Compression Therapy - Uses, Types, Risks, and Benefits

Introduction:

The use of compression therapy can be traced back to ancient times when compression bandages were used to treat injuries and varicose veins (swollen, twisted veins found just under the skin). In the 18th century, the physician and inventor John Trotter developed a mechanical compression device known as the "Trotter's compression machine," which used adjustable straps to apply pressure to the legs. In the 19th century, compression stockings were developed to treat varicose veins. Initially, stockings were made of heavy materials and were ineffective. Compression stockings, worn to apply graduated compression to the legs, became more common in the 20th century. The stockings were made from an elastic material, but the development of new synthetic materials, such as nylon and spandex, made it possible to create stockings that were more comfortable to wear and more effective at providing compression.

What Is Compression Therapy?

Compression therapy is an effective treatment method that uses compression socks, stockings, or bandages to improve blood circulation and reduce discomfort associated with the legs and feet. These compression devices apply gentle pressure over the leg, which helps to push blood back up to the heart, improving circulation and preventing blood from pooling in the legs.

Stockings or socks are worn during the daytime and removed at night. Certain bandages, such as those used for ulcers or wounds, may be worn overnight.

Who Needs Compression Therapy?

Compression therapy can greatly improve comfort in various medical conditions as listed below:

• Deep Vein Thrombosis (DVT): This condition develops when a blood clot is formed in one of the veins in the leg. Compression therapy keeps the blood flow smoothly in the legs, which helps to prevent this condition.

• Chronic Venous Insufficiency (CVI): It is a condition that affects the veins present in the legs. Eventually, it damages the valves of the affected veins and impairs the blood flow from the legs to the heart. It is common in people who are obese, pregnant, have varicose veins, and have other injuries.

• Varicose Veins: Swollen or enlarged veins seen under the skin are generally referred to as varicose veins. It is commonly seen in legs and caused due to weak blood vessels and their valves. Compression stockings help to apply pressure to the legs, which reduces the size of veins in this condition.

• Edema: This swelling happens due to fluid collection in the body tissues. It is commonly seen in the legs, ankles, and feet. Prolonged sitting, standing, and varicose veins cause edema.

• Leg Ulcers: It is commonly seen in diabetic patients. These are open wounds on the leg. Untreated varicose vein cases can also develop into leg ulcers.

What Are the Benefits of Compression Therapy?

Compression therapy offers a range of benefits which includes the following.

• Improves Circulation: It helps to improve circulation by pushing blood back up to the heart.

• Reduces Swelling: It can help to reduce swelling by applying pressure to the affected area.

• Reduces Pain: It can help to reduce pain by applying pressure to the legs or arms.

• Reduces the Risk of Blood Clots: It can help to reduce the risk of blood clots by keeping blood flowing smoothly in the legs.

• Improves Athletic Performance: It can improve athletic performance by improving circulation and reducing muscle fatigue (feeling tired).

What Are the Different Types of Compression Therapy?

There are several options for compression therapy which include:

1. Compression Bandaging: Multiple layers of bandages are usually applied. Bandages with varying compression levels are available, including light, moderate, high, and extra high. Bandage selection is based on the severity of swelling and the amount of compression needed. These are beneficial for people with active ulcers, as they can be wrapped around the leg from the toes to the calf after wound cleaning and dressing. Elasticated bandages offer graduated compression, with the higher pressure at the ankle where it is most required. Padding should be placed in strips over bony areas to prevent undue pressure.

2. Compression Hosiery or Compression Stockings: It is used after the healing stage of the ulcer to reduce the pressure over the ulcer and prevent its recurrence. Compression hosiery is classified based on the pressure applied over the ankle.

   • Class 1: Pressure range of 14 to 17 mm of Hg (mm of Hg- millimeter of mercury). Indication for use includes mild swelling and varicose veins.
   • Class 2: Pressure range of 18 to 24 mm of Hg. Indication for use includes mild swelling, moderate to severe varicose veins, small ulcer, and prevention of ulcer recurrence.
   • Class 3: Pressure range of 25 to 35 mm of Hg. Indication for use includes severe varicose veins, chronic venous insufficiency (gross swelling), ulcers, and prevention of ulcer recurrence.
   • The correct leg measurement should be taken to ensure the proper fit of stockings. Correctly fitted stockings will provide sufficient compression and make the patient comfortable to wear. Stockings are usually worn just below the knee, but thigh-length options are also available for patients with swelling or joint deformities above or below the knee. Compression stockings are made of materials like cotton, nylon, or elastane. Ready-made options include circularly knit and flatbed knit stockings. Flatbed knit stockings are more flexible and easy to put on and off. Custom-made options like net stockings and one-way stretch stockings are also available.
3. Sequential Compression Devices: This device includes an air pump and an inflatable wrap which will be covered around the leg to compress the veins sequentially and improve blood flow. These devices are mostly used among athletes for recovery after surgery. This method is also useful in bedridden patients due to other health issues.
4. Compression Gloves: It is also known as arthritis (swelling or pain of joints) gloves. These are helpful while performing gardening, sewing, or typing activities. These gloves also help to improve circulation throughout the hand.
5. Compression Sleeves and Braces: Compression sleeves are normally worn on the wrists, elbows, calves, and knees. It protects the weak joints by improving blood flow in that area. Braces are generally used to provide support and stability to a specific joint or area of the body. Athletes widely use both these methods for quick recovery after exercise.

What Are the Risks of Compression Therapy?

• Skin Irritation or Damage: Compression therapy can cause irritation or damage to the skin if they are too tight or worn for too long.

• Reduced Circulation: Compression therapy can reduce circulation to the affected area, which can be dangerous for people with certain medical conditions.

• Allergic Reactions: Some people may be allergic to the materials used in compression devices.

• Poor Fit: Compression therapy is less effective if the stockings do not fit properly.

• Reduced Mobility: Compression devices can make moving more difficult, which can be especially problematic for people with limited mobility.

• Worsening of Symptoms: Compression therapy may worsen symptoms in some situations.

Conclusion:

Compression therapy is an effective solution for numerous blood circulation issues. It involves compression garments, such as stockings, bandages, or sleeves, to apply pressure to the legs or arms. The main objective of this therapy is to improve blood circulation in an affected area and to minimize pain and swelling. It is important to consult the healthcare professional before starting compression therapy to determine if it is appropriate for the condition and to fit the compression garments properly.