You can have compression treatment for lymphoedema in different ways, depending on where the swelling is.
What compression treatment is
Compression treatment for lymphoedema puts pressure on the area where you have swelling. It needs to be a light, even pressure on the tissues in the area.
The pressure helps the lymph to flow through the lymph vessels. The compression garment or bandages also act as an extra force for the muscles to work against, which helps the fluid to drain out of the area.
There are different ways to apply compression. They include bandaging, garments, pumps, and taping.
Compression garments help to stop lymphoedema getting worse. They can reduce swelling slightly. But if you have severe lymphoedema, your specialist will usually recommend multi layered bandaging first.
The garments vary in how much pressure they put on the tissues. They should:
- cover the whole area that is swollen
- not stop you moving normally
- not have any baggy or loose areas
- be comfortable, giving firm support that is not too tight
- be measured just for you
- be replaced every 4 to 6 months – they lose shape with washing and the pressure they put on the tissues may change
You should wear the garments during the day and take them off at night. Put them on as soon as possible in the morning. You need to wear them when you’re doing any form of exercise.
These photographs are examples of compression garments.
Keeping your garments in good condition
You usually have 2 garments so that you can wear one and wash one. Follow the washing instructions using a mild washing powder or liquid. Dry the garment flat, away from direct heat.
At first you may need to be measured again every few months. You can get a repeat prescription for the garment if the lymphoedema is not changing and you’re happy that the garment fits.
See your doctor, nurse or physiotherapist if you ever think the garment isn’t right.
Garments for different parts of your body
There are different types of compression garment. The type you need will depend on where your lymphoedema is and how much swelling you have.
You should be able to put the sleeves or stockings on and take them off easily. Here are some tips for putting them on.
- Make sure your skin is clean and dry and any moisturiser has been fully absorbed
- Put the garment on in the morning when the limb is at its smallest
- Wear rubber gloves to make it easier and to stop any snagging
- Fold the garment back on itself to the level of the ankle or wrist – make sure all of it is smooth
- Pull it on to your limb up to the knee or elbow. Then pull the bit that was folded back up the rest of the limb
- Smooth the garment with your gloved hand to make sure there aren’t any wrinkles
To take the sleeve or stocking off, fold it back on itself to the knee or elbow. Then pull it off the rest of your limb.
You can sometimes use a readymade garment, such as a sports bra, with advice from your lymphoedema specialist. Occasionally people need a compression bra or vest that's made to measure.
Bras or tops should not dig in to the chest, back or shoulders. Your lymphoedema specialist can advise you what you need to wear, depending on where you have swelling.
You can get compression garments made to measure to help control the lymphoedema. Cycling shorts or other types of sporting clothes that contain lycra can work just as well.
You need to get your specialist to make sure they fit properly, don’t dig in and are comfortable.
Men might need to wear a scrotal support. You might also need to wear padding to protect your skin. Your lymphoedema specialist will be able to advise you.
Compression garments that apply a light pressure are available for head and neck lymphoedema. You should not wear a compression garment around your neck.
Bandaging for lymphoedema is called multi layered lymphoedema bandaging (MLLB).
The aim is to help lymph to drain and stop it building up. It can also help parts of the body to get back to their normal shape.
You sometimes have the area bandaged immediately after the massage. You usually have this daily while you are having intensive treatment. Some people only need the bandaging.
Bandaging needs to be done in a particular way. It might not work if it’s uneven or not done right. It could even make swelling increase or build up unevenly.
How bandages are put on
How the bandaging is done depends on the type of bandages used. There are various layers that are put on in this order:
- finger or toe bandaging if you have lymphoedema of a limb
- a tubular bandage
- a layer of soft synthetic wool or foam
- a dense foam layer
- the bandage layer – these are low stretch bandages
- taping to fix everything in place
There’s now a bandage that includes the foam and the compression bandage as one layer – so you don’t need to have them done separately.
You can shower or have a bath at home, but you might need to cover the bandaging to keep it dry.
You might be able to shower or bath when you have the bandages changed. After washing, the lymphoedema specialist will clean, dry and moisturise your skin before putting the bandages back on.
Things that help during bandaging treatment
- Bandaging is bulky – wear loose or baggy clothes for comfort
- Wear comfortable shoes that are not too tight if you have lymphoedema of your leg
- Driving – contact your insurance company to check they'll cover you. The bandaging could stop you reacting as quickly as you would normally (it shouldn't be a problem if you can get your shoe on and move the pedals)
- Move around normally – movement helps the bandaging to move the fluid out of the swollen area
- Do the exercises that your lymphoedema specialist gives you twice a day
The bandaging should not be painful, uncomfortable or cause numbness or tingling. If you get any of these feelings, remove the top layer of bandaging and see if this helps. Take off the other layers if you're still uncomfortable, and get in touch with whoever put the bandage on.
Compression pumps are another way of applying pressure to your arm or leg. Doctors don’t use them as much now as they did in the past.
You shouldn't use the pump if:
- you have an infection or inflammation
- you have any pain when you use it
There aren’t many compression machines available. They are very expensive to buy yourself.
How to use the pump
Have MLD first, to clear an area for fluid to drain into.
Remove your compression sleeve or leg garment while you are using the pump and put it back on immediately afterwards.
To use the pump, you put a double layered plastic sleeve onto your arm or leg. This attaches to an electric pump which pumps air into the sleeve to gently squeeze your limb.
The machine slowly pumps air into the sleeve over a few minutes. Then it slowly goes down (deflates) over a few minutes. The amount of pressure can be changed – your specialist should advise you on how to set it.
Taping for lymphoedema is a new treatment. It was originally used for sports injuries. You might also hear it called by its trade name Kinesiotaping.
A specialist sticks a number of narrow tapes onto your skin in the area of the lymphoedema. The idea is that it helps the muscles work and lifts the skin. This takes pressure off the lymph vessels so that the lymph flows better.
There is no research into taping as a treatment for lymphoedema. So we don’t know how well it works.
Some people are now being taught by their nurse to apply the tape themselves or for their partner to apply it.