Effect of Manual Lymph Drainage Massage on Urinary Excretion of Neurohormones and Minerals in Chronic Lymphedema

Abstract

Treatment of 29 cases of chronic lymphedema of various origins, mostly of the lower limbs, by manual lymph drainage massage resulted in significant changes of neurohormone excretion in the urine, whereas the secretion of 17-KS, thyroxine, minerals, and creatinine was not significantly changed. Comparison of the values of urinalysis before and after manual lymph drainage of the patients showed the following changes: 17-KS; -3.5% (non significant); 17-OH: -31% (significant); adrenaline: +50% (significant); noradrenaline: +19% (significant); serotonin: -22% (significant); 5-HIAA: +21% (significant); histamine: +129% (highly significant); thyroxine: -17% (nonsignificant); creatinine: -17% (nonsignificant); sodium: -1% (nonsignificant); potassium: -14% (nonsignificant). The corresponding values for ten controls were all non significant. These findings underline the importance of adrenaline and noradrenaline release by manual lymph drainage, which improves circulation. On the other hand, our results indicate the involvement of histamine and perhaps of serotonin in lymphedema formation, and suggest a combination of manual lymph drainage massage with antihistamine and antiserotonin treatment.

A Prospective Randomized Controlled Trial of Manual Lymph Drainage (MLD) for the Reduction of Hand Oedema after Distal Radius Fracture

“…The role of the lymphatic system is often not fully understood among hand therapists and hand surgeons, although many articles emphasise the necessity of lymphatic drainage of plasma proteins and fluid from the injured area (Casley-Smith 1981, Drake et al 1998, Ikomi et al 1996, Sallustio et al 2000, Szczesny and Olsweski 2002. Fluid transportation both in veins and lymphatics needs skeletal muscle contraction and the lymphatic system has, in addition, its own ability to pump and to increase its capacity several times (Boland and Adams 1999, Boris et al 1994, Campisi et al 2001, Földi and Clodius 1989, Kurz et al 1978, Morey and Watson 1986, Rockson 2001, Sallustio et al 2000, Schmid-Schonbein 1990, Simons et al 1996, Szczesny and Olsweski 2002, 2003. The MLD technique, according to Vodder, used in this study to reduce oedema was applied in the experimental group six times for 40 minutes over 13 days.…”

“…MLD as described by Vodder (Kurz 1994, Kasseroller 1998, Wittlinger and Wittlinger 1996 is a technique that starts with increasing lymphomotoricity proximal to the injury before reaching the injured area. The massage starts at the left supraclavicular space, draining the lymph fluid into the axillary and subclavian veins (Boiselle Howard 2001, Földi and Clodius 1989, Kasseroller 1998, Kurz et al 1978, Rockson 2001. The number of published studies is limited and they are based on oedema of the hand due to traumatic injuries of the upper limb.…”

Bilateral Changes in Deep Tissue Environment After Manual Lymphatic Drainage in Patients with Breast Cancer Treatment-Related Lymphedema

“…Kurz et al 21 found changes in excretion of urinary neurohormones, specifically significant increases in histamine and serotonin, immediately following MLD in patients with lymphedema whereas no changes were found in healthy controls post-MLD. 21,22 In a pilot study, Tan et al.…”

“…Kurz et al 21 found changes in excretion of urinary neurohormones, specifically significant increases in histamine and serotonin, immediately following MLD in patients with lymphedema whereas no changes were found in healthy controls post-MLD. 21,22 In a pilot study, Tan et al. 23 reported near-infrared fluorescence imaging visualized lymphatic contractility improvements with an increase in both lymph velocity and propulsive frequencies immediately post-MLD for the involved and contralateral limbs in patients with known lymphedema and in both limbs of healthy controls.…”

Lipedema

“…Beyond its well-known benefits, MLD is able to improve blood microcirculation blood flow, has peripheral analgesic, central sedative, analgesic, vagotonic reaction [38,39,40,41] and improves muscular recovery after physical exercise [42].…”