One of the nurses I work with asked me to look at her mother’s elbow, and see if we could do anything for her chronic pain. She had seen a surgeon about a possible elbow transplant/implant, but this was going to be a last resort.

I had been working with people with chronic pain and injuries for quite some time, so I thought I could possible help her. What I didn’t know was that she had severe lymphedema in that arm for over thirty years and has been unable to wear a Jobst due to severe arthritis.

When I saw her in the clinic last Thursday, she was holding her right arm with her left, couldn’t bend her elbow or move her thumb, or lift her hand above her shoulder. Her elbow was so sore that she couldn’t rest it on any surface, she had to hold it up on her abdomen.  This was much worse then I had imagined.

But now that I have worked with her I am so excited that I can hardly stand it.

I started her on a short course of Bemer Vascular Therapy. We have been using it with great success for chronic pain due to injury, inflammation, sciatica, and other nerve impingement syndromes.

While it does not overtly treat any disease, it has been proven to improve both microcirculation and lymphatic circulation, and my primary goal was to assist in relieving the elbow pain by increasing the local blood supply. I assumed that over time, perhaps months, the swelling from the lymphedema would also go down somewhat.

Boy, was I surprised. We started daily sessions, and gave her an initial therapy session on Thursday. I saw her Friday, and she reported mild pain relief. I saw her Saturday, and it seemed to me that her arm was much less swollen, which she confirmed. On Sunday, her arm was one half the size it was on Thursday. She asked me what we were going to do about all the loose skin and wrinkles!

On Monday she was bending her arm completely at the elbow, using her thumb, and was raising her arm above her head and rubbing the back of her head, something she hadn’t done for over thirty five years. We were all ecstatic!! She was able to eat soup that night with her right hand. Today showed similar reduction in swelling and improved range of motion.

We are all thrilled, and never expected such a rapid reduction in swelling; that wasn’t even our goal. I felt this was so important and so exciting, I had to share!

The following documents a current study:

Systemic endothelial/lymph therapy with systemically active “BEMER® physical vascular therapy”

Wittlinger Lymphedema Clinic in Walchsee/Tirol Austria


“BEMER® physical vascular therapy” acts systemically.  The technology is patented and the therapy is based on the endothelium-mediated effectiveness of processes that depend on nitric oxide (NO) (1).

Supported by scientific evidence, reduced vasomotion frequency of small and very small precapillary arteriolar vessels is thus improved, with significant improvements in the capillary microcirculation networks (2).

In recent years, dysfunction in the area of microcirculation has been recognized as causal and scientifically confirmed for an increasing number of relevant disease patterns. Among these are diabetes mellitus, overweight, high blood pressure, aging processes, inflammatory bowel diseases, dementia, rheumatological disease patterns, ischemic heart diseases, nicotine abuse, and many more. (3).

These also and particularly include pathological disorders in the entire lymphatic system (4).

What is the endothelium?

The endothelium is a single-layer cell complex that lines the interior vessel walls of arteries, capillaries, lymphatic vessels and veins.

The endothelium operates as a biological network system (biosensor and biotransducer) in reaction to internal and external influences and it is jointly responsible for the adequate supply of energy to approximately 80 trillion cells.

In view of its coordinated overall functioning, the endothelium is a systemic organ.  Its functional integrity is vital for development and differentiation in the entire vascular and lymphatic system.

The main functions of the endothelium include:

• Regulation of hemostasis (coagulation and anticoagulation) 

• Immunomodulation

• Regulation of vessel width

• Vascular growth processes

• Vascular impermeability

• Remodelling and apoptosis processes (5)

Furthermore, the integrity of the endothelium is largely determined by its protective layer – the glycocalyx (6).

Today, the key pathophysiological processes leading up to arteriosclerosis are localized in the area of glycocalyx dysfunction (7).

With chronic lymphatic diseases, initial endothelial processes are also affected (8, 9).

Early scientific data on the systemic effectiveness of the BEMER® signal configuration in the area of the lymphatic system can be found in “Mikrozirkulation im Fokus der Forschung” (Microcirculation in the Focus of Research) (10).

The scientific data is condensed as follows:

“The functionality of the vascular smooth muscles in the lymphatic system is its key role.  This intrinsic contractile quality of the vascular smooth muscles – the “inner lymph pump” – represents the main mechanism for generating adequate lymph flow drainage…and this process can be influenced by “physical signal frequencies” (9).

In the context of my scientific therapy work at the Wittlinger Lymphedema Clinic in Walchsee/Tirol, the data that was available led me to the following question:

Is there any NO(nitric oxide)-mediated improvement in vasomotion or edema reduction in patients with lymphedema of the leg through use of the “BEMER® physical vascular therapy”?

We investigated this based on 10 patients in a pilot study in 2015.

Question: “Does BEMER® physical vascular therapy influence the reduction of edema in addition to established lymph therapy (CLT) during a 3-week intensive therapy period?”

Findings: Yes, it shows significant influence for all of the parameters studied:

Lymphedema volume reduction

HADS score (Hospitality Anxiety and Depression Scale)

Laboratory data: CRP, interleukins IL6, IL8, TNF alpha (11).

These findings led us to conceive the first lymph study in the world to verify the positive effects of the BEMER® therapy on the diseased lymphatic system.

This “BEMER® lymph study” is conceived as a randomized, double-blind, placebo-controlled study with 208 patients, and it has been approved by the Innsbruck ethics committee.


• The endothelium is an organ that operates systemically

• The integrity of the endothelium depends on the integrity of the glycocalyx – the endothelial protective layer.

• The success of the systemic “BEMER® physical vascular therapy” as an adjuvant therapy is based on the systemic  endothelium-mediated effectiveness of processes that depend on nitric oxide (NO)

• Significant improvements with “BEMER® physical vascular therapy” in patients with leg lymphedema were studied and verified in the first “BEMER® lymph study”, which was initiated in June 2016 at the Wittlinger Lymphedema Clinic in Walchsee/Tirol Austria.

Author’s address:
Dr. med. Rainer Pawelke
Wittelsbacher Str. 20
82319 Starnberg
+43 (0) 5374 5245 0


(1) W. Bohn, L. Hess, R. Burger: jcim-2013

(2) Informational Dynamics of Vasomotion in Microvascular Networks: A review ACTA Physiologica Volume 201, Issue 2, February 2011

(3) The Human Microcirculation – Regulation of Flow and Beyond. David G. Gutterman, Circ. Res. 2016; 118: 157-172

(4) Lymphatic smooth muscle: the motor unit of lymph drainage. Pierre-Yves von der Weid: The International Journal of Biochemistry & cell Biology, Volume 36, Issue 7, July 2004

(5) Endothelial Signaling in Development and Disease: Springer 2015

(6) The endothelial glycocalyx: a potential barrier between health and vascular disease. O. Nieuwdorp M., et al. (2005). Curr Opin Lipidol 16: 507-511

(7) Arterial glycocalyx dysfunction is the first step in the atherothrombotic process. Noble MI, Drake-Holland A.J., Vink H. (2008): QJM 101:513-518

(8) Mechanical Forces and Lymphatic Transport: Microvasc Res. 2014 Nov: O: 46-54

(9) Contractile Physiology of Lymphatics: Lymphatic Research and Biology: Volume 7, Number 2, 2009

(10) Dr. med. R. Klopp: Mikrozirkulation im Fokus der Forschung (Microcirculation in the Focus of Research), Issue 2008

(11) Dr. med. R. Pawelke: Unpublished data: pilot study 2015

Witlinger Lymphedema Clinic, Walchsee, Austria

Vessel cross-section – endothelium

Nitric oxide (NO

Leg lymphedema stage II



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