What is compression therapy

The term "compression" refers to externally applied mechanical pressure on the skin and underlying tissue.

Compression therapy is the standard of care in the treatment of lymphedema and chronic venous disease and a core component of lipedema management.

How does compression therapy work

Compression therapy uses specialized garments, adjustable compression wraps, or bandages to apply controlled pressure to the limbs or other parts of the body.

To understand how compression therapy may help you, it is important to understand how compression supports the body’s anatomy through several key mechanisms:

Reduces pooling and swelling

By applying graduated compression, which is stronger at the ankle or wrist and gradually reduces as it progresses up the limb, blood pooling is decreased, blood flow is enhanced, and lymphatic drainage is improved.

Increases venous blood flow

Compression therapy helps push blood back toward the heart by increasing venous blood flow. This is especially important when the veins or the calf muscle pump are not working properly.

Improves lymphatic drainage

Compression therapy improves lymphatic drainage, which helps to reduce swelling (edema) in the affected body part.

Reduces pain and inflammation

Compression therapy may help alleviate pain and modulate underlying inflammatory processes. In lipedema, compression garments are primarily used for pain relief.

Provides support and aids mobility

Compression garments provide external support to the affected body part and can aid mobility. By limiting friction between adjacent skin lobes, they can help prevent skin irritation caused by rubbing. In addition, compression garments can give the affected body part a smoother shape.

When is it recommended to use compression?

Compression therapy is widely regarded as the gold standard treatment across lymphedema and chronic venous disease. For lipedema, it is recommended by international consensus. Its effectiveness is reflected across multiple studies, guidelines, and consensus documents.1-12

Compression therapy may also be beneficial for people who experience heavy or swollen legs during pregnancy, those who sit or stand for long periods at work, or who take frequent long flights or journeys.

If you have any questions about compression therapy or experience any of the above, ask your healthcare professional. They can provide advice about further benefits of compression therapy and the best compression solution for you.

Why it is important to use ‘medical compression’

Not all compression garments have the same effect. Medical compression garments are subject to strict quality and safety standards, ensuring they can be used safely and deliver the intended therapeutic effect. Medical compression may require a prescription or professional measuring and fitting. Key indicators that a product provides medical compression include:

  • Classification as a medical device
  • CE marking – The legal prerequisite for selling products in the European Economic Area (EEA)
  • Certifications such as RAL (RAL-GZ 387 is the German quality standard for recognized testing and documentation for medical compression stockings)
  • Clearly defined compression classes or levels

How does gradient compression work

Lecture et pause vidéo

Compression classes and pressure levels (mmHg)

Medical compression garments are typically categorized into classes, sometimes referred to as levels or ranges, based on the pressure they exert, usually measured in mmHg (e.g., 15–20 mmHg, 20–30 mmHg). The most appropriate compression level depends on the medical condition, the patient’s comorbidities, and individual patient needs.

How to choose the right medical compression product for you

Selecting the right medical compression product should be guided by a healthcare professional. The choice is based on a combination of clinical and individual factors including the underlying medical condition, severity of swelling, comorbidities, mobility, and comfort needs.

Compression therapy solutions vary in design, construction, and intended use. For example, some products are designed for post-surgical recovery, while others are suited for managing chronic conditions like lymphedema or venous insufficiency.

Based on these factors, the most appropriate compression solution can be recommended from the options below.

Made-to-measure and ready-to-wear

  • Ready‑to‑wear garments: Available in standard sizes and styles, offering comfortable and effective compression for regular limb shapes. They are typically used for venous conditions.
  • Made-to-measure garments: Precisely adapted to your body’s anatomical shape to ensure a good fit and consistent compression; usually recommended for lymphedema and lipedema, and in case of obesity where shapes may vary.

Flat-knit and circular-knit

  • Flat-knit compression garments: Are designed to offer higher wall stability to bridge skin folds, with little to no digging‑in. They can accommodate irregular limb shapes and are typically used for lymphedema and lipedema patients. Flat‑knit also allows for more specialized garment designs, such as gloves and toe caps, to address individual patient needs.
  • Circular-knit compression garments: Are made from thinner, more flexible material than flat-knit. They are suitable for regular limb shapes and usually recommended for venous conditions (e.g., chronic venous insufficiency).

Daytime and nighttime

Compression garments, bandages, and adjustable compression wraps

  • Compression garments: Provide consistent gradient pressure to help support venous blood return and lymphatic drainage, as well as to manage swelling, making them suitable for specific medical conditions, daily wear, and long‑term care. They are available in a range of designs to meet different needs.
  • Compression bandages: Allow flexible application and can be adapted to varying limb shapes and different body parts. They are typically used in the early stages of lymphedema treatment, such as in the first phase of Complete Decongestive Therapy (CDT) to reduce severe swelling before your limb can be measured for compression garments.
  • Adjustable compression wraps: Are an easy to apply alternative to bandaging that can support self-management. They are also especially beneficial when edema fluctuates or requires reduction.

JOBST® product portfolio provides tailored solutions for your condition and needs. Find out more about our wide range of compression products for lymphedema, lipedema, and venous conditions.

References

  1. Wong IK et al. Randomized controlled trial comparing treatment outcome of two compression bandaging systems and standard care without compression in patients with venous leg ulcers. J Eur Acad Dermatol Venereol. 2012;26(1):102-110.
  2. Rabe E et al. Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology. 2018;33(3):163-184.
  3. AWMF. Diagnostics and Therapy of Lymphoedema. S2k Guideline. Registry No. 058-001. 2017.
  4. Lymphoedema Framework. Best Practice for the Management of Lymphoedema. International consensus. 2006.
  5. De Maeseneer M et al. Editor's Choice - European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63(2):184-267.
  6. Bozkurt K et al. Chronic Venous Insufficiency: Management and Treatment. EMJ Dermatol. 2017;5[Suppl 2]:2-13.
  7. Isoherranen K et al. Lower Leg Ulcer Diagnosis & Principles of Treatment. Including Recommendations for Comprehensive Assessment and Referral Pathways. J Wound Management, 2023;24(2 Sup1):s1-76.
  8. Vandongen YK & Stacey MC. Graduated Compression Elastic Stockings Reduce Lipodermatosclerosis and Ulcer Recurrence. Phlebology. 2000;15(1):33-37.
  9. Deutsche Gesellschaft für Phlebologie und Lymphologie e.V.: S2K-Leitlinie Diagnostik und Therapie des Ulcus cruris venosum, 4.1, 2024.
  10. Marston W et al. Wound Healing Society 2015 update on guidelines for venous ulcers. Wound Repair Regen. 2016;24(1):136-144.
  11. Faerber G et al. S2k guideline lipedema. J Dtsch Dermatol Ges. 2024;22(9):1303-1315.
  12. Bertsch T et al. Lipoedema: a paradigm shift and consensus. J Wound Care. 2020;29(Sup11b):1-51

Frequently asked questions

Compression therapy is generally considered safe when properly prescribed, measured, and fitted by a healthcare professional. It is essential for users to follow medical advice and ensure the correct use of compression garments according to the Instructions for Use. Always consult with a healthcare professional to determine the appropriate treatment for your specific condition.