Compression treatment for lymphoedema
You can have compression treatment for lymphoedema in different ways, depending on where the swelling is.
What compression treatment is
Compression treatment reduces swelling caused by a build up of lymph fluid (lymphoedema). It puts pressure on the area of swelling. The pressure needs to be even but firm on the tissues in the area.
There are different ways to apply compression. They include bandaging and garments.
The pressure helps the trapped lymph fluid to flow through the lymph vessels. The compression garment or bandages also act as an extra force for the muscles to work against. This helps the fluid to drain out of the area.
Compression garments
Compression garments help to stop lymphoedema getting worse. They can reduce mild swelling. Your specialist will usually recommend multi-layered bandaging first if you have severe lymphoedema.
The garments vary in how much pressure they put on the tissues. They should:
- cover the whole area of the swelling
- allow you to move normally
- not have any baggy or loose areas
- be comfortable, giving firm support that is not too tight
- be chosen just for you
- be replaced every 4 to 6 months – they lose shape with washing and then apply an uneven pressure
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.
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, your lymphoedema specialist will measure you every few months. You can get a repeat prescription for the garment if your swelling is not changing and your garment fits well.
See your doctor, nurse or physiotherapist if you 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.
These photographs show examples of a sleeve and glove for arm or hand swelling:
An example of stockings for leg swelling:
Compression wrap system
Your lymphoedema therapist may suggest a compression wrap system for your swelling. A compression wrap system is a garment that is made up of overlapping, single layers of fabric bands.
You fasten the fabric bands with Velcro fasteners that are easy to attach. You wear a fabric liner that protects your skin underneath the wrap system. The wrap system works in the same way as other compression garments or bandaging, but might be easier to put on.
You can sometimes use a ready-made garment, such as a sports bra. Speak to your lymphoedema specialist first before doing so. Occasionally people need a compression bra or vest that's made to measure.
Bras or tops should not dig into the chest, back or shoulders. Your lymphoedema specialist can tell you what you need to wear. It will depend on where you have swelling.
An example of a compression bra for breast swelling.
You can get compression garments made to measure to help control lymphoedema in the genital area. 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 can advise you.
An example of compression shorts for women with genital or tummy (pelvic) swelling:
Examples of compression shorts for men with genital or tummy (pelvic) swelling and a Whitaker pouch for scrotal swelling:
Compression garments are available for head and neck lymphoedema. They apply a light pressure. You should not wear a compression garment around your neck.
An example of a garment that can help with swelling in the face.
This photograph shows an example of the Hereford collar. It can help to soften tissues in the neck when worn during neck exercises and normal movements of the neck.
Compression bandaging
Bandaging for lymphoedema is called multi-layered lymphoedema bandaging (MLLB).
The aim is to help lymph fluid to drain and stop it building up. It can also help parts of the body to get back to their normal shape.
You usually have daily bandaging during intensive treatment. You have it for a few weeks and might have it with or without a specialised type of skin massage called manual lymphatic drainiage (MLD).
Your lymphoedema specialist does your bandaging in a particular way. It is very important to have bandaging done by a trained lymphoedema specialist. It might not work if the bandaging is uneven or not done properly. It could even increase your swelling. Or the swelling may build up unevenly.
How your specialist puts on bandages
How your specialist applies your bandages depends on the type of bandages used. There are various layers:
- 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 a new type of bandaging that includes just two layers. The foam layer and compression layer sticks together. So you don’t need to have them done separately.
Bathing and showering
You can shower or have a bath at home, but you will need to cover the bandaging to keep it dry.
You might be able to shower or bath when you have the bandages changed. Clean, dry and moisturise your skin properly afterwards. Your lymphoedema specialist will put the bandages back on.
Things that help during bandaging treatment
- Bandaging can be bulky – wear loose or baggy clothes for comfort.
- Wear comfortable shoes that are not too tight if you have lymphoedema of your leg - a large trainer shoe may be helpful.
- Contact your insurance company to check if they'll cover you if you drive. The bandaging could stop you reacting as quickly as you would normally. It might be best to ask someone to drive you to the clinic.
- Move around normally – movement helps the bandaging to move the fluid out of the swollen area.
- Aim to 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. Put on your compression garment.
Let your lymphoedema specialist know.
