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Pneumatic pumps, also known as pneumatic compression garments, were originally developed for the treatment of chronic venous insufficiency. These devices resemble a blood pressure cuff and contain a compressor that automatically inflates and deflates the garment to a predetermined pressure. The older "intermittent" pneumatic pumps provide even pressure throughout the limb. The newer devices, known as sequential pneumatic pumps, provide sequential compression with varying degrees of pressure along the length of the affected limb.

The pneumatic pump involves the use of a single- or multi- chamber pump which externally pumps the fluid away from the extremity towards the torso. It has been compared to "milking" the limb. However, as the fluid is pumped away from the extremity, it accumulates in the trunk at the base of the extremity. In order to prevent the fluid from accumulating at that point, manual drainage must be initiated to decompress the root of the limb. Though efficacy of the pump is controversial, some clinicians feel that the sequential pneumatic pump is most effective before subcutaneous fibrosclerotic changes take place and that the pneumatic pump can actually prevent its development. The treatment is performed either at home or as an outpatient setting.

At one time, pneumatic compression pumps were a standard treatment for lymphedema in the United States, however, their use today is controversial. While some studies have shown that these devices are effective for the treatment of lymphedema, other studies have found them not to be effective and they may even cause harm to the limb. Some studies have shown that fluid flows right back into the edematous limb with the cessation of treatment. The absence of clear guidelines and the lack of standardized treatment protocols has contributed to the controversy surrounding the routine use of these devices in the management of lymphedema.

Treatment with pneumatic pumps is not very popular among patients because:

• It is very expensive
• It is very time consuming
• It does not help break down fibrotic tissue

Pneumatic compression is contraindicated if several conditions are present including, ischemia, reduced blood supply to the limb, congestive heart failure, or deep vein thrombosis.