When should you not do lymphatic drainage massage?

September 25, 2025 •

4 min read

While often lauded for its benefits, lymphatic drainage massage is not suitable for everyone. Over 7 million people in the U.S. alone live with a circulatory disease, and for many with specific conditions, a lymphatic drainage massage could pose a serious health risk. It's crucial to understand when to avoid this therapy to ensure your safety.

Quick Summary

Certain health conditions, including active infections, deep vein thrombosis, and congestive heart failure, are major contraindications for lymphatic drainage massage. For individuals with these issues, stimulating the lymphatic and circulatory systems can lead to severe complications. It is imperative to consult a healthcare professional before proceeding with any massage therapy.

Key Points

Blood Clots are a Major Risk: Individuals with deep vein thrombosis (DVT) or other blood clots must never undergo lymphatic drainage massage, as it can dislodge clots and cause a life-threatening pulmonary embolism.
Avoid During Active Infections: If you have a fever or an active infection like cellulitis, wait until you've fully recovered to avoid spreading the infection throughout your body.
Heart Conditions Require Caution: Untreated congestive heart failure and severe hypertension are absolute contraindications due to the increased fluid load on the heart. Always consult a cardiologist first.
Kidney Failure is a Concern: The body's fluid filtering capacity is compromised with kidney failure; a lymphatic massage can overwhelm the kidneys with mobilized fluid and toxins.
Consult a Doctor for Cancer: Patients with active cancer or malignant tumors should consult their oncologist before considering lymphatic drainage massage to assess the risk of spreading cancer cells.
Pregnancy and Other Conditions Need Clearance: Relative contraindications like pregnancy or thyroid issues require a medical professional's approval and careful consideration by a certified therapist.

Understanding the Contraindications: Who Should Avoid This Therapy?

Manual lymphatic drainage (MLD) is a specialized, gentle massage technique designed to encourage the natural drainage of lymph fluid, which helps remove waste and toxins from bodily tissues. While beneficial for many, it is not a one-size-fits-all treatment. Certain medical conditions and circumstances can make it dangerous. Understanding these contraindications is essential for both your safety and the effectiveness of the treatment.

Absolute Contraindications: When to Never Get a Lymphatic Massage

These conditions present the most serious risk and are considered absolute contraindications. A qualified therapist will refuse to perform the massage if any of these are present.

Deep Vein Thrombosis (DVT) and Blood Clots: This is arguably the most critical contraindication. A lymphatic massage increases circulation and could dislodge a blood clot. If the clot travels through the bloodstream and lodges in the lungs, it could cause a potentially fatal pulmonary embolism.
Active Systemic Infections: During an acute infection, such as a fever or the flu, the body is already working overtime to fight pathogens. Stimulating the lymphatic system in this state can spread the infection more rapidly throughout the body.
Congestive Heart Failure: Individuals with untreated or decompensated congestive heart failure have a heart that cannot pump blood effectively. Increasing the lymphatic fluid load returning to the heart can put a dangerous strain on an already weakened organ, potentially worsening the condition.
Kidney Failure: The kidneys are responsible for filtering excess fluid and waste from the blood. For patients with kidney failure, their kidneys may be unable to handle the sudden influx of fluids and toxins mobilized by the massage. This can lead to fluid overload and other severe complications.
Untreated Malignant Tumors (Active Cancer): While lymphatic massage can be used post-cancer treatment, performing it over an area with active cancer or undiagnosed lumps carries a hypothetical risk of spreading cancer cells through the lymphatic system.
Cellulitis: This is a serious bacterial skin infection. Massaging an area with cellulitis can easily spread the bacteria, making the infection much worse. It's important to wait until the infection is completely cleared with antibiotics.

Relative Contraindications: Use Caution and Consult a Doctor

These conditions require caution and, in many cases, clearance from a healthcare professional. A certified therapist may modify the treatment or delay it.

Pregnancy: While generally safe in a low-risk pregnancy when performed by a certified prenatal massage therapist, certain techniques or areas (like the abdomen) may be restricted. Always get your doctor's approval first.
Untreated Hypertension (High Blood Pressure): The increased circulation from a massage can cause a temporary rise in blood pressure. While often mild, it can be a risk for those with severe, uncontrolled hypertension.
Asthma: Gentle massage can be beneficial, but specific neck work could potentially trigger a hyperthyroid reaction or an asthmatic attack in susceptible individuals. Communication with your therapist is key.
Thyroid Problems (Hyper- or Hypothyroidism): Massaging directly over the thyroid gland in the neck can upset the body's delicate hormone balance. A skilled therapist will either avoid this area or use very gentle techniques.
Recent Surgery or Radiation: Avoid massaging directly over surgical sites or areas of skin damaged by radiation therapy until fully healed and with a doctor's clearance. The delicate tissues need time to recover.

Comparison of Absolute vs. Relative Contraindications


Feature	Absolute Contraindications	Relative Contraindications
Risk Level	High; potentially life-threatening	Moderate; caution and medical clearance needed
Action	Must be avoided entirely	Can proceed with adjustments and medical approval
Examples	DVT, congestive heart failure, acute infection	Pregnancy, controlled hypertension, post-surgery (healed)
Underlying Reason	Increased fluid load/circulation could worsen severe condition or spread infection	Potential for exacerbating a manageable condition

The Importance of a Professional and a Thorough Health History

When seeking a lymphatic drainage massage, it is vital to choose a qualified and certified professional. They are trained to recognize contraindications and will conduct a thorough health intake before beginning the session. Be honest and transparent about your medical history, as withholding information could be dangerous.

Why is this intake process so important? A comprehensive health history allows the therapist to understand your unique physiological risks. They can then tailor the session to your needs or, if necessary, advise against it and recommend you consult a physician. For instance, a certified lymphedema therapist (CLT) has specialized training to work with complex cases that a standard massage therapist might not.

What to Do If a Contraindication Applies to You

If you have a condition that is a contraindication, do not despair. It may not mean you can never receive this therapy. Many relative contraindications can be managed with a doctor’s guidance and a qualified therapist's expertise. The most important first step is to consult your doctor or healthcare provider. They can provide clearance or alternative recommendations that are safe for your specific situation. Waiting for an acute infection to pass or managing a pre-existing heart condition properly can pave the way for safe treatment in the future.

Conclusion

Lymphatic drainage massage offers numerous potential benefits, but its safety hinges on the presence or absence of certain health conditions. Absolute contraindications like DVT, active infections, and heart or kidney failure make the procedure dangerously risky. Relative contraindications, including pregnancy and certain chronic conditions, require careful consideration and medical consultation. Prioritizing your health by understanding these risks and seeking professional guidance is the most responsible approach to this therapy.

Frequently Asked Questions

No, you should wait until you are completely recovered. Performing the massage during an active infection can cause the germs to spread more quickly throughout your body, potentially worsening your illness.

No, you should never get a lymphatic massage if you have a current blood clot or deep vein thrombosis (DVT). The increased circulation can dislodge the clot, leading to a life-threatening condition called a pulmonary embolism.

While it can be beneficial, it's a relative contraindication. You should only get one with your doctor's clearance and from a therapist certified in prenatal massage. Certain areas, particularly the abdomen, should be avoided.

It depends on the severity. If you have decompensated congestive heart failure, it is an absolute contraindication. For less severe conditions, you must get clearance from your cardiologist, as the increased fluid load can strain a compromised heart.

If you have active cancer or malignant tumors, it is an absolute contraindication without an oncologist's clearance. If you are a post-cancer patient, it is often recommended, but you must work with a certified lymphedema therapist.

You should not proceed with a lymphatic massage. Any undiagnosed lump or swelling should be evaluated by a healthcare professional first. Massaging an area with an unknown lump can be risky.

For individuals with kidney failure, it is generally an absolute contraindication. The therapy mobilizes fluids and toxins that the kidneys may not be able to process, potentially causing dangerous fluid overload. Always consult a nephrologist.