Compression treatments for lymphoedema
This page is about different types of compression treatment for lymphoedema. There is information about
What compression treatment is
Compression treatment for lymphoedema puts a light, even pressure on the tissues in the area of the swelling. The pressure helps the lymph to flow through the lymph vessels. Compression garments or bandages also act as an extra force for the muscles in the area to work against, which helps to drain the lymph fluid. There are different ways of doing compression treatment
Compression garments – there are different types of garment depending on where you have lymphoedema. There are stockings, sleeves, corsets and underwear. If you have mild or moderate lymphoedema, garments are often the first way of controlling it. Your garment should cover the whole area and not restrict your movement. It should also be measured for you so that it is comfortable and not too tight. Garments should be replaced every 4 to 6 months because they start to lose their shape.
Compression bandaging is called multi layered lymphoedema bandaging (MLLB). It is specialist bandaging and is used for moderate or severe lymphoedema.
Compression pumps – these are rarely used now and you should not use one without advice from your lymphoedema specialist. They are for arm or leg lymphoedema. You wear a garment that is attached to a machine. The machine slowly pumps air into the garment over a few minutes and then it slowly goes down (deflates) over a few minutes.
Taping is a new type of treatment. A specialist sticks a number of narrow tapes onto your skin in the lymphoedema area. The idea is that the tapes help the muscles to work. They also lift the skin. This takes pressure off the lymph vessels so that the lymph flows better.
You can view and print the quick guides for all the pages in the Treating lymphoedema section.
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 and they include bandaging, garments, pumps, and taping. You can find information about these on this page.
Compression garments help to stop lymphoedema getting worse. They can reduce swelling slightly but multi layered bandaging is usually recommended first if you have severe lymphoedema.
There are different types of compression garment. The type you need will depend on where your lymphoedema is and how much swelling you have.
The garments vary in the amount of 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 are doing any form of exercise.
Your compression garment should not cause any pain, be uncomfortable, or cause numbness or tingling. If it does, take the garment off and contact your lymphoedema specialist as soon as possible.
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. If the lymphoedema is not changing and you are happy that the garment fits, you can get a repeat prescription for the garment. If at any time you think the garment isn’t right, see your doctor, nurse or physiotherapist.
- Garments for leg or arm lymphoedema
- Garments for breast or chest lymphoedema
- Garments for genital lymphoedema
- Garments for head and neck lymphoedema
Garments for leg or arm lymphoedema
If you have leg or arm lymphoedema you should be able to put the sleeves or stockings on and take them off easily. To put 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
- Wearing rubber gloves may make it easier to get the garment on and to stop any snagging
- Fold the garment back on itself to the level of the ankle or wrist – make sure it is all smooth
- Pull it on to your limb up to the knee or elbow and 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 and then pull it off the rest of your limb.
Garments for breast or chest lymphoedema
If you have breast or chest lymphoedema you can sometimes use a readymade garment, such as a sports bra, with advice from your lymphoedema specialist. Occasionally people need to have a compression bra or vest made to measure. Any bras or tops should not dig in to the chest, back or shoulders. Your lymphoedema specialist can advise you about what you need to wear, depending on where you have swelling.
Garments for genital lymphoedema
If you have genital lymphoedema you can get compression garments made to measure to help control it. 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 may need to wear a scrotal support. You may also need to wear padding to protect your skin. Your lymphoedema specialist will be able to advise you.
Garments for head and neck lymphoedema
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. If it is uneven or isn’t done correctly it may not work. It may even make swelling increase or build up unevenly. How the bandaging is done depends on the type of bandages used. There are various layers that are put on in the following 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
A bandage is now available that includes the foam and the compression bandage as one layer. Then you don’t need to have them done separately.
You can shower or have a bath at home but you may need to put a cover over the bandaging to keep it dry. You may 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 if they will cover you. The bandaging may stop you reacting as quickly as you would normally (if you can get your shoe on and move the pedals it should not be a problem)
- 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 have any of these feelings with the bandages on, remove the top layer and see if this helps. If you are still uncomfortable, take off the other layers and get in touch with whoever put the bandage on.
Compression pumps are another way of applying pressure to your arm or leg. They were used more in the past than they are now. You shouldn’t use the pump if you have an infection or inflammation, or if you have any pain when you use it. And don’t use one at all unless you have been advised to by your lymphoedema specialist. There aren’t many compression machines available. They are very expensive to buy yourself.
Remove your compression sleeve or leg garment while you are using the pump and put it back on immediately afterwards. You should have MLD beforehand to clear an area for fluid to drain into.
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 and 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. 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. You may also hear it called by its trade name Kinesiotaping.
Some people are now being taught by their nurse to apply the tape themselves or for their partner to apply it.
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