Do healthy people need lymphatic treatments?

Do healthy people actually need lymphatic treatments?

The hosts examine whether lymphatic drainage treatments are medically necessary for healthy individuals or primarily a wellness trend.

"At Sierra, you'll always find apparel, footwear and gear for 20 to 60% less than department and specialty store prices. But right now it's clearance time, so you can save even more on everything you need to get active and outside. Visit your local Sierra store today. Down a long gravel road. Very quiet and secretive. Behind locked gates. You can see the future. Lies a wellness cult. If you break the rules, then things begin to go wrong. Behind the promises. I was scared. I was shaking. Lay something more disturbing. They were healing her energetically, Phil. How does that go, though? I don't know. Obviously it doesn't work because she's dead. Who should you trust to make you better? Follow and listen on rnz.co.nz forward slash podcasts or your favourite podcast app. ABC Listen. Podcasts, radio, news, music and more. Am I right in remembering, Norman, that you hate massages? I loathe massages. I cannot imagine why anybody would spend money to have somebody hurt you like that. It doesn't always hurt. I get so uptight about them and tense up that I don't get any benefit out of it. It's the opposite effect. Yeah, that's fine. Oh, well, I can get it. Some people are addicted to them. They just absolutely love it. You're going to hate this episode of What's That Rash? Yeah, it's kind of what we're going to talk about on this week's What's That Rash, the podcast where we answer the health questions that everybody's asking. So today, the questions come from Nikki and Kate, who are both asking about lymphatic massage. So a very specific type of massage, maybe one that you would hate less than others, I don't know. Nikki says, I want to know if lymphatic treatment actually works or if it's just another money grab. Nikki said, I had my second bout of diverticulitis and was recommended by a non-medical person to try it. What do you know about this treatment? Well, I will say I'm always a bit sketchy when a non-medical person is the person giving medical advice. I say that myself, not being a doctor. Quickly, what's diverticulitis, Norman? Well, diverticulitis is where pouches develop in your colon, in your large bowel, and become plugged and infected. And it's really quite a painful condition. And it can actually turn into something surgical requiring major surgery, either to remove the diverticula of these pouches, but usually it can be settled with diet and antibiotic treatment. And maybe lymphatic drainage massage, as we'll discover soon together. I'm not sure I'd want somebody pummeling my stomach while I've got diverticulitis. That might just be a... Oh, goodness. Anyway, Kate is asking the more broad question saying, is lymphatic massage as beneficial as claimed for otherwise healthy adults? I've seen massage gloves with metal bumps claiming that the recommended massage technique, along with essential oils and massage creams that I'm sure you all get for a fee, will detoxify and drain your lymphatic system, boost your circulation and support skin health. Is this something we should all be doing? Detoxify is always a red flag word for me. Well, it's a sort of TikTokify word, isn't it really? Yeah. And I think this is a very TikTok-y space. I don't know about all of the different types of lymphatic drainage massage, but at least on my algorithm, I see a lot of stuff about facial massage to de-puff the face. You make you look snatched, isn't that the word? I'm just snatched from where I'm not quite sure, but anyway. You're always like it when I'm up with the terminology. I love it when you're up with the terminology. I'm up with the lingo. Always on. Well, you always look snatched to me, Norman. Oh, you're very kind. Yeah. So where do we even start with this? The lymphatic system is perhaps the lesser known and loved of some of the systems in the body. It is. Once you describe it, people say, oh, of course that exists, but they don't know. It's in a sense a parallel circulatory system in the body. This is a network of vessels which carry fluid, white blood cells, rubbish often, infective particles, back up, often in line with the arteries in the same sort of channel, to lymph nodes. So you get blood coming through the arteries to tissues, goes into the tissues, the veins then take away the deoxygenated blood. But fluid gets Thank you. So you get blood coming through the arteries to tissues, goes into the tissues. The veins then take away the deoxygenated blood. But fluid gets pushed into the tissues, but also cells themselves live within, if you like, an aqueous environment where stuff from cells goes into this aqueous environment. and the lymphatic system is designed to take a lot of this away, filter it through the immune system and return, in effect, filtered fluid back into the bloodstream. So I think most people's point of reference with the lymphatic system is lymph nodes. You know, when you've seen a doctor and they felt around your throat to see if maybe your lymph nodes in your throat are a bit swollen as a sign of infection, or you might have heard of lymph nodes in relation to cancer treatment that perhaps they're sort of like a sentinel that cancer might have spread out of the original site, say for breast cancer or something like that. But beyond that, apart from maybe having puffy ankles at the end of a long flight, it is something that we don't seem to think about quite as much. And puffy ankles at the end of a long flight may have nothing to do with your lymphatic system. It may simply be something going wrong with the blood getting back to your heart. That's not always the case. Problems with your kidneys can cause swollen ankles. The point being that swollen ankles, swollen limbs needs to be investigated in its own right and not assuming that it's just poor lymphatic drainage because you could be missing something serious like heart failure. Okay, that is a really good word of warning there. And so then the lymph nodes are kind of part of your immune system. It's part of the way your body's checking what's running around it and making sure there's no nasties in there. Yeah, and the lymph nodes are, if you like, waste stations for foreign material that's coming into the body, and the lymph nodes can alert the rest of the immune system that something's up and trigger various immune reactions, both nonspecific and specific to the threat. I know that sometimes when people have cancer, they have to take lymph nodes out as part of the treatment, and then that can be something that causes lymphedema, where someone has a buildup of fluid in, say, their arm because their lymph node isn't working, which is just sort of one of the many ways that the lymphatic system isn't working sometimes in some people. Yeah, it's very different from the sort of swelling that you might get with heart failure or kidney problems. It's the whole limb that gets swollen, and's usually just one side. And it is a recognized and all too common side effect of cancer surgery and therefore needs to be thought about and people try to prevent it. And it's also where lymphatic massage can help. We'll come back to that in a moment. But there are other causes of lymphedema. Lymphedema can occur in its own right where they just don't know what the cause is. You can get cancer of the lymphatic system itself, which is, you know, lymphoma is one of those. You can get inflammation of it, lymphangitis. You can get congenital problems with the lymphatic system. You can have parasitic infections of the lymphatic system. So there are lots of things that can go wrong with the lymphatic system causing lymphedema. And people might have seen photographs of filariasis where the limbs can become enormous due to the blockage of the lymphatic system due to parasites. So I did a couple of stories on lymphedema as part of the health report a few years ago. And when I was speaking to the people involved in that, one of them was a woman who'd had breast cancer. Another was the parent of a child who had congenital lymphedema. And for them, massage was a really big, important part of their therapy. So it obviously works to drain this lymphatic fluid for people who have a malfunctioning of that system. But I think the question, especially Kate's question is for otherwise healthy adults, is there any health benefit here? Well, before we get there, let me just deal with a little bit with the causes that you spoke about. Post-surgery for people where the surgeon suspects that you might be susceptible to lymphedema because of the surgery. They do compression bandages. There's exercises that can be done. And indeed, there's a dragon boat racing for women with breast cancer was originally... What? Well, I don't know if you know, there's a whole worldwide movement of dragon boat racing for women who've had breast cancer, who are breast cancer survivors. Okay. I mean, that sounds awesome. And one of the reasons that it started was a group of women with lymphedema. And they found that paddling in the dragon boats helped their lymphedema. And this has now become a real thing. You'll find boats full of women following their breast cancer around the world in dragon boat racing. Okay. Is there something specific about the type of paddling with dragon boat racing or is it just that they're active? They're active arm exercises, which gets things moving, gets whatever lymph drainage you've got is enhanced. Plus community and it's awesome. They do those chants. That is very cool. So there's a whole process involved in the treatment of lymphedema and manual lymph drainage, which is a specialized technique, which is following the drainage of the lymphatics. And the thing about the drainage of the lymphatics is there's some areas in the body where we know that lymphatic fluid drains into the bloodstream. It's about three litres a day in normal circumstances. And so the idea is just to get this moving, often with quite light touch, but it's a mixture of light touch, heavy touch. There are various techniques used to release the fluid and try to get it moving. And in expert hands, this can help. In severe lymphedema, you do need other techniques, but lymphedema massage does work. So that's obviously very specific cases in people that have a disordered lymphatic system that needs manual help, as well as other things. I've also seen some studies around lymphatic draining massage comparing to other massages for sports recovery. The studies that we found for this particular podcast have not shown a big difference between manual lymphatic drainage and other specialized forms of massage, such as petrissage massage, which is really more of a kneading style of massage. So that's very specific application there. I guess what I'm, we talked about the TikTokiness of this before. I think some of the claims that I've seen around this area and that our correspondents are writing to us about is this sense of your lymphatic system is perhaps congested, that it's, you know, making you bloated, it's making you puffy, you're not snatched, as you said, Norman. What do we know about whether there's... What does snatched actually mean? It's when you make... I thought you knew you were using it so perfectly. It's where you sort of like lifted and especially around your face or your waist that you look kind of very tight and angular in a way that is culturally aesthetically pleasing in this specific moment in time. Yeah. Whenever people claim that a particular factor explains almost everything that's going wrong with your body, it's not. It's as simple as that. And you can never say never, but the likelihood that abnormal lymphatic drainage has effects on a wide range of conditions, including diverticulitis, is just not there. Yet, when you've got inflammation, you will have an effect on the lymphatic system. You'll have more fluid going through the lymphatic system, more rubbish, in a sense, getting into your lymph nodes. That would be an issue. But there's no sense that the drainage is particularly abnormal and would benefit from massage. The thing about massage is it's not necessarily going to do you any harm unless you're treating something that should be investigated medically before you jump to the idea that it's lymphedema. And we've spoken about that earlier. The specific type of massage that I think is worth digging in on with this, especially around skincare, is gua sha and facial rolling. Are you familiar with this? Yes. I mean, I do it every morning before I go to work. Do you? Do you have a jade roller? No, I don't. So if you're not... Okay, so the facial roller is a little bit more self-explanatory. It's like a little rolling pin that's usually made of jade and you can sort of use it to roll on your face and it's kind of cold and some people use it like with this skincare that put their moisturizer on it. So it's not a stretching roller like you would lie in the ground and run your face over a rough roller. No, it's like a little tiny magic wand that you kind of rub around on your face. And then the gua sha tool, it looks like a kind of wonky love heart and it's sometimes made of jade, it's sometimes made of metal, but it's the same sort of thing. And the gua in gua sha, it's Chinese medicine thing, means scrape. And sha refers to the kind of bruising effect that like in traditional Chinese medicine, you might do it over your whole back. And it's a very firm scraping motion that leaves that kind of, what do you call it? That sort of speckly red bruising mark behind it. It's called petechiae. Petechiae, what a cute word for something that looks kind of intense when you first see it. And that's very much embedded in Chinese traditional medicine. As far as I could see, I couldn't find a huge amount of evidence to support it. But in terms of making your skin look, I don't know, tighter, brighter, lighter, higher, I don't know, what do we know about that? Well, we found one study, which was a small study, not well controlled, where people were either using the facial roller or the full gua sha technique. So it was about 34 people. So it was one against the other rather than control. There was no placebo, obviously."