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

Compression garments are an essential way of controlling lymphoedema. Sleeves can be used for swollen arms and stockings can be used for swollen legs. Compression garments are also available for lymphoedema affecting the breast/chest and genital area.

They work by:

  • compressing the swollen tissues and stopping fluid from building up
  • helping to move fluid to an area that’s draining well
  • providing support, which allows the muscles to pump fluid away more effectively

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

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 the garment is fitted by someone experienced in selecting, measuring and fitting compression garments. Your lymphoedema specialist will usually do this or arrange it for you. Compression garments are available in different grades of pressure depending on the degree of lymphoedema you have.

In many hospitals, compression garments are available from the breast care nurse or surgical appliances department.

They come in a range of shades to match different skin tones and hypo-allergenic types are available for people with sensitive skin. Some garments are available ’off the shelf’ and others need to be made-to-measure.

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

Putting on and removing compression garments

During your fitting you sh ould also be advised and 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, but not immediately 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 of it. 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. Don’t turn or roll the top over – this will restrict the blood flow and cause more swelling.
  • If you have arm lymphoedema, 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 applicator aids available to help put garments on and to take them off.
  • Make sure the material is distributed 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.

Wearing compression garments

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

When you start wearing a compression garment for the first time, 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 way you will become gradually used to the feeling and pressure of the garment against your skin.

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

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. Worn every other day, they usually last between 4–6 months.

If your compression garment is too loose, it won’t control swelling and needs to be refitted. If it’s too tight, it will restrict blood flow. If you get pins and needles or pain, or your fingers or toes change colour, it’s 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.

When not to use compression garments

There are some situations when compression garments shouldn’t 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 the 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.

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.

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