What is a Compression Sleeve for Lymphedema?

How a Compression Sleeve helps with Arm Lymphedema

compression sleeve used for lymphedema from breast cancer
LympheDIVAs Compression Sleeve. Image © LympheDIVAs LLC

A compression sleeve is an elasticized garment that is worn to reduce the symptoms of lymphedema, such as pain and swelling. While lymphedema related to breast cancer treatment is perhaps best known, lymphedema may occur due to a number of different conditions in which the lymphatic vessels are damaged, such as melanoma and more. Recent studies suggest that the regular wearing of a compression sleeve may not only control symptoms, but may help prevent the development of lymphedema in the first place. Compression garments, such as sleeves, gloves, vests, and support bras may be used all of the time, only during the day or at night, only during exercise, or only in special circumstances such as when flying. Let's look at what you should know when purchasing one of these garments.

Understanding Lymphedema

Lymphedema is caused by damage to lymphatic vessels in the body so that the normal flow of lymph is disrupted. With nowhere to go, this fluid builds up, causing swelling in the affected region. Lymphedema after breast cancer treatment is far too common, though estimates of the incidence vary. It may occur anytime after treatment, from immediately after surgery, to many decades after treatment has been completed.

With breast cancer, and cancers such as melanoma, lymphedema occurs most commonly when lymph nodes are removed as part of staging the cancer. Lymphedema may also occur without lymph node dissection due to the formation of scar tissue after surgery or radiation; when lymphatic vessels are cut or damaged during surgery; and when tumors grow and compress lymph nodes and lymphatic vessels.

Use and Benefits of Compression

Compression garments work by creating a pressure gradient, causing the flow of fluids away from the area where they are accumulating.

Role in Symptom Management

Compression garments can help reduce the pain and swelling associated with lymphedema.

Role in Prevention

In the past, it was thought that the primary role of compression sleeves was to control symptoms of lymphedema and that active prevention was not possible, but this view may be changing. A 2017 study looked at the regular use of compression sleeves (15 to 21 mm Hg) on the later occurence of lymphedema in women who had axillary lymph node procedures (such as an axillary lymph node dissection or sentinel node biopsy) for breast cancer. In those who wore compression sleeves, less post-operative swelling was noted a month after the procedure. The benefits appeared to last far beyond this, however, and less arm edema was noted at 3 months, 6 months, 9 months, and even 12 months following the surgery.

Both groups underwent a standardized exercise program as well, and it's not certain what the results of this study would show without regular physical activity.

Limitations

While compression garments may help with pain and swelling, and may even prevent the development of lymphedema, there are drawbacks. Compression garments can be uncomfortable, and warm, especially during the summer months. Aesthetically, some women find them unattractive. Fortunately, a 2018 study found that wearing compression sleeves did reduce physical activity or lower the quality of life for women who wore these garments regularly for 1 year.

Compression Options

Compression garments come in a number of different forms:

Sleeves

Compression sleeves usually extend from the wrists to the upper arms and come in a number of different styles and materials.

Gloves

Gloves, such as fingerless gloves are often worn along with a compression sleeve. For some people, wearing a compression sleeve results in more edema in the hand, which can be reduced by combining the sleeve with a glove.

Support Bras and Vests

Support bras and vests are available for those who have chest and breast lymphedema related to breast cancer surgery or other conditions. It's very important to have a professional assist you in choosing the right product, as the wrong bra or vest can be painful and worsen your symptoms.

Buying a Compression Sleeve

It's important to work with a reputable retailer or lymphedema therapist when purchasing a compression sleeve, as a poor fitting sleeve may actually worsen symptoms. When trying on sleeves, make sure that the sleeve is not too tight in areas such as your wrist or elbow, and check to see if the compression feels uniformly over the entire sleeve. The sleeve should cover the entire area where you experience swelling and be comfortable, but not loose. If you experience any numbness or tingling, the sleeve is probably too tight.

Once you have your sleeve it's important to listen to your body, and find a different product if your symptoms worsen or are not improving. Well cared for, a sleeve often lasts for around 6 months before it needs to be replaced.

Some insurance companies cover all or part of the cost of a compression sleeve, whereas others do not. If you need to pay out-of-pocket, keep in mind that these sleeves can be deducted on your taxes as a medical deduction related to cancer.

Wearing Your Compression Sleeve

Wearing your compression sleeve can reduce pain and swelling, but the benefits can vary depending on when you wear it and whether you have a sleeve that fits comfortably.

Timing

People vary on how often they wear their compression sleeves, from 24 hours a day to only during air travel. Most commonly, sleeves are worn during the day and removed at night. For some people, however, rebound edema occurs when the sleeve is removed at night, and adjustable night sleeves may be helpful.

Important Times to Wear Your Sleeve

The most important time to wear your sleeve is during exercise, or when you will be experiencing the pressure changes associated with air travel.

Daily Use

You should ideally don your compression sleeve each morning after you shower (if you shower in the mornings), as lymphedema is usually at its minimum upon awakening. Your arm should be completely dry, and if you apply lotions, the area should be allowed to dry fully. When you purchase your sleeve, ask to see the best way to apply the sleeve so that it flows on easily and without wrinkles.

A Word From Verywell

Compression sleeves may reduce the symptoms of lymphedema and make you more comfortable, and possibly reduce the risk of complications, such as infections. They do not, however, resolve the underlying problem. A compression sleeve should be used as part of a comprehensive lifestyle plan to minimize pain and prevent further swelling that includes exercise, meticulous skin care, and weight control.

While there is still controversy as to the precise role compression sleeves play, recent research is encouraging in that they may even have a preventive role. There is currently a lot of research looking into the causes and prevention of lymphedema, and hopefully we will learn more in the near future. As with other aspects of your cancer care, being your own advocate and staying abreast of the latest research can help you feel empowered in your journey, and, in some cases, may even have an impact on your outcome.

Sources:

Ochalek, K., Gradalski, T., Szygula, A., and H. Partsch. Physical Activity With and Without Arm Sleeves: Compliance and Quality of Life After Breast Cancer Surgery—A Randomized Controlled Trial. Lymphatic Research and Biology. 2018. 16(3):294-299.

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