1. Swelling

This is the Main indication The MLD. Edemas can have different causes:

• Primary lymphedema
  Congenital malformations or functional disorders of the lymphatic vascular system.

• Secondary lymphedema 
  Acquired, mostly as a result of:

  • Cancer treatment Status post Lymph node removal (e.g., for breast cancer, melanoma).

  • Radiation therapy Damage to lymphatic vessels from radiation.

  • Trauma, surgeries, and injuries: Post-traumatic or post-operative swelling (e.g., after joint replacement, ACL surgery).

• Phlebodema 
  Swelling due to venous insufficiency or chronic venous insufficiency.

• Lipedema
  Adipose tissue distribution disorder, often accompanied by secondary lymphedema (lipo-lymphedema).

• Inactive or dormant edema
  Swelling from lack of movement or immobility.

2. Pain and inflammation conditions

MLD is used for pain relief and to support healing in certain inflammatory and traumatic conditions:

• After injuries/trauma
  For faster reduction of hematomas (bruises) and swelling.

• Chronic pain conditions
  MLD can have a pain-relieving effect (analgesic effect), for example, in fibromyalgia.

• Rheumatic Diseases
  To support swelling and inflammation in the joints.

• Sudeck's disease (CRPS)
  For pain relief and decongestion in this complex regional pain syndrome.

3. Neurological Indications

• Migraine and tension headaches
  As supportive treatment for relaxation and decongestion in the head and neck area.

• Neuralgia
  For pain relief and reduction of pressure sensitivity.

4. Other indications

• • Scar treatment
    For improving scar elasticity and reducing post-operative swelling in the scar area.

  • Acne and dermatological problems
    In the facial area for decongestion and to promote healing.

  • Stress and autonomic dysfunction 
    Due to the relaxing and calming effect of the gentle technique on the nervous system.

Absolute contraindications (treatment must not be performed)

These conditions generally require immediate or other medical treatment:

1. Acute Deep Vein Thrombosis (DVT)
   The massage could dislodge the thrombus (blood clot), leading to a Pulmonary embolism can lead.

2. Acute and decompensated heart failure
   MLD mobilizes large amounts of tissue fluid, which is then returned to the heart via blood volume. In an already overloaded heart, this can lead to dangerous overexertion.

3. Acute bacterial infections and high fever
   Lymphatic drainage could spread pathogens faster through the body (risk of sepsis).

4. Erysipelas (cellulitis)
   An acute bacterial skin infection that could spread with treatment.

5. Untreated or acute malignant tumors (malignant edema)
   In the past, MLD was absolutely ruled out here due to fears of dissemination. Today, however, the main indication is the treatment of lymphedema after cancer (secondary lymphedema). But at active, untreated Cancer diagnosis always requires medical approval.

⚠️ Relative Contraindications (Caution and medical consultation required)

Under certain conditions or with modified techniques, MLD can be performed in these cases:

1. Hypotension (Low Blood Pressure): The treatment can further lower blood pressure and cause dizziness. Therapy must be carried out slowly and carefully.
2. Hyperthyroidism Treatment in the neck area should be avoided.
3. Bronchial asthma Strong manipulation in the chest and neck area can trigger an asthma attack; treatment must be very gentle.
4. Pregnancy
   Generally safe, but some reflex zones and techniques should be avoided, especially in the first trimester.
5. Kidney dysfunction
   The increased excretion of fluids can strain the kidneys; therefore, consultation with a doctor is necessary.
6. Chronic inflammation
    MLD can be helpful under certain circumstances, but must be used with caution.