Location
Philadelphia, PA
Start Date
17-4-2026 1:30 PM
End Date
17-4-2026 2:30 PM
Description
Background:
Stasis dermatitis (SD) is a chronic inflammatory dermatologic condition that arises secondary to chronic venous insufficiency (CVI) and impaired lymphatic drainage. The condition commonly presents with erythema, scaling, pruritus, edema, and in advanced stages, ulceration. SD is particularly prevalent among older adults and individuals with risk factors such as obesity, prolonged standing, and prior deep venous thrombosis. Persistent venous hypertension leads to venous valve incompetence, venous pooling, interstitial fluid accumulation, and chronic edema. These pathophysiologic changes result in tissue hypoxia, inflammatory mediator release, and progressive skin barrier dysfunction. Standard management strategies include compression therapy, leg elevation, topical medications, and pharmacologic interventions; however, many patients continue to experience persistent symptoms and impaired quality of life. Osteopathic manipulative medicine (OMM) offers a holistic, patient-centered approach that may address the underlying physiologic contributors to venous and lymphatic dysfunction.
Objective:
This study reviews the pathophysiology of stasis dermatitis and evaluates the potential role of osteopathic manipulative treatment (OMT) as an adjunctive therapy aimed at improving lymphatic and venous circulation, modulating autonomic function, and supporting tissue recovery in patients with SD.
Methods:
A narrative literature review was conducted utilizing peer-reviewed sources in dermatology, vascular medicine, and osteopathic manipulative medicine. Databases searched included PubMed, MEDLINE, and osteopathic medical literature repositories. Search terms included stasis dermatitis, chronic venous insufficiency, lymphatic drainage, venous congestion, myofascial release, pedal pump, thoracic inlet, and osteopathic manipulative treatment. Articles examining the physiologic mechanisms of venous and lymphatic flow, autonomic regulation, and OMM techniques relevant to circulatory and lymphatic function were analyzed and synthesized.
Results:
The pathophysiology of SD involves venous valve incompetence leading to venous pooling, increased hydrostatic pressure, and interstitial fluid accumulation that contributes to chronic edema and tissue hypoxia. These changes promote inflammatory signaling, impaired lymphatic clearance, and progressive skin damage. OMM techniques may target these physiologic disturbances through several mechanisms. Thoracic inlet release and rib raising may reduce sympathetic overactivity and improve venous and lymphatic drainage. Suboccipital release may enhance parasympathetic tone and reduce autonomically mediated vascular congestion. Cervical and myofascial soft tissue techniques can relieve fascial restrictions that impair venous and lymphatic flow. Additionally, lymphatic pump techniques—including pedal pump, thoracic pump, and effleurage—facilitate distal-to-proximal lymphatic movement, improve fluid mobilization, and reduce tissue edema. These techniques collectively support enhanced circulation, improved immune cell trafficking, and reduced inflammatory mediator accumulation.
Conclusion:
Stasis dermatitis represents a multifactorial condition driven by chronic venous hypertension, lymphatic congestion, and inflammatory tissue injury. OMM provides a complementary therapeutic approach that targets structural and physiologic dysfunction contributing to these processes. Techniques such as thoracic inlet release, pedal pump, effleurage, and myofascial release may enhance venous return, promote lymphatic circulation, and reduce edema, potentially improving symptom burden and skin integrity. While current evidence largely consists of mechanistic rationale and small clinical studies, the integration of OMM into SD management may offer a promising adjunct to conventional therapies. Further research, including controlled clinical trials and standardized treatment protocols, is needed to evaluate efficacy and optimize osteopathic interventions in dermatologic care.
Embargo Period
6-3-2026
Included in
The Role of Osteopathic Manipulative Medicine in Addressing Lymphatic and Venous Dysfunction in Stasis Dermatitis
Philadelphia, PA
Background:
Stasis dermatitis (SD) is a chronic inflammatory dermatologic condition that arises secondary to chronic venous insufficiency (CVI) and impaired lymphatic drainage. The condition commonly presents with erythema, scaling, pruritus, edema, and in advanced stages, ulceration. SD is particularly prevalent among older adults and individuals with risk factors such as obesity, prolonged standing, and prior deep venous thrombosis. Persistent venous hypertension leads to venous valve incompetence, venous pooling, interstitial fluid accumulation, and chronic edema. These pathophysiologic changes result in tissue hypoxia, inflammatory mediator release, and progressive skin barrier dysfunction. Standard management strategies include compression therapy, leg elevation, topical medications, and pharmacologic interventions; however, many patients continue to experience persistent symptoms and impaired quality of life. Osteopathic manipulative medicine (OMM) offers a holistic, patient-centered approach that may address the underlying physiologic contributors to venous and lymphatic dysfunction.
Objective:
This study reviews the pathophysiology of stasis dermatitis and evaluates the potential role of osteopathic manipulative treatment (OMT) as an adjunctive therapy aimed at improving lymphatic and venous circulation, modulating autonomic function, and supporting tissue recovery in patients with SD.
Methods:
A narrative literature review was conducted utilizing peer-reviewed sources in dermatology, vascular medicine, and osteopathic manipulative medicine. Databases searched included PubMed, MEDLINE, and osteopathic medical literature repositories. Search terms included stasis dermatitis, chronic venous insufficiency, lymphatic drainage, venous congestion, myofascial release, pedal pump, thoracic inlet, and osteopathic manipulative treatment. Articles examining the physiologic mechanisms of venous and lymphatic flow, autonomic regulation, and OMM techniques relevant to circulatory and lymphatic function were analyzed and synthesized.
Results:
The pathophysiology of SD involves venous valve incompetence leading to venous pooling, increased hydrostatic pressure, and interstitial fluid accumulation that contributes to chronic edema and tissue hypoxia. These changes promote inflammatory signaling, impaired lymphatic clearance, and progressive skin damage. OMM techniques may target these physiologic disturbances through several mechanisms. Thoracic inlet release and rib raising may reduce sympathetic overactivity and improve venous and lymphatic drainage. Suboccipital release may enhance parasympathetic tone and reduce autonomically mediated vascular congestion. Cervical and myofascial soft tissue techniques can relieve fascial restrictions that impair venous and lymphatic flow. Additionally, lymphatic pump techniques—including pedal pump, thoracic pump, and effleurage—facilitate distal-to-proximal lymphatic movement, improve fluid mobilization, and reduce tissue edema. These techniques collectively support enhanced circulation, improved immune cell trafficking, and reduced inflammatory mediator accumulation.
Conclusion:
Stasis dermatitis represents a multifactorial condition driven by chronic venous hypertension, lymphatic congestion, and inflammatory tissue injury. OMM provides a complementary therapeutic approach that targets structural and physiologic dysfunction contributing to these processes. Techniques such as thoracic inlet release, pedal pump, effleurage, and myofascial release may enhance venous return, promote lymphatic circulation, and reduce edema, potentially improving symptom burden and skin integrity. While current evidence largely consists of mechanistic rationale and small clinical studies, the integration of OMM into SD management may offer a promising adjunct to conventional therapies. Further research, including controlled clinical trials and standardized treatment protocols, is needed to evaluate efficacy and optimize osteopathic interventions in dermatologic care.
Comments
Presented by Jina Park.