Compression Sleeves and Garments
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Compression sleeves and garments are designed to do just what their name suggests: apply pressure to the arm, hand, or trunk to keep lymph moving in the right direction. (Remember that some lymphatic vessels are located just under the surface of your skin.) Research studies have not yet looked at the effectiveness of compression sleeves alone in treating lymphedema. However, experts have found them to be effective as part of the overall treatment plan. Examples include:
- a sleeve worn on the arm
- a fingerless glove or a gauntlet (which does not have individual finger openings), often worn with a sleeve
- a support bra for the chest area or a vest for the entire trunk area
All of the garments are made of flexible fabric. Sleeves are tighter at the bottom than they are at the top. This helps create the graded (or “gradient”) pressure that keeps the lymph moving out of the arm. In addition, there is a variety of fabrics available: Some feel softer, others stiffer, and some may include materials such as wool or latex.
If you have mild lymphedema (stage 0 or stage 1), a compression sleeve or garment may be your initial treatment. For stage 2 and stage 3 lymphedema, the treatment program called complete decongestive therapy (CDT) is recommended first in order to bring down swelling (or “decongest” the limb). After that, you would wear a compression sleeve or garment to maintain those results. Your lymphedema therapist will help you determine how often you need to wear it (all day? part of the day? just for “riskier” activities?) and for how long. You also may need to wear a different type of sleeve at night for more compression.
Some other important tips:
- Get your compression sleeves and garments from your lymphedema therapist or from a durable medical equipment company he or she recommends and works with regularly. “Durable medical equipment” simply means medical equipment or supplies that you use at home.
Have your sleeve or garment properly fitted by someone with experience. An improperly fitted sleeve can make lymphedema worse by placing too much or too little pressure on certain areas of the limb — which can cause fluid backup to worsen. In some cases, your lymphedema therapist may do the fitting, in others, the medical supply company’s fitter will. He or she will take measurements of the arm, hand, chest, or other area to select the
right sleeve or other garment for you, or order a custom garment. Just be sure to ask how many people either your therapist or the fitter has worked with in the past.
- Consider buying two sleeves or garments so you can alternate them for washings. Typically they need to be replaced every 3 to 6 months because they lose stretchiness over time.
If you’re getting a compression sleeve, ask your lymphedema therapist if you should wear a glove or gauntlet on your hand, too. This is especially important if you’ve ever had any hint of symptoms in the hand — for example, heaviness, tingling, or swelling — no matter how mild or short-lasting. There also is some concern that wearing just a sleeve might trigger lymphedema in the hand. Sometimes a glove or gauntlet is recommended as a precaution until you see how your body adapts to the sleeve. Or, if you haven’t had any hand symptoms, your lymphedema therapist may ask you to pay attention to any changes in the feeling or appearance of your hand.
“There are no absolute rules on this, but we really want to avoid lymphedema in the hand,” says Andrea Cheville, MD, associate professor of physical medicine and rehabilitation at Mayo Clinic. “It’s hard to treat and it is much more functionally debilitating — whether you use your hand to type, write, play music, or for other activities. So it might be wise to wear a garment on the hand if you are in a ‘provocative situation’ where you don’t really need to use your hand. But you really have to be counseled individually on this.”
- Avoid applying moisturizers to your arm and hand before putting on the sleeve. Their ingredients can break down the elastic fibers in the sleeve over time.
- Know that insurance plans don’t always cover the cost of compression sleeves and other garments. You can ask your lymphedema therapist or garment fitter about other patients’ experiences with insurance coverage. However, you may have to pay out-of-pocket. The cost of a sleeve or garment can range from $50 to $300, sometimes more for custom sleeves.
Learn more about the different types of compression sleeves. To learn more about all the different types of compression garments, check out the websites of some of these manufacturers:
For arm compression:
For the chest and torso: