Compression therapy

Compression therapy helps increase blood circulation in the lower legs, ankles and feet. It’s an effective treatment for venous leg ulcers, diabetic foot ulcers, lympodeamea and general pain and swelling.

What is compression therapy?

Compression therapy is a powerful treatment regime that supports legs in their healing or reduction in swelling. It can seem old fashioned or difficult to use but it is incredibly effective and has a great deal of research to underpin its use and tell us how important it is as a treatment.

Legs create problems for wounds because of gravity – what a wound on the arm or abdomen needs to heal is very different for a leg. Legs need support to heal and even more so if there is underlying venous disease, leg swelling or excess weight or immobility.

If your wound isn’t healing because of venous hypertension and there are no problems with the blood supply to your legs, then you must be offered compression therapy.

What is compression therapy good for?

Compression therapy improves the return of your venous blood supply by applying pressure to the leg and foot. This can be done by bandaging the lower leg or by wearing supportive socks, stockings or tights. Compression therapy is very effective at reducing swelling, improving blood flow in the veins and healing or preventing sores or ulcers.

Research is increasingly pointing to the role of compression therapy reducing inflammation around the wound or swelling; thus this will have a direct impact on reducing pain, reducing swelling, reducing skin changes and supporting the calf and foot muscles to work more effectively. Using compression with ankle and calf exercises is important and will make the compression therapy more effective.

What are the different type of compression therapy?

There are lots of different types of compression therapy so ask your nurse to find something that is right for you. Compression comes in different strengths or classes and is measured in mmHg. Similarly to medication, the dosage of compression you need is to do with what works or how bad your problem is. Compression bandage therapy also reduces its compression dosage on larger legs.

Asking for the correct dosage of compression therapy

Unfortunately across the UK many patients are having a reduced dosage of compression therapy and not healing.

Top tip: ask your healthcare provider if you are having strong compression therapy. Having reduced or light levels of compression is like taking half a tablet of Paracetamol for a headache. It is unlikely to work! So the dosage of compression needs to be strong enough to work for your leg and your condition

Reduced compression dosage may be required if:

• You have mild disease or a small leg ulcer or wound. You may be offered Class 1 Compression sock
• You are in significant pain. Reduced dose of compression will help you get accustomed to the compression bandage. But if this dose does not reduce the swelling or wound exudate, then this is not creating an effective therapy and you need stronger compression.
• You have moderate or mild Peripheral arterial disease plus a leg ulcer

Strong compression dosage is required for:

• All venous leg ulcers. You will be offered Class 2-3 socks or wraps, Hosiery kit or a variety of compression bandage regimes.
• A variety of leg ulcers of other causes, especially if you are tall, have a lot of swelling or have large legs.

Does compression therapy hurt?

Compression can be a little uncomfortable when you first start treatment but should not cause you any pain. Any discomfort should reduce as the swelling goes down. If you do experience discomfort or have difficulty with footwear talk to your nurse or doctor about it and they will advise you on ways of alleviating this. Often people are fearful of compression, fearing that it is ‘cutting off the circulation’. They may have heard that a relative had to have an amputation for a foot ulcer. Express your concerns and the healthcare practitioner will be able to reassure you that your wound, if prescribed compression will only benefit you and not create harm.

The only time when compression must not be used without specialist advice is when you have critical ischemia or significant peripheral arterial disease.

Remember! Compression therapy is a critical part of a treatment plan which will speed up healing. It is likely that if you do not use it or find a regime or compression dosage that works, your wound and swelling will simply deteriorate. Getting the dosage right is essential and needs having a good conversation with your nurse or therapist.