Description of the Pressotherapy Method (Lymphatic Drainage / Pneumatic Compression) and Indications for Its Use

Important
This page is a brief reference guide to pressotherapy (intermittent pneumatic compression, IPC). The information is for informational purposes only and does not replace consultation with a specialist.

What is Pressotherapy

Pressotherapy is a method of sequential air compression: multi-section cuffs are placed on parts of the body (most commonly the legs or arms). Air is delivered to the cuff sections under a preset pressure, creating a “wave” of pressure along the limb (usually from the feet upward). In clinical literature, this approach is commonly referred to as intermittent pneumatic compression (IPC). The cycles of inflating the chambers in the cuffs repeat according to the programmed mode. The sensations from the procedure can be described as deep muscle relaxation and a feeling of lightness in the legs after the session.

History of the Method

The method of pressotherapy, or intermittent pneumatic compression (IPC), is far from new. It began to develop actively in the mid-20th century, when in the 1950s the first simple pneumatic devices with single chambers appeared, designed to improve venous circulation and treat edema in patients with lymphedema and venous ulcers. The driving force behind the creation of these devices was the urgent clinical need for non-invasive alternatives to surgery and pharmacology for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE), especially in postoperative and bedridden patients, where traditional methods such as compression stockings did not always provide a dynamic effect. In the 1960s–1970s, studies confirmed the effectiveness of IPC in increasing arterial and venous flow, leading to its integration into hospital practice to reduce the risk of VTE (venous thromboembolism). In the 1980s, multi-chamber cuffs emerged, enabling sequential compression that mimics the muscle pump and manual lymphatic drainage (MLD), with the goal of accelerating lymph flow, reducing stasis, and improving quality of life in chronic conditions. In the 1990s, the method expanded beyond medicine thanks to the increasing availability of portable devices and accumulated observations of “side” positive effects such as edema reduction, improved microcirculation, and tissue relaxation. In cosmetology, IPC began to be used to combat cellulite, puffiness, and skin laxity, integrating it into body contouring and detox programs, as lymphatic drainage visually smoothed contours and improved tone — this was noticed in clinical cases and led to adaptation for aesthetic purposes in salons. In sports, the transition occurred similarly: athletes and trainers noted accelerated recovery after loads (reduction of muscle fatigue, DOMS, and “tightness”), which led to the use of IPC in professional teams since the 1990s, especially with the advent of cryopneumatic devices (compression combined with cold), making the therapy convenient for home and post-workout use, with a focus on improving performance and injury prevention.

What Happens in the Tissues and Vessels During the Procedure?

During pressotherapy, the tissues undergo rhythmic changes in external pressure: the cuff sequentially compresses segments of the leg (or arm) and then releases the pressure. In the compression phase, interstitial (tissue) pressure temporarily increases, soft tissues slightly “compact,” and interstitial fluid and blood in superficial veins receive a mechanical “push” toward proximal segments (upward along the limb). In the relaxation phase, the tissues “unload,” local microcirculation improves, and conditions are created for refilling the vessels before the next cycle. Thanks to this alternating “compression–pause” pattern, stasis in soft tissues decreases, and skin and fascial receptors receive a gentle mechanical stimulus that patients perceive as deep relaxation. The procedure should be comfortable and pleasant for the patient. If it is not, the pressure and/or mode are usually incorrectly selected, or there is an issue with the device/cuff design.

When and for Whom Is the Pressotherapy Method Indicated?

Sedentary Lifestyle

In a sedentary lifestyle, pressotherapy is particularly beneficial because it helps compensate for the lack of regular work of the “muscle pump” of the calf. When we sit for long periods, the calf muscles are less active, yet they normally support natural venous and lymphatic outflow. The rhythmic external compression during the procedure creates a gentle “wave” from the feet upward — therefore, many people feel noticeable relief, lightness, and reduced heaviness already after the first session.

High Load on the Legs

Conversely, with high leg load (long standing shifts, lots of walking, active days), pressotherapy is valued for rapid comfort recovery. Compression massage helps relax tissues after load and gives the feeling that the legs have “let go”: subjective “tightness” disappears, the calves and feet feel lighter, and it becomes easier to switch to recovery mode — especially in the evening or the next day after a hard day.

Medical Indications for Pressotherapy

• Varicose veins and chronic venous insufficiency.
• Edema (chronic/recurrent).
• Lymphedema.
• Excess body weight / obesity with venous and edematous conditions.
• Chronic edema on the background of obesity.
• Postoperative recovery.
• Venous trophic ulcers (venous leg ulcers).
• Lipedema / lipolymphedema.
• Bedridden and low-mobility patients. To reduce the risk of venous thrombosis.
• Combined thrombosis prophylaxis (depending on the clinical situation).
• Other diseases and conditions.

Pressotherapy in Cosmetology

• Cellulite.
• Support for body contouring and weight loss programs.
• Tendency to puffiness / edema and “blurred contours” in the legs and thighs.
• Laxity, reduced tone and elasticity of the skin.
• Uneven silhouette and visual “blurriness” of leg / thigh / buttock contours.
• Heterogeneous skin texture (“unevenness”).
• Local “looseness” of tissues (soft, watery texture).
• Enhancement of the effect of cosmetic wraps and care programs (as part of a complex).
• Post-procedure care after anti-cellulite and contouring treatments.
• Recovery after body cosmetic procedures.
• Preparation for vacation / photo shoots / events.
• Skin support during weight fluctuations (as part of comprehensive care).
• Postpartum rehabilitation within care programs.
• Comprehensive “detox / drainage” programs in cosmetology (as part of a care course).

Pressotherapy in Sports

Athletes and sports specialists actively use pressotherapy, primarily as part of recovery.

• Muscle fatigue and sensation of “tightness,” discomfort, heaviness in the legs after sports loads.
• Accelerated recovery after training / competitions.
• Improvement of sports performance.
• Accelerated recovery after sports injuries / strains.

Safety of the Pressotherapy Method. When It Can Be Used Independently and When It Is Better to Consult a Specialist First

The pressotherapy procedure, when following the manufacturer's equipment recommendations, is generally physiological and safe and is widely used independently at home. However, it is advisable to consult a specialist in the following cases:

• exacerbation of chronic diseases;
• severe heart failure;
• severe arterial insufficiency;
• acute inflammation / infections, fever;
• unhealed wounds / injuries / recent surgeries in the treatment area;
• discomfort during the procedure.

Examples of Pressotherapy Use in Practice and References to Studies

Pressotherapy often produces a noticeable effect already after the first sessions in everyday situations, and with a course of treatment the results become more stable. Here are several typical cases:

• Relief of heaviness and leg swelling after a long sedentary day or sedentary lifestyle
  Woman 40+, office job 8–10 hours a day, by evening legs are heavy, swollen, with a feeling of “buzzing” and fatigue. After 1–2 pressotherapy sessions (30 minutes, comfortable pressure 80–100 mm Hg) swelling noticeably decreases: calves and feet look visually slimmer, a feeling of lightness appears that lasts 2–4 days. With a regular course (1–2 times a week) leg heaviness reduces by 70–80% according to subjective feelings, microcirculation and blood rheological properties improve (reduced viscosity and erythrocyte aggregation).
  (The Effect of Lower Limb Pressotherapy Treatment on Selected Rheological and Biochemical Indices of Blood in Young, Healthy Women. MDPI, 2024. https://www.mdpi.com/2077-0383/13/19/5743)

• Improvement of cellulite appearance, puffiness, and body contours (cosmetological application)
  Woman 35 years old with stage II cellulite, puffiness in the thighs, and “watery” tissue texture after vacation or weight fluctuations. A course of 8–10 pressotherapy sessions (often combined with wraps) leads to reduced swelling, smoothing of “orange peel,” and visual improvement of skin texture due to lymphatic drainage and reduction of fluid in tissues. Thigh circumferences may decrease by 2–4 cm, contours become sharper, and skin smoother and more elastic. The effect is especially noticeable when preparing for an event or vacation.
  (The Effect of Lower Limb Pressotherapy Treatment... MDPI, 2024. https://www.mdpi.com/2077-0383/13/19/5743; indirectly supported by data on edema reduction and microcirculation improvement in cosmetology reviews.)

• Recovery after intense workouts in athletes (reduction of DOMS and muscle “tightness”)
  Man 30–35 years old, regular workouts (running, gym, 4–5 times a week). After a heavy session (marathon volume or leg day) — severe muscle soreness (DOMS), calf/thigh swelling, feeling of “tightness.” A pressotherapy session (20–40 minutes immediately after training or the next day) reduces subjective soreness by 30–50%, accelerates fluid outflow, and restores leg lightness already after 1–2 procedures. Meta-analyses confirm moderate reduction in muscle soreness (SMD = −0.33) and improvement in perceived recovery.
  (The Effect of Pressotherapy on Performance and Recovery in the Management of Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis. PMC, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9028309/; Effects of lower-limb intermittent pneumatic compression on sports recovery: A systematic review and meta-analysis. PMC, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11475002/)

• Preparation for an event: “draining” excess fluid and improving silhouette
  Woman 38 years old before vacation or an important event performs a course of 6–8 sessions to reduce puffiness in thighs, calves, and abdomen. Result — reduction in circumferences due to drainage (1–3 cm), feeling of lightness, clearer body contours without fat loss. Many notice a “wow effect” already after 2–3 procedures — legs look slimmer and more defined, perfect for photos in a swimsuit or dress.
  (An Advanced Pneumatic Compression Therapy System Improves Leg Volume and Fluid, Adipose Tissue Thickness, Symptoms, and Quality of Life... MDPI, 2025. https://www.mdpi.com/2075-1729/15/5/725 — data on significant reduction of edema, ECF/ICF, and swelling symptoms in similar conditions with puffiness/edema.)

• Postpartum recovery (postpartum edema and leg heaviness)
  Young mother 29 years old, 3–6 months after childbirth, notices leg swelling, heaviness, and slower recovery after walks or light loads. A course of pressotherapy (10 sessions + maintenance home sessions) quickly removes excess fluid, restores tone and lightness, helps accelerate return to activity without discomfort.
  (An Advanced Pneumatic Compression Therapy System Improves Leg Volume and Fluid... MDPI, 2025. https://www.mdpi.com/2075-1729/15/5/725 — significant reduction in leg volume, edema, and heaviness/swelling symptoms; indirectly applicable to postpartum edema as a model of lymphatic drainage.)

• Improvement of symptoms in varicose vein disease (heaviness, pain, and leg swelling)
  Woman 50 years old with varicose veins (stage C2–C3), experiences pain, heaviness, and leg swelling after standing work or long walks. A course of pressotherapy (6 weeks, sequential compression + exercises) leads to significant increase in venous blood flow velocity (by 20–30%), shortening of venous refilling time, and reduction of pain on the VAS scale (from 5–6 to 2–3 points). Quality of life according to CIVIQ improves by 15–20 points, with a feeling of lightness and reduced swelling already after the first sessions.
  (Effect of sequential pneumatic compression therapy on venous blood velocity, refilling time, pain and quality of life in women with varicose veins: a randomized control study. PMC, 2016. https://pmc.ncbi.nlm.nih.gov/articles/PMC4968489; updated data confirm effectiveness in similar studies 2020–2025.)

These examples show that pressotherapy is particularly valuable as a complement to lifestyle: it provides quick subjective comfort (lightness, reduced heaviness) and objective changes (reduced edema, improved blood flow), but the maximum effect is achieved with regularity and proper mode selection. It is always recommended to start with a consultation with a specialist, especially if there are chronic conditions.

FAQ

• What is pressotherapy in simple words?
  It is an air compression massage: sections in the cuffs inflate one by one and create a “wave” of pressure along the limb or body (depending on the cuff design).

• Can massage be done on arms and legs at the same time?
  This is not recommended. As a result of the procedure, a small portion of excess fluid (blood, lymph) from the arms or legs moves to other parts of the body. Using cuffs on arms and legs simultaneously may create increased pressure and load on the heart.

• How long does one procedure last?
  Usually 20–30 minutes (depending on the selected program).

• How often can pressotherapy be performed?
  There are no strict limits — usually guided by well-being. Typically, 1–2 procedures per day are sufficient, with breaks, for example: one week on, one week off.

• How soon is the effect felt?
  Depends on the purpose. As a rule, relief from heaviness and fatigue in the legs occurs already after the first procedure; more noticeable systemic changes usually appear after a full course.

• What pressure is optimal for pressotherapy?
  High pressure is generally not required and may even be harmful. Remember that the procedure should always be pleasant and cause no discomfort. Start with minimal pressure and gradually increase it based on sensations. For most people, the comfortable pressure range is 60–120 mm Hg.

• How to know if the pressure is too high?
  If pain, numbness, discomfort, or painful marks from the cuff appear — the pressure is too high.

Sources

• National Institute for Health and Care Excellence (NICE). Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism (NG89). NICE Guideline. Published 21 Mar 2018; last updated 13 Aug 2019.
• Kakkos S, Kirkilesis G, Caprini JA, et al. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism. Cochrane Database of Systematic Reviews. 2022;1(1):CD005258. https://doi.org/10.1002/14651858.CD005258.pub4
• West Suffolk NHS Foundation Trust, Lymphoedema Service. Intermittent pneumatic compression (IPC) (patient leaflet). Issue date: 03 Dec 2021.
• Nelson EA, Hillman A, Thomas K. Intermittent pneumatic compression for treating venous leg ulcers. Cochrane Database of Systematic Reviews. 2014;2014(5):CD001899. https://doi.org/10.1002/14651858.CD001899.pub4
• Zaleska M, Olszewski WL, Jain P, et al. Pressures and timing of intermittent pneumatic compression devices for efficient tissue fluid and lymph flow in limbs with lymphedema. Lymphatic Research and Biology. 2013;11(4):227–232. https://doi.org/10.1089/lrb.2013.0016
• Deol ZK, Lakhanpal S, Franzon G, Pappas PJ. Effect of obesity on chronic venous insufficiency treatment outcomes. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2020;8(4):617–628.e1. https://doi.org/10.1016/j.jvsv.2020.04.006
• Burian EA, Rungby J, Karlsmark T, et al. The impact of obesity on chronic oedema/lymphoedema of the leg – an international multicenter cross-sectional study (LIMPRINT). International Journal of Obesity (London). 2024;48(9):1238–1247. https://doi.org/10.1038/s41366-024-01544-0
• Wright T, Scarfino CD, O’Malley EM. Effect of pneumatic compression device and stocking use on symptoms and quality of life in women with lipedema: A proof-in-principle randomized trial. Phlebology. 2023;38(1):51–61. https://doi.org/10.1177/02683555221145779