Tips & Tricks

To Pump or Not to Pump?

Once the standard for lymphatic treatment, the benefits of compression pumps are becoming largely questioned within the lymphedema community. Why is that? And what, exactly, do pumps do?

Let’s start with the basics: A compression pump is an inflatable garment for the arm or leg. An electrical pneumatic pump fills the garment with compressed air, inflating and deflating at different intervals and providing cycles of compression on the limb. They are not meant to open up lymphatic passages, but rather offer an alternative to bandaging.

An example image of a man wearing a compression pump on his legs.

Aria Degillio, a reader here at The Lymphie Life, had begun using a pump a few months ago. Every day before bed, Aria would pump her leg for an hour, and enjoyed the decrease in swelling that resulted. Emails between us flew back and forth, and she enthusiastically recommended that I get one, too.

If you asked Aria if she recommended the pump today, however, her response would be very different. A couple days ago, Aria went to a lymphatic specialist in Michigan. He told her that the pump was a bad idea because it removes the fluid but not the solid particles, therefore speeding up the hardening of the tissue. Talk about bad news!

It’s true that pumps can cause complications and further damage to the lymphatic system, although there have been improvements made upon the old models. For example, there are newer devices referred to as intermittent pneumatic compression devices that are designed for the leg or plantar region of the foot.

If you are interested in getting a pump of your own, it’s important that you talk to a lymphedema specialist or doctor first. As with anything, success really depends on the correct usage of the right pumps, as well as a commitment to maintaining the treatment.

What do you think, lymphies? Have you used a pump before? What is your experience with them? Share your stories in the comments below!

42 comments on “To Pump or Not to Pump?

  1. Jim Miller

    I have avoided the pumps myself not so much for the issues you present (very interesting, by the way) but for two other reasons. One, I have “Restless Leg Syndrome (RLS) that causes my lymphedema leg to get extremely agitated most times when wrapped or in a pump AND when I’m sitting still. Wrapped and active – no problem. Wrapped and resting or sleeping – big problem. The leg just wants to dance and bounce and move all night. Same when I have a lymph pump – the leg just twitches and jumps inside the bag. Reason number two, I am afraid I’d lose the independence that wrapping gives me if I become dependent on a pump. I can carry wrapping materials all over the world with me. The pump? Not so much. I tried the original Wright Lymphedema Pump for several years before RLS took hold. While the new pumps are smaller and lighter,they still could lead to you losing your “wrapping skills” if you weren’t diligent about continuing to wrap. A friend at our LE support group uses the new pump for his leg and swears by it, so definitely look into it and see your specialist. It might work for you; then again it might not.

    • Aria Degillio

      Dr. Riutta out of Beaumont Hospital in MI was adamant about my not using it. He said that wrapping was the only way you’ll get reduction without solidification. I know, I know. The pump seemed like a magic bullet to me; I could slip it on for an hour and read, talk on the phone, or even sleep (I am fortunate in that lymphedema is the only medical issue I have). And my leg was getting slimmer, but my foot was getting harder, which is a very BAD thing! Pumps are primarily for vascular use. If your lymphedema stems from a vascular problem, then by all means I’d say to look at pumps. But Dr. Riutta spoke very knowledgeably about the dangers of relying on a pump. He’s the first doctor I’ve ever talked to who specializes in the lymphatic system. Please, please, PLEASE talk to a lymphatic specialist (not a salesperson or a physical therapist, with all due respect) before buying one!!!

    • VIRGINIA MIERS

      I have RLS and have had it for years but on a med for it. I have had no signs or symptoms of the problem with my going on the pump.

  2. Hi there, what a great blog, just recently discovered it! I have had Primary Lymphedema in my right leg for just over two years now.

    It’s interesting with the pumping issues. I believe pumping acts somewhat similar to MLD, but as you say, it is all about correct usage of the right pump and it is very important to manually open up the lymphchannels before pumping. I am no expert, but I find it hard to imagine that it could be bad if pumping as gently as a set of hands. The settings I use are 30 seconds of pumping, then pausing for 10. Pressure 40-50.

    I have a Pulse Press Multi 12 and though it does do something I am not impressed with this machine. This pump works by inflating from the foot upwards, but only the first time, then it inflates all over at the same times, which doesn’t make sense to me. Therefore I have recently borrowed a LymphaPress Mini and tested, and it was clearly different and much better. I felt that especially my foot and ankle felt completely drained and the tissue went very soft, also in the lower leg. I am currently waiting to try a LymphaPress Optimal which sounds really flash with a pre-pumping program etc.
    I dont believe the man on the picture is doing himself a favour by sitting with his leg and foot downwards when he is trying to push lymphfluid upwards. Also, it is important to ensure free access through the groin by not bending the hip too much. I usually lie down on my sofa when pumping.
    I am no expert, but I wouldn’t think pumping was meant as a substitute for wrapping but a “do-at-home” alternative to MLD. Maintainance. Exercising the lymphfluid, keeping it from building up and eventually growing hard or converting into fatty tissue. I carry bandages with my on travels, and I sometimes wrap myself at home after pumping.
    I too have a blog where I have some posts about pumping – and other things. Maybe we can learn from each other. I am looking forward to follow your blog.

    Kind regards,
    LymphedemaGirl
    http://www.lymphedemagirl.blogspot.com

    • Sorry for not responding sooner, but, gosh! Your blog is wonderful! I have already bookmarked your post about clothing – so helpful. I’m glad you shared it.

      So you find the LymphaPress to be helpful? I’m so wary of pumps in general, although I DO like the idea of draining the fluids in a way that’s a little more effective than regular MLD. I haven’t been seen by a lymphedema specialist in a while, though, so perhaps I’m a little overdue for that..

      • edwin roberts

        Hi: I have lymphedema in both legs (calfs). One big improvement came after I jacked up the foot of my bed 6 inches! So all night there is a gradual drainage is going on . In the morning I am quite slimmed down. But then as the day wears on the swelling comes back. I DO recommend daily walks even with a cane or crutches of at least a half hour. Any activity that increase blood circulation will also help lymph get moving. I also use a massage vibrator with mild heat and this Really works and can be done sitting down. I also just started deep knee bends since they also help circulation. I do not take any prescription medications, even at age 90! Ed.

        • edwin roberts

          Hi: Is it possible for excess lymph to leave the body through a persons urine? I am taking an over the counter med called Lymphatonic That is helping me walk better by removing excess Lymph in me left leg. Have any of you tried this OTC med? If so let me know if it worked for you. Thanks, Ed.

  3. Thanks for taking the time to share. Keep it up.

  4. hi,

    Couldn’t resist making a comment here. The reason why pumps were recommended and then not has more to do with the dangers of causing genital and abdomen swelling in lower limb lymphoedema more than anything going hard. (Your foot is more likely to go hard than the top of your leg due to it being further away from the primary lymph nodes draining the leg. Also, when using a pump and/or some other therapy, the treatment works from the top down, so your foot is the last to show improvements). Anyway, research into this showed that old pumps (like in the picture) could cause new swelling due to them pumping all at once and overwhelming the lymph system (the problem was they were too effective and moved the fluid too quickly for the body to handle). Newer pumps like the lymphapress use a sequential movement that mimic the movement already in the body (from foot to thigh) and is gentle by not holding the pressure for longer than 30sec (26s on and 4 sec rest).
    New research shows that the pumps work rather like MLD in stimulating lymph flow and are safe to use if prescribed by a lymphatic specialist.

    Right, that’s my 5cents worth!

    • Hi, Melissa,

      Thanks for clearing that up. It’s good to know that they’ve got newer ones that are gentler – I probably should have looked into that further when writing this post!

  5. Pingback: That’s a wrap! | The Lymphie Life

  6. Pingback: New study shows benefits of compression pumps for lymphedema patients | The Lymphie Life

  7. Annette

    I have lymphoedema in my r leg I have wraps and a Velcro brace but like I told them it falls down the brace it slides down my leg and the wraps don’t hold the fluid up and it hurts near my ankle and foot meet so I end up unwrapping and if I don’t wear it my leg swells so bad it hangs on the floor and I can’t walk so I was wondering if the leg machine would work

    • Hi, Annette,
      I’m sorry to hear about the struggles you’re having with your wraps! It sounds very difficult and frustrating. Could you talk to your lymphedema therapist or doctor about other options that could better serve your needs? If the wraps and brace aren’t staying up or providing enough compression, could you perhaps get a compression stocking? Before you speak to your medical team about getting a compression pump, I would probably get your regular compression sorted out first as it’s important to put on your wraps or stockings as soon as you finish a pump treatment, otherwise the swelling will return.

      I am not a doctor so I can’t advise you on your personal treatment—however, I support you in talking with your lymphedema therapist or doctor about your other treatment options!

      Best of luck and be well,
      Alexa

  8. What are your opinions on the Air Relax Compression Device? I travel a lot and am looking for a good portable device that will not break the bank. If you like it which mode setting do you use.

    • Hi, Deb,
      I’ve not used the Air Relax before, and am admittedly not super familiar with it — I’m sorry! I do have experience using the CircuFlow by Devon Medical and FlexiTouch by Tactile, although I’ve never traveled with either… I’m afraid I’m not much help here :(

      If you’re on Facebook, I’d recommend posting in some of the lymphedema support groups to ask around and see if anyone has used the Air Relax, or if they have experiences travelling with pumps in general. (If you need links to any groups, let me know!)

      Be well,
      Alexa

      • Hey Alexa,

        What are your thoughts on the Flexitouch? I am considering getting it but haven’t heard that many great things about it

  9. Full Disclosure, this is a commercial message from NormaTec Medical: We agree that using the right pump correctly for your specific condition is key (as our founder, Laura Jacobs, M.D., Ph.D. stated: “no single antibiotic cures all infections”). Pump technology from all manufacturers has come a long way recently in, e.g., new garments, pressure waveforms that more closely replicate the natural physiologic mechanism of the body’s “muscle pump”, increased functionality and smaller, lighter units more suitable for travel. More information on the newest option available (since Feb. 2017) can be found at http://www.normatecmedical.com.

  10. Lisa Overly

    I’m wondering if you can sleep with leg pump on.

    • Hi, Lisa,
      Usually the pump is worn for thirty minutes to an hour at a time. I would definitely check with your lymphedema therapist or doctor to be sure!

      Be well,
      Alexa

  11. Alison Jefferies

    I just got my pump for my arm today. It automatically shuts off after an hour and my doctor said that I could sleep in it. A friend with a pump said that her therapist said to walk around after pumping, but my therapist disagreed.

  12. Kem Friddle

    I don’t have lymphedema actually have nerve pain sensitivity.A physical therapist put in on my foot leg( I said I couldn’t tolerate blood pressure cuff) since it’s caused knee pain swelling. Side of foot worse hurts. Is this right?

  13. sam smiles again

    not all devices are created equal.

    a simple reply to a complex nightmare.

    i use the lympha press. it’s been quite the exercise, so far.

    i am a stage 4 cancer sufferer. developed lymphedema, legs hard as rocks, now they’re ‘improving’ but i’m really feeling it through out my body.

    but, my body is being rampaged by toxin hell. a real tragedy to embark upon, though i’m feeling quite improved.

    now, if only we can CURE not only cancer(s) but late stage, that would really be a VAST uplift in society overall.

    (no matter how defeatist many of our applications and abilities in our medical society is afflicted with. (so far.)

  14. Rolanda Mitchell

    I have lymphedema in my lower extremities and I use the Flexi-touch system that was suggested by my therapist. She stated that she didn’t particularly care for pumps until this system came along. It’s supposed to mimic treatments given by a therapist. After reading many of these statements, now regarding the use of pumps, I’m beginning to have doubts and worry. Do you feel that it’s safe to use this brand of pump?

  15. I have been providing Lymphedema pumps for 25 years. I have had a number of patients who started with the pump, then stopped for what ever reason. Many call me back complaining the boots no longer fit. Some try to tell me ” the boots shrunk”. Well, the vinyl material in the boots doesn’t shrink. Their legs got bigger. The size of the legs may not dramatically decrease, but the pump and boots keep them from getting a lot bigger.

  16. I. Have bilateral lower limb lipo-lymphedema, due to, 17 different referrals for treatment and NOT one knew what was going on, I diagnosed myself found a interventional radiologist, by having a CT, who found I also had Msy-Thurners Syndrome , and Severe Venous Insufficiency with both reflux and stenosis . .I found a vascular surgeon who stripped 13 veins, to tell me , all my valves are shot!
    Now, my entire body is filled with Lymphedema and nothing thus far has been a good or positive outcome !
    I tried manual lymph massage,
    XP2 machine treatment
    As well as wraps also,
    I tried compression pantyhose hose, and I swell so bad, I feel like I’m going to pass out, due to lack of blood flow . .
    The textile pump, oh yes, I’ve also did this for awhile , then I realized that it was taking the lymph fluid from one leg only to simply put it in the other leg, so, in my opinion $12,000 waste of space !!
    I have gained well over 100lbs, and I can’t find a doctor in AZ well educated on Adipose Tissue Disorders, a coagulation blood mutation ( I’m on 2 blood thinners ) Very suceptib
    blood clots May Thurners, and Severe Chronic Venous insufficiency ..
    May 27th 2018 I had surgery on my foot it was extremely destroyed
    The plantar plate was a mess I had 2 toes that were dislocated and torn ligaments, they put pins in and due to the severity of the swelling during the procedure the Dr had to skin graft my heal to close the toes. .
    It’s almost 2 months and still not healing, my toes kept getting darker from bruising, I call the surgeon his staff tells me wait for your appointment next week, furious but, with possibility of tissue and toes dying. I contacted the vascular surgeon, he did a ultrasound on my leg veins and arteries ..I had 3 blockages in my tibial artery he had to put stents in via, femoral artery! !
    At this point , I’m not convinced that there is anything or Anyone that can/will help me!?
    I give up guessing and loosing money seeing Dr after Dr!! Who ALL tell me something different!!
    I’m miserable and don’t like myself ?
    Judy

    • Tod Tepfenhart

      Judy,
      Dr. Karen Herbst is in Tucson, AZ. She specializes in Adipose Tissue Disorders. She’s an incredible person doctor. I have Dercums disease and she has been extremely helpful. Her webpage is Lipomadoc.org, You can also go to YouTube and look up Fat Disorder Research Society to find videos of presentations from their annual conferences. I wish you luck. I know how frustrating and depressing it can be to not be able to get answers or help. If anyone can help you, I’m confident that Dr. Herbst can.

    • Hello Judy. I just read your post and I just had to respond. I was so sad to hear all that you have been through. I’m so sorry. I have horrible swelling as well as many other medical problems as well. But the main thing I wanted to ask you is this/ when you say you tried compression pantyhose, do you mean you bought the ones over the counter or did you actually go get measured? I say that because if the hose don’t fit just right, you won’t find them nearly as helpful. Also, and I probably should have mentioned this first, have you ever gone to a lymphadema specialist where they actually wrap your legs? If not, you NEeD to do that! They can get your swelling down significantly and then the compression socks keep the swelling down- they maintain. The pumps maintain too. I hope this helps as I speak from experience

  17. Edwin Roberts

    Sounds like there are some Lymphomaniacs among the posts! How sexy!

  18. rick boyd

    i fell into this horrible condition after an auto accident in 2009. having fallen three time and hospitalized three times the only thing that really worked is 24 hour care,wraps and water pills 6 days days straight..i swelled to 527 pounds entering the hospital and left after 6 days at 362. 20 years later i am again waging a battle to reduce the swelling in massive thighs and calves. doctors suggest tummy surgery to reduce pressure on the water pathways..wraps are frustrating because you can’t get out of therapy before they start to lose integrity from simple movement.the pump used properly should work,and velcro garments allows for easier self care

  19. Hi all Lymphie-warriors! Greetings from downtown NYC. Hubby Ric is portly, though he has well controlled diabetes. A1C # excellent. Recently, some dermatitis, minor swelling in his ankles, so his Doctor at the VA recommended the latest Flexi-Touch. They even sent a therapist to the house to give me a full set-up and monitoring tutorial. (I home cared mother when she suffered from dementia until she passed away, aged 95 at home. So even without a medical degree, nursing tasks for me are really, no big deal). The Flexi-Touch guy answered my questions, showed me how to set everything up, what to do, and how to make sure hubby got best results. We do this therapy in the afternoons.. I say to him with a smile, “Dear, how about I help you on with your ‘space suit?”Having a family member to be supportive and help with this is a real plus!! My husband feels far less sluggish, and sure enough his ankle swelling and wound healing all show marked improvement. I would urge anyone diagnosed with this condition to do the research, speak with your Doctor, learn all you can, and consider whether a device like this can help improve your health and life quality. It certainly helped my husband. And is also – a nice way to have ‘together time’…

    • Oh dear, here I am again..Cindy’s Lymphedema doppelganger!! No, seriously I wanted to check back in and just give an update, AND a shout out to our Tactile Med people, who replaced a part of hubby’s Flexi-Touch lymphedema device that, after months of trouble free use, suddenly developed a ‘beep’. The service people were timely and prompt when I called, and we received the new pieces via UPS in just a few days.Warranty still in effect. We are great fans of this device. For hubby, it has made a big difference. Bottom line: Ric’s treatments have resumed. He said the new pump works even more strongly, his leg swelling vastly improved in just hours, he slept like a baby that evening. Staying on top of how your particular devices are (or are not) working, and tracking results, is an important part of optimal home care. I am glad to be here to monitor things. Call me weird, but I look forward to our ‘space suit time’… (‘Lymphie Love?”…LOL).

  20. Would it be better to be laying down when I use my pump or sitting. They said sitting, but I remember when my mom had fluid in her legs the doctors always told her to put her feet up.

    • I sit in a recliner and it helps. when I am not pumping they say to lay with your legs up against a wall it help too.

  21. Excellent explanation, it’s simple & focus

    • Edwin Roberts

      Hi: I have swelled legs as a result of surgery. I found that elevation is THE best way to live with this disease. I raise the head of my bed with 2×6 wood blocks. I screw the blocks with 3 inch deck screws. That way my legs look great in the morning!

  22. I have had lymphedema for years but just got diagnosed in May by a vascular doctor as well as a vein specialists in Michigan.
    I started using a compression pump as well as compression stockings. I have noticed that some swelling has gone down. and I have to go to the bathroom a lot now. which I suppose the fluid is coming out. It is not changing the size of my legs but it sure seems to feel better. they don’t know how I got this disease but from trauma from having 2 DVT’S and just hereditary.
    I also have osteoarthritis in my knees so walking is horrible. I deal with pain everyday along with swelling.
    I still work everyday and hope to continue as I am only 56 and need too. SSD doesn’t pay much so hoping I can make it awhile longer. I am learning everyday from support groups how to manage this disease.
    I hate it but learning a lot more sure helps. This is not a fat issue. trust me I lost over 100 pds and my lower half is still big.

  23. We got Ric’s FlexiTouch from the NYC-VA as part of a LE test study. And so they sent a techie guy to the house, to show me exactly how to set up/use it. As Ric’s caregiver,I needed to know the basics. While it is not exactly rocket science, it is still wise to become familiar with the device, so as to get the best result for yourself or your ‘lymphie loved one.’ As far as leg elevation, we were instructed to have Ric recline on the bed. Then with rolled up blankets or pillows, gently raise his leg above his heart: for each leg as it is being compressed and treated while on the machine. That works fine. He also wears light JOBST compression socks, and has resumed bike riding here in the French Quarter where we now live. Our apartment is a three flight walk up. So far, so good. I would say elevate your legs, but let your LE PC Doc have the last word. Anyway, that’s what’s best for Ric! Stay informed, stay positive, active, and PROactive. Best wishes from Jackson Square!

    • edwin roberts

      Hi: I have raised the foot of my bed 6″ which is semi-permanant. So I get elevation all night. This does not interfere with my sleep. I also use message (electric) on sore spots during the day. I also use a wrap around stretch fabric that seals with velcro. The vibrator also has high or low heat. It’s made by WAHL and cost about $30.00. The heat and vibration easily take care of any aches in about one minute. I used 3 2X6X6 boards screwed together then used a car jack to raise up the foot of the bed. Takes some mechanical smarts and a saw. Any carpenter can do it in less than an hour. Oh I forgot: Walking really helps! Ed

  24. Keep up the great work! Thank you so much for sharing a great posts.

    • Being a retired ESL teacher, I try never to miss a ‘teaching moment’ when someone brings up the subject of LE, perhaps I can facilitate a dialogue. Outcome: They understand and know more, and I have a chance to share information. And maybe I learn something myself, along the way.. I was telling a neighbor, “If you go visit someone in the hospital, often when you stand by their bed, you’ll hear a whooshing noise? That’s a type of compression device used on the legs, for people confined to bed. Keeps them from getting circulatory problems. Now Ric’s compression machine is..” I have made a smooth conversational segue, into a mini LE lesson. Yes, I admit lymphedema is a problem, and can be a real challenge to live with on a daily basis. But informing others really does help, for me at least to get the word out. My husband’s LE condition is minor, his diabetes well controlled. Still and all I keep aware of what I need to, as caregiver/partner so he is in better shape and, can stay active and healthy as long as possible.

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