Managing Swelling/Edema

Swelling, otherwise known as edema, can happen in any part of the body, in various extremes, and for various reasons. At Back To You Osteopractic Physical Therapy and Rehabilitation in Royal Oak, Grosse Pointe and Canton, common areas where we treat edema include:

  • Post acute injuries, such as a broken bone
  • Chronic neurological issues, such as brachial plexus injury, stroke, etc.
  • Injuries after a motor vehicle accident
  • Osteoarthritis and Rheumatoid Arthritis

Edema Management in the Therapy Clinic

At Back To You, we provide edema management services, and can recommend and educate on ways to manage it at home in a safe and effective manner. Back to You offers various modalities to help manage edema. These include: 

Moist Hot Packs

Based on research and the evidence presented in our clinics, we often utilize moist heat packs that are kept in a “hydrocollator”, at approximately 160 degrees. We place the pack into an insulated cover and place onto the affected area for 10-20 minutes. 

Electrical Stimulation

We often couple moist hot packs with an electrical stimulation unit (we use H-wave) which also has evidence to reduce edema on the low setting. According to, 

“The H-Wave device delivers a non-fatiguing current that promotes injury recovery and rehabilitation by inducing contractions that result in interstitial fluid shifts. (It:)

  • Activates muscles to stimulate circulation, bringing in nutrients and assisting with recovery
  • Promotes faster recovery by triggering the lymphatic system to flush out waste and congestion”

Paraffin Wax Bath

Paraffin wax is melted in a warmer. The patient dips their hand/s into the bath and then places them into designated gloves. A moist heat pack is often applied as well, to insulate the heat even more. After 10-15 minutes, the wax starts to dry and is peeled off. It often decreases stiffness and edema, and also helps with pain. 

Cupping (dynamic and static)

“Cupping is a healing therapy that uses a globe-shaped cup. After placing the open side of the cup against your skin, your provider creates a vacuum that gently pulls the skin, muscles, and fascia up into the cup. As the tissues go into the cup, blood circulation increases, delivering more oxygen and nutrients to the tissues. At the same time, the boost in circulation allows your lymph system to remove more toxins and cellular waste.” 

Kinesiology Taping

“Taping is a method of applying a special elasticized tape to the skin to treat injuries, pain and edema. The tape used for this treatment has unique properties that make it ideal for people recovering from injuries. It stretches to up to 140% of its starting length as needed, but it also retracts fully to its original position without stretching out. This allows you to remain active while you’re recovering without being held back by a heavy or clunky apparatus. It’s latex-free and is safe for nearly everyone to use.” 

Edema Management at Home

Back To You also educates patients on how they can manage edema at home. We may use these modalities in the clinic, but we also demonstrate techniques and then practice in the clinic until patients feel comfortable. These include: 

Contrast Bath

A two sided bucket, or two separate containers, are filled with water- one with warm water at 95-110 degrees F, and the other with cold water at 50-70 degrees F. The injured area is then soaked in the warm water for 3-4 minutes, and then is immediately switched to the cold water for 3-4 minutes, continuing to alternate between the two for 20-30 minutes. This creates a pumping motion in the blood vessels that increases blood flow to the injured area and decreases pain and edema. 

Retrograde Massage

This technique can be done on yourself, or by another, using one or two hands to massage the affected area with light, even strokes distal to proximal (i.e., from the wrist to the elbow). This has been known to help with lymph drainage and distribute the fluid more evenly, but should not be done too aggressively. 

Home Exercise Program

The clinicians at Back To You create a unique HEP for each patient, considering which exercises can help with edema, such as tendon glides and muscular contractions to pump the edema away from the injury. 

Compression stockings/gloves

Compression garments, such as gloves or stockings, may be recommended, and Back To You clinicians can help with advising in proper fitting and wear and care schedule. “The garment acts as an external counter pressure which compensates for the inelasticity of edematous tissues, and, therefore improves circulatory efficiency by facilitating venous and lymphatic flow.” 


Elevating the affected area, with pillows or other means, for at least 20-30 minutes multiple times a day, allows gravity to assist with edema drainage. 


As with many modalities, there are sometimes contraindications. These risks may include open wounds, deep vein thrombosis, diabetes, or peripheral vascular disease. These and other risks may or may not be an issue when managing edema. All of our edema management techniques are included in a personalized plan of care that is unique to each patient, and best monitored in the clinic under the care of a trained practitioner. Edema often points to underlying causes, which are addressed within the therapy plan. Back To You Osteopractic Physical Therapy and Rehabilitation in Royal Oak, Grosse Pointe and Canton looks at the whole patient and can help with the many causes of edema, as well as the edema itself. 


How H-wave Helps Your Body Relieve Pain and Recover From Injury. Accessed 2 November, 2022. 

Taping for Canton, Royal Oak, and Grosse Pointe Woods, MI and Port St. Lucie, FL/Back To You Osteopractic Physical Therapy and Rehabilitation. Accessed 2 November, 2022. 

Miller, L. K., Jerosch-Herold, C., & Shepstone, L. (2017). Effectiveness of edema management techniques for Subacute Hand edema: A systematic review. Journal of Hand Therapy, 30(4), 432–446.

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