Lymphoedema Evidence Library › Topics › Adjuncts: HBOT, laser and others
Adjuncts: HBOT, laser and others
Adjuncts: HBOT, laser, carboxytherapy, negative pressure
45 sources
Evidence in one minute
- Hyperbaric oxygen: no benefit for chronic arm lymphoedema after breast radiotherapy (randomised phase II, 58 patients, 30 sessions at 2.4 ATA, no volume or functional difference at 12 months). Low certainty (revised 2026-10-08 from moderate after RoB 2: open label, 79% analysed). Uncontrolled studies report less breast oedema and pain; one case of breast oedema resolved (symptoms only, no oedema measure; JBI 5/8). Do not motivate HBOT for limb lymphoedema. Gothard 2010 · Meier 2023 · Carl 1998
- TcPO2 is normal in lymphoedematous arms — oedema alone does not create the hypoxia HBOT targets. Mayrovitz 2005
- Low-level laser: immediate softening and tissue-water fall at fibrotic sites, larger than sham (non-randomised); ISL: limited evidence, more for pain and tissue mobility than volume. Mayrovitz 2011
- Carboxytherapy: physiological rationale plus 15 uncontrolled patients treated with compression at the same time; the review states CO2 contains hydrogen. Does not support use (revised 2026-10-09). Varlaro 2007
- Negative pressure: incisional NPWT after node dissection (era-confounded, very low certainty); negative-pressure massage device vs MLD after knee replacement (manufacturer-funded). Full NPWT appraisals are in the NPWT Evidence Library. Poirier 2022 · Weber 2025
Update 2026-10-09 — open-access batch 3
- Drugs and supplements: no systemic drug or herbal agent has been shown to prevent or treat BCRL (Lommer 2026 scoping review); a diosmin–bromelain–melilotus supplement did not reduce leg swelling after pelvic lymphadenectomy (Montanaro 2026, low). Laser: no added effect on fluid or lymphatic imaging (Yoon 2026, low). Lommer 2026 · Montanaro 2026 · Yoon 2026
Update 2026-10-09 — open-access batch 4
- NPCDs: all evidence manufacturer-funded and unblinded — very low; see compression. Rockson 2022 · Barfield 2025
- Kinesio taping v bandaging with IPC (crossover, 43 women): bandaging plus IPC reduced volume slightly more (2.2% v 0.9%); taping more comfortable — low. Pajero Otero V 2022
Update 2026-10-09 — open-access batch 5
- IPC in diabetic leg lymphoedema (de Sire 2021 pilot): unregistered, text and figure disagree — very low. de Sire A 2021
- IV selenium: only a 29-patient metabolomics secondary analysis — very low. Lee 2021
- Synbiotics: no added effect (moderate). Vafa 2020
Update 2026-10-09 — open-access batch 6
- Electrotherapy (ultrasound, faradic), acupuncture, shock wave: small trials, very low certainty; none justifies routine use. Hemmati 2022 · Friedman 2023 · Zhou 2025
- ADRC (stem-cell) lipotransfer: no benefit over placebo. Andersen 2024
Update 2026-10-09 — open-access batch 7
- Tuina with moxibustion, neural mobilisation, silicon-oxide point tablets: small, poorly analysed trials — very low; none affects practice. Wang 2023 · Joshi 2023 · Giron 2025
Update 2026-10-09 — open-access batch 8 (reviews)
- Heat therapy (Hill 2024): controlled local heat may reduce swelling and seems safe — very low. Herbs (Sheikhi-Mobarakeh 2020): uncritical review; no basis for use. Hill 2024 · Sheikhi-Mobarakeh 2020
Update 2026-10-09 — open-access batch 10 (reviews)
- Drugs and cells (Walker 2022, 8 RCTs): nothing supported. Laser and endermology (Wahid 2024): small volume gains (LLLT 92 mL), taping none — very low. Acupuncture/moxibustion (Gao 2021): impossible pooled numbers — disregard. Walker 2022 · Wahid 2024 · Gao 2021
Update 2026-10-09 — open-access batch 11 (reviews)
- Kinesio taping (Marotta 2023): no volume reduction — low. LLLT overview (Wang 2022): small benefit only against weak comparators — low. Acupuncture/moxibustion (Yang 2024, Xu 2024): low-quality Chinese trials — very low. Marotta 2023 · Wang 2022 · Yang 2024 · Xu 2024
Update 2026-10-09 — open-access batch 12 (reviews; final)
- LLLT (Mahmood 2022): modest size reduction, no effect on pain or mobility — low. Meridian sinew tuina (Zhao 2026): uniform large effects in unblinded Chinese trials — very low. Mahmood 2022 · Zhao 2026
How the evidence points
| High | Mod. | Low | V. low | None | |
|---|---|---|---|---|---|
| Positive | 0 | 0 | 2 | 12 | 0 |
| Null or negative | 0 | 1 | 7 | 1 | 0 |
Sources on this page with a comparison, by the result of their primary outcome and the GRADE certainty of their main finding (Mod. = Moderate, V. low = Very low, None = not graded). Context sources are not counted. How direction is decided.
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