Manual Lymphatic Drainage in the Treatment of Chronic Venous Disease

Abstract

Abstract Chronic venous disease (CVD) is a chronic condition that is associated with venous hypertension, vein’s valves damage, venous obstruction, and calf muscle pump impair- ment. This blood circulatory condition is also characterized by important inflammatory changes affecting the skin, the subcutaneous tissue and the muscles, which are probably triggered by blood stasis and venous edema. With disease progression, severe ulcerative skin damage might occur, which when present represent the more severe stage of this condition. CVD has a significant economic, social and health impact, mostly due to raised morbidity and chronicity. The treatment of patients with CVD might focus on both the symptoms and second- ary changes of the disease, such as edema, skin and subcutaneous changes or ulcers. Usually, initial treatment of CVD patients involves a non-invasive, conservative treat- ment to reduce symptoms, treat secondary changes, and help prevent the development of secondary complications and the progression of the disease. Complementary, some interventional or surgical treatments can be undertaken. There are several conservative treatments to treat and prevent complications associated with CVD that have been described in the literature, like manual lymphatic drainage (MLD) and compression, physical exercise, intermittent pneumatic pressure, kinesio tap- ing, electrical muscle stimulation, transcutaneous electrical nerve stimulation, hydrother- apy, and health education. Most of these techniques are complementary to compression therapy or pharmacological treatment.