As a Certified Decongestive Therapist trained in manual lymphatic drainage, and a Registered Physiotherapist, I’m often asked by my lymphedema patients why I am so focused on the neck during my lymphatic massage treatments, even when the Lymphedema is presenting in an arm or leg. The reason is simple: there is a huge collection of cervical lymph nodes located in the neck region that can be capitalized upon to stimulate the lymphatic system to improve its overall flow. The number of lymph nodes located in the neck region is approximately 300, far greater than in the armpit, groin, or abdomen, and may represent over half of the total number of lymph nodes in the body. This is not surprising given that it is at the neck where lymphatic fluid rejoins the cardiovascular system via the subclavian vein.
The neck represents a great target for improving overall lymphatic flow, not just because of the total number of lymph nodes present, but also because of the infrequency of functional limitations in the lymphatics at the neck. Patients with Secondary Lymphedema which arises due to radiation to, or removal of, lymph nodes in the armpit region from their breast cancer treatment (for example), typically retain full functional capacity at the neck. Similarly, in the case of Primary Lymphedema, the nodes at the neck typically retain sufficient functional capacity as well.
In manual lymphatic drainage massage, we always begin the massage series with several strokes specific to the neck region, to draw lymphatic fluid from other regions of the body, and send this fluid back into the cardiovascular system. Such stimulation contributes considerably to the results we see with manual lymphatic drainage. We encourage all of our Lymphedema patients, be they Primary or Secondary, to incorporate self-massage of the neck into their daily self-management strategies. The entire series of neck strokes should only take about 5 minutes to perform, and is easy and comfortable to do. A certified Lymphedema therapist would be able to show you the appropriate technique. You can also learn more by visiting our website where we have posted a short video demonstrating lymphatic drainage self-massage at the neck. Best of luck!
Lindsay Davey, PT, MScPT, MSc, CAFCI, CDT