

Starner says this differs from a regular massage because there has to be a proper balance of pressure so vessels don't collapse but skin is still stretched.

"And [our strokes] can't be so light that it won't stimulate the lymphatics to drain," she adds.

Lymphatic drainage massage helps ease the pain and swelling that often results from a buildup of fluid, says Christine Hudacek, PT, CLT, a physical therapist and certified lymphedema therapist who sees patients at the University of Maryland St. Joseph Medical Center in Towson, Maryland.

Hudacek says the swollen tissue can also feel "fibrotic and uncomfortable," so draining the fluid can help the tissue feel softer.

"We use lymphatic drainage massage on [people who have any condition] that could cause swelling," Starner says. Some of these include:

Lymphedema is a type of painful swelling that often affects people recovering from cancer surgeries. Lymphatic drainage massage helps move lymph to working lymph nodes, which can reduce the swelling in areas where there's a buildup of fluid, per the Mayo Clinic.

Health care experts can actually see the benefits for people with lymphedema, too.

"There are cameras that can see through the skin and show that [lymphatic drainage massage] can work," says Melissa Aldrich, PhD, an associate professor with the Center for Molecular Imaging at McGovern Medical School at UTHealth Houston.

And "the earlier someone gets treated when they notice the swelling, the better," she adds.

Chronic venous insufficiency happens when leg veins get damaged and limit blood flow back to the heart. This can increase blood pressure in the legs and make tiny blood vessels burst, resulting in inflammation, tissue damage and sores that appear on the skin, according to Johns Hopkins Medicine.

While research is limited, one small March 2017 study in ‌Physiotherapy‌ found lymphatic drainage massage can help increase blood flow in the veins. And another small June 2013 study in ‌Archives of Medical Science‌ found the technique can help ease the severity of the condition in the feet and lower legs, while also improving quality of life.

Fibromyalgia is a chronic condition that causes muscle pain, fatigue and tenderness. The symptoms tend to flare up at various times, and there are lifestyle changes you can make to help ease symptoms, per the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

It's thought that different types of massage can help ease the symptoms of fibromyalgia. One October 2014 review in ‌Manual Therapy‌ found people saw improvements in their symptoms with myofascial release therapy, Shiatsu and lymphatic drainage massage, which was shown to help ease stiffness and depression.

Rheumatoid arthritis (RA) is a type of inflammatory arthritis that affects the joints, causing pain, stiffness and swelling.

Lymph nodes can swell when you have RA, according to Harvard Health Publishing. Lymphatic drainage massage may help stimulate the drainage of lymph and reduce the inflammation and swelling you may have.

Lymphatic drainage massage is generally considered safe for most people, but that's not to say it's risk-free. You shouldn't get lymphatic drainage massage if you have the following conditions, per the Cleveland Clinic:

• ‌An infection‌: Swollen lymph nodes are fighting off the infection and you "want them to do their job," Hudacek says.
• ‌Blood clots‌: They can become dislodged and travel to the lungs or heart, which can increase risk for heart attack and stroke. An indicator for a clot in one leg is pain and swelling on one side.
• ‌A kidney injury‌: Waste products from lymph drain through the kidneys.
• ‌Congestive heart failure‌: Sending too much fluid to the heart can worsen this condition.

In fact, if you have any underlying medical conditions, you should talk to a doctor before trying lymphatic drainage massage, Starner says.

There's no shortage of people online who claim to be experts at this massage and swear it's a guaranteed way to get glowing skin and a flatter stomach.

Truth is, manual lymphatic drainage is only used for specific medical conditions — it's not a technique that's practiced at your average spa.

Some of the biggest myths include:

Lymphatic drainage massage is used to treat swelling from conditions like lymphedema, which is different from bloating. Getting a lymphatic massage after, say, eating a large meal probably won't result in any noticeable differences, Hudacek says.

"You also probably won't see very long-lasting results," she says. "With true swelling from lymphedema, you can see dramatic changes from one session to the next."

There's no evidence that lymphatic drainage massage will reduce puffiness from a bad night's sleep or give you more defined cheekbones (as beauty magazines, lifestyle websites and social media influencers claim).

Rather, lymphatic drainage massage — when used on the face and neck areas — is often used to help break up fluid blockages in people who've undergone head and neck surgeries or radiation for cancer.

A September 2022 article in the ‌Journal of Cosmetic Dermatology‌ does say there are other techniques that may stimulate the lymphatic system and increase blood flow to the facial area — like jade rolling, which uses a small tool that resembles a paint roller made with a jade stone to massage the skin, and gua sha, which uses a jade stone to scrape the skin. Note: All of these methods still need further research, too, per the article.

Keep in mind, these still differ from true lymphatic drainage massage, which aims to open up regional lymph nodes to remove fluid, Hudacek says.

And with jade rolling and gua sha, "you're not using the hand-skin stretch, which is the gold standard of manual lymphatic drainage," she says.

If you're a candidate for lymphatic drainage massage, you'll likely receive a referral from a cancer surgeon or a vascular doctor, Hudacek says. Many of these specialists are physical or occupational therapists who work at medical centers.

You can also find specialists through organizations that offer certifications for manual lymphatic drainage massage, Aldrich says. The Lymphatic Education and Research Network maintains a list of organizations — often cancer centers at universities — that have certified experts who are vetted yearly for their lymphedema care and treatment, she says.

Bottom line: There are a lot of disparities between what lymphatic drainage and regular massage is, Starner says. Watch out for self-proclaimed therapists online who use heavy-handed, improper techniques, which is problematic, Hudacek says.

You can. In fact, if you have a condition like lymphedema — or are at risk for it — your physical or occupational therapist may ‌want‌ you to do lymphatic drainage massage on yourself every day, Starner says.

This is partly because there's no cure for lymphedema — it's a condition that needs to be managed over the long term.

Your physical therapist can give you specific instructions for how to give yourself a lymphatic drainage massage, Hudacek says. They may recommend starting at a specific area of the body and moving your hands in a specific pattern or motion — and it likely won't look like what you've seen on social media.

All in all, lymphatic drainage massage may be one of the newest wellness trends on social media, but only certain people are candidates for it. Those who are will want to seek out a specialist, and ‌not‌ take the advice of anyone they happen to see on TikTok.