Leg Compression: Medical Miracle or Quackery?

Leg Compression: A Primer

Leg compression is a simple, inexpensive, and generally effective method of relieving circulatory problems in the legs, calves, ankles, and feet. Although it is easy to implement, it is perhaps not as widely used as it should be.

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Compression Therapy for the Legs

Compression therapy increases blood circulation in the lower legs by strengthening vein support. Mild to moderate pressure is applied to all or part of one or both legs with the assistance of compression apparel or bandages. This has been shown to strengthen venous tissues, which improves blood flow. It also results is greater nutrient delivery to affected tissues and reduced swelling.

Who Would Benefit From Compression Therapy

Compression therapy is especially beneficial for those suffering from leg ailments, including swelling, venous problems, wounds, ulcers, lymphedema, and general poor circulation. It is also used by athletes, long-distance flyers, those who work long hours in one position, and pregnant women.

Frequent flyers use leg compression because they have to remain seated in a cramped space for a long time. This can lead to poor circulation, which can in turn lead to deep vein thrombosis (DVT). Compression helps to reduce swelling and the risk for complications from poor circulation.

Athletes are known to suffer from muscle fatigue, shin splints, sprains, muscle tears, and other leg injuries. Compression therapy can help to prevent these injuries and hasten recovery when they do occur by improving circulation in the leg.

People who are on their feet all day, including nurses, retail workers, hair stylists, and others, can benefit from compression therapy. It can help to reduce the risk of long-term health issues while providing immediate relief from pain and swelling.

Pregnant women often experience leg and ankle swelling, varicose veins, and lower limb pain because of hormonal changes and weight gain. There are many specially designed maternity compression stockings that help to reduce the symptoms of these problems.

Patients with wounds or venous ulcers can also benefit from compression therapy. Comparative studies have shown that patients who wear compression socks have faster healing rates compared to those who don’t.

Even office workers can benefit from compression therapy. Sitting at a desk for long periods of time has been known to cause poor leg circulation in addition to numerous other problems. Fortunately, compression apparel can not only help to improve circulation, but it can help to improve posture, which reduces musculoskeletal stress.

Finally, lymphedema patients can use compression therapy to aid in healing. Lymphedema is a serious condition that occurs when the lymph system becomes impaired. It can make people more susceptible to other major illnesses such as cancer, cardiovascular disease, and chronic obesity. Compression therapy lowers these risks by reducing the chronic swelling (edema) associated with lymphedema.

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How Does Compression Therapy Heal Swelling in the Lower Limbs?

While there is still much to learn about compression therapy, it is known that the pressure applied to the circulatory system increases the velocity of blood flow in the veins. This causes the blood to more efficiently through the venous system, reducing blood pooling and swelling while promoting recovery.

Compression Apparel and Devices

Typically, compression is induced by wearing specifically designed apparel such as compression socks or compressive bandages. There are also some therapeutic compression devices available.

Compression Socks and Other Apparel: Compression apparel, including socks, stockings, sleeves, shorts, and pantyhose are used in a wide variety of treatments. The most common of them, however, are compression socks and stockings. These include ankle-high, knee-high, and thigh-high styles, all of which are manufactured to provide graduated compression. This means that they apply the highest amount of pressure at the ankle and less pressure further up the leg. All styles of compression apparel are available in different degrees of compression.

Compressive Bandages: Compressive bandages can help with wound and ulcer care. They are available in many sizes and styles, including elastic, inelastic, tubular, and short-stretch versions. Some patients benefit from multi-layered bandaging.

Compression Devices: Intermittent pneumatic compression devices (IPC) can also help with wound and ulcer care. An IPC consists of a pump with one or more bladders. The bladders are intermittently inflated, which causes compression. IPC therapy is often used in conjunction with conventional compression apparel and bandages. One of the benefits of using IPC therapy is that the compression can be gradually increased or decreased to more effectively promote healing. Despite this, IPC treatment is much less common than other forms of compression therapy.

How Much Compression is Provided

The amount of compression provided by an individual piece of apparel is usually measured in millimeters of mercury, mmHg. For graduated compression gear, the largest number is the pressure at the ankle. Light compression socks, known as “support socks” typically provide less than 20 mmHg of compression.

Higher compression levels are typically prescribed by health care providers for more serious conditions. 20-30 mmHg is often used to treat swelling, varicose veins, and edema, while 30-40 mmHg is prescribed fro more severe swelling and lymphedema. In rare cases, 40 mmHg or more may be recommended for particularly serious problems.

It’s important to note that pressure ratings for compression gear vary by country. European countries are working to develop a unified classification system. The U.S. does not currently have a standard system. The measurements taken to get accurate sizing also vary from country to country.

How To Receive Compression Therapy

If you have serious medical problems in the legs, your doctor will likely talk with you about compression therapy. He or she will work with you to develop a specific plan of action, including what style compression gear to wear and how often to wear it. You will also be prescribed a compression level.

If you suffer from a more minor issue such as tired feet, you can purchase a pair of over-the-counter compression socks. Custom compression socks are relatively inexpensive and widely available.

Are There Any Downsides to this Type of Therapy?

There are very few downsides to compression therapy, and most of them are a matter of simple mechanics. Some people do not like the regularity with which bandages must be changed and the fact that they do not maintain the desired pressure for very long periods of time. IPC systems require patients to stay still for long periods of time. Other people may have difficulty putting on and taking off compression stockings.

When not done correctly, compression therapy can result in pressure damage. This usually includes minor problems such as redness or tenderness, particularly over old wounds.

Health care providers sometimes struggle to determine the ideal pressure for their patients. The different classification systems and standards from different countries contribute to this confusion. They also worry about poor compliance on the part of their patients. This can be avoided by making sure that a prescription is tailored to the patient’s specific circumstances.

Summary

Compression therapy is useful for treating mild to several venous diseases. It is effective at treating swelling, tired and sore legs, lymphedema, varicose veins, and deep vein thrombosis. It is also used by frequent travelers, those with leg wounds and ulcers, stationary workers, athletes, and pregnant women. Therapy involves the use of apparel, bandages, or devices, all of which have their advantages and disadvantages. Compression is relatively inexpensive, easy to implement, and highly effective at delivering results.

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