Controlling lymphoedema with compression garments

Compression garments, such as a sleeve for an arm or a stocking for a leg, are an important way of controlling lymphoedema. They put pressure on tissues to stop fluid build-up and encourage fluid to drain.

Your compression garment should be fitted by a specialist to make sure it’s effective. If it’s too loose, it won’t help with drainage. If it’s too tight, it’ll restrict blood flow. Your lymphoedema specialist will select the type of garment and the grade of pressure appropriate for you. They will also explain how to put on and remove the garment.

At first, wear your garment for a few hours a day. Then increase this gradually until you can wear it for most of the day. You shouldn’t use a garment if your limb is very swollen or an irregular shape, or if the skin is damaged.

If you can’t wear compression garments because your limb is too swollen, your lymphoedema specialist may suggest using special, multi-layer bandages (compression bandages). These are used with other techniques to reduce swelling so you can use compression garments.

How compression garments work

You may be prescribed and fitted with a compression garment to help control lymphoedema. Sleeves can be used for swollen arms and stockings can be used for swollen legs. You can also get compression garments for lymphoedema that affects the breast or chest and genital areas.

The garments work by:

  • limiting the build-up of lymph fluid
  • helping to move fluid to an area that’s draining well
  • providing support, which allows the muscles to pump fluid away more effectively
  • applying more pressure in certain areas to encourage the fluid to drain.

Lymphoedema and compression garments explained

Lymphoedema practitioner Yolande Borthwick gives advice on lymphoedema and explains how to use compression garments.

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Lymphoedema and compression garments explained

Lymphoedema practitioner Yolande Borthwick gives advice on lymphoedema and explains how to use compression garments.

About our cancer information videos


Having a compression garment fitted

It’s important to be fitted by someone who is experienced in measuring and fitting compression garments. Your lymphoedema specialist will usually do this or arrange it for you. Compression garments are available in different levels or grades of pressure depending on how bad the lymphoedema is.

In many hospitals, compression garments are available from your lymphoedema specialist, your specialist nurse or the surgical appliances department.

They come in a range of shades to match different skin tones and hypo-allergenic products are available for people with sensitive skin. There may be a ready-made garment that matches your exact measurements. Otherwise you may need to have made-to-measure garment ordered.

Your GP can prescribe garments but usually only on the recommendation of your lymphoedema specialist. Your specialist will discuss which is the best garment for you and they will choose the correct size. Your GP will then be asked to provide the garment.

If you have lymphoedema around the chest area, sometimes a compression bra or vest that is made to measure can help. The garment should not dig in to the chest, back or shoulders. Your lymphoedema specialist can tell you whether this would help in your situation.

If you have lymphoedema in your fingers or toes, you may need a garment that covers these areas as well as your arm or leg.


Putting on and removing compression garments

When you’re fitted for your compression garment you will be shown how to put on and remove the garment. Here are some useful suggestions:

  • Put your garment on first thing in the morning when the limb is at its smallest. It is best not to put it on straight after a shower or bath as dampness can make it difficult to put on.
  • Start by turning the stocking or sleeve inside out as far as the wrist or heel part. Pull the garment over your hand or foot and ease it up, a bit at a time. Make sure you don’t pull it up by the top of the garment.
  • Do not turn or roll the top over – this will restrict the blood flow and cause more swelling.
  • If you have lymphoedema in your arm, wearing a rubber glove on your unaffected hand may help when putting your compression garment on. Holding onto something like a doorknob or handle so that you can pull against it when pulling the sleeve up your arm can also help.
  • Applying a little unperfumed talc to your arm or leg can help to ease the garment on. There are also different aids available to help put garments on and to take them off.
  • Make sure the material is spread evenly and there are no wrinkles or creases when your garment is on. Wearing a rubber glove on the unaffected hand can help you smooth the garment out.
  • Moisturise your skin at night after you’ve taken off your garment rather than in the morning, because cream makes the sleeve or stocking difficult to put on.

‘My compression garment is like a very thick pair of tights. Now that I use it, the swelling is very rare.’ Patricia

Patricia


Wearing compression garments

It’s important to wear your compression garment all day. It can usually be taken off at night when you’re lying down and resting.

When you first start wearing a compression garment, wear it for a few hours the first day. Then gradually build up the time you wear it for each day, until you can keep it on for most of the day. This will help you to become used to the feeling and pressure of the garment against your skin.

If the garment feels very uncomfortable at first, you could try wearing it only when you are most active. Gradually you will find it more comfortable and can increase the amount of time you wear it. However, if you still are finding it difficult to wear, ask your lymphoedema specialist to check that it is fitted correctly.

You should be given at least two garments so that you can have one in the wash, while you wear the other. The manufacturer will supply washing instructions. The garments tend to last longer if they are washed by hand rather than in a washing machine.

When worn every day, each garment should last 4–6 months. Therefore, your two garments usually last about a year before needing to be replaced. You will need to be re-measured by your lymphoedema specialist before you get a replacement.

If your weight changes you may need to be measured again for a new garment. If your compression garment is too loose, it won’t control swelling and if it’s too tight, it will restrict blood flow.

If you notice a change in sensation such as numbness, pins and needles, or pain, or your fingers or toes change colour, the garment is probably too tight. Remove it straight away and contact your lymphoedema specialist for advice. It’s important that you’re properly measured and fitted to prevent these problems from happening.

It can often be uncomfortable to wear garments in hot weather. Some manufacturers produce cotton-rich garments that can be helpful in the summer months and for people who have skin allergies.

You can cool down your garments by putting the spare one in a plastic bag in the fridge (not freezer). It can also help to spray cool water, using a spray bottle, over the garment while you are wearing it. If wearing the garment in hot weather is still too uncomfortable talk to your lymphoedema specialist. They may have other suggestions to help you.

If you’re travelling a long distance, especially by air, make sure you wear your compression garment for a few hours before your journey, for the full length of the journey and for some hours afterwards.

‘It’s like putting your shoes on – I get up and put my sleeve on. It’s just part of me and I'm glad it’s under control.’ Irene

Irene


When not to use compression garments

There are some situations when compression garments should not be worn. You should avoid wearing one if:

  • the arm or leg is large and irregular in shape
  • the skin is fragile or damaged
  • the skin is pitted, folded or leaking lymph fluid.

Compression garments used incorrectly can be harmful, and won’t help the swelling go down. The material can form tight bands across the skin and even damage it. If you’re in doubt, ask your lymphoedema specialist for advice.

If your limb is large and irregular in shape, compression bandaging (see below) is used first to reduce the size of the limb, before a compression garment is fitted.


Compression bandages

If your arm or leg is very swollen or its shape has changed a lot, it may be difficult to fit a compression sleeve or stocking.

To reduce the swelling and improve the shape, special multi-layer lymphoedema bandages and different types of foam can be used as part of your treatment.

Sometimes bandaging is used if the skin is fragile and could be damaged by putting on and removing a compression garment.

A lymphoedema specialist will usually put the compression bandages on for you every day. It may take two or three weeks of bandaging before it’s possible to fit a compression sleeve or stocking.

Bandaging is often combined with manual lymphatic drainage (MLD) massage or simple lymphatic drainage (SLD) massage, exercises and skin care to reduce the size of a limb that’s very swollen.

There are other forms of compression bandages that are like wraps. They have overlapping straps and are often secured with Velcro. Wraps can be easier to use and may be more effective when swelling is harder to control.