How do compression garments help lymphoedema?

How does compression work?

Compression garments apply external pressure to the skin and tissues, which reduces the amount of fluid leaking from blood vessels into the tissues and helps move lymph fluid towards areas where it can drain. When muscles contract against the garment during movement, this effect is enhanced.

Compression also helps prevent the skin and tissues from stretching and can reduce feelings of heaviness and tightness.

Where do compression garments fit in treatment?

International consensus describes complex decongestive therapy in two phases. In the first, intensive phase, swelling is reduced with manual lymphatic drainage, multilayer compression bandaging, exercise and skin care. In the second, maintenance phase, compression garments, exercise and skin care help maintain the reduction 1.

People with mild lymphoedema may start directly with compression garments, while more severe or irregular swelling often needs bandaging first.

Are garments alone enough?

A randomised trial of 103 women with breast cancer-related lymphoedema compared compression garments alone with daily manual lymphatic drainage and bandaging followed by garments. After six weeks, the reduction in excess arm volume was 29.0 per cent with the intensive therapy and 22.6 per cent with garments alone, a difference that was not statistically significant 2.

Absolute volume loss was greater with intensive therapy (250 millilitres compared with 143 millilitres), and quality of life and arm function did not differ between groups 2. This suggests garments are an effective foundation, with more intensive therapy considered depending on individual needs.

Can I exercise wearing a compression garment?

Yes, and wearing a garment during exercise is common practice. In a randomised trial of 141 breast cancer survivors with stable arm lymphoedema, participants wore a well-fitted compression garment during twice-weekly progressive weight lifting 3.

An increase of 5 per cent or more in limb swelling occurred in 11 per cent of the weight lifting group and 12 per cent of the control group. Lymphoedema flare-ups were less common with weight lifting (14 per cent compared with 29 per cent), and symptoms and strength improved 3.

How should a garment fit?

Garments should be measured and fitted by a trained professional. They come in different compression classes, materials and styles, such as sleeves, gloves, gauntlets, stockings and custom flat-knit garments for irregular limb shapes.

A garment should feel firm but not painful, without digging in, rolling or causing numbness, tingling or colour changes in the fingers or toes.

How long do garments last, and how are they cared for?

Garments lose elasticity with wear and washing and usually need replacing every few months. Having two garments allows one to be washed while the other is worn.

Putting garments on in the morning, when swelling is lowest, and using rubber gloves or donning aids can make them easier to apply. Moisturising the skin at night helps prevent dryness.

What is the difference between ready-made and made-to-measure garments?

Ready-made garments come in standard sizes and are often suitable for limbs with a regular shape and mild to moderate swelling. They are usually round-knit, meaning they are knitted without a seam and are more elastic.

Made-to-measure garments are usually flat-knit, with a seam and firmer material. They suit limbs with irregular shapes, skin folds or more severe lymphoedema, because they are less likely to dig in. A trained therapist recommends which type suits each person.

When should compression not be used?

Compression may not be suitable for people with significant arterial disease, severe heart failure, acute skin infection or certain skin conditions, so assessment is needed before starting.

Stop wearing the garment and seek advice if you develop pain, numbness, skin damage, increasing swelling or signs of infection.

Frequently asked questions