Compression Therapy

A Long-Standing History of compression therapy

Compression therapy has been around for thousands of years, but modern compression stockings as we think of them only emerged in the 1940s and 1950s, making them a relatively recent development.

History of Compression Therapy

Like many medical devices, compression garments have their roots in ancient history. Physicians in ancient Rome and Egypt used bandages to wrap patients’ legs to bind and treat injuries. However, compression garments as we know them today didn’t arise until thousands of years later, in the late 1930s just before World War II.

Many companies, including Jobst, Juzo and Mediven, began manufacturing compression stockings in Europe around the same time and quickly innovated on the design. While we can’t know for sure, it seems that Conrad Jobst, founder of the eponymous company, was probably the first to invent compression garments.

A medical engineer and inventor originally born in Germany, Jobst suffered from severe chronic venous insufficiency (CVI). According to Johns Hopkins Medicine, chronic venous insufficiency is a condition that occurs when veins in your legs don’t function properly. Instead of allowing blood to flow back to your heart, the valves malfunction, which can cause blood to flow backwards and/or pool in your lower legs.

Jobst noticed how swimming in the pool helped with his swelling and poor circulation. Reasoning that the relief came from the gentle pressure of the water, he sought to make a product that could emulate the same effect that the liquid had on his legs. Thus, the medical compression stocking was born.

Jobst worked with professionals in phlebology and lymphology to further refine his compression stocking design. Alongside other brands, Jobst compression stockings spread all over Europe. In the wake of WWII, the use of medical compression stockings made its way across the pond, becoming popular in the United States as well.

These medical compression stockings were a boon to people like Jobst who suffered from chronic venous insufficiency and other potentially debilitating venous conditions. However, the design hadn’t quite reached its peak form yet. Original compression stocking designs provided the exact same pressure all up and down the garment. However, you need more pressure at the bottom of the limb than at the top because the bottom of the limb is where gravity’s effect is the strongest. In the 1980s, graduated compression stockings were invented and soon became the standard in compression garment design. Compression therapy has come a long way from ancient leg binding techniques!

Compression Therapy Today

Today, compression therapy is used to prevent or manage a wide variety of venous issues, including chronic venous insufficiency, deep vein thrombosis and other blood clots, spider veins and varicose veins. Compression socks may also help alleviate swelling, pain and/or achiness in the legs.

To be exact, compression therapy is often used to address venous issues, especially in the elderly, who experience these health problems more often. But don’t knock compression therapy because you think you’re too young or healthy to need it. Compression garments may be used by people of all ages for all kinds of reasons. For example, many young athletes in their physical prime swear by compression gear to help them reach peak performance and recover faster from workouts and competitions. Other people might wear compression gear in order to cope with the symptoms of DVT. Frequent travelers turn to compression socks to help reduce their risk of blood clots and help keep their legs limber during long flights and driving. Meanwhile, expecting moms use maternity compression tights to help them manage swelling and leg pain during pregnancies.

Compression garments come in many different styles. Perhaps the most popular are those for the lower body, including compression socks, compression thigh highs, compression tights and maternity pantyhose. Compression therapy is also available for the upper body in the form of an arm sleeve or gauntlet. While much less common, compression products can also be found for other areas of the body such as the torso and groin. (More on popular compression products in the next section.)

Compression wraps are also available for people who find one continuous tube of fabric hard to don. Compression wraps are made of sturdy fabric with hook and loop tabs so you can adjust the level of compression as needed. If you struggle to put on traditional compression stockings, compression wraps are a great alternative.

Popular Styles of Compression Products

If you’re new to the world of compression therapy or haven’t worn the garments in a while, all the options can feel overwhelming. Here’s a quick primer on some of the most popular styles of compression products:

Compression Socks

The most common type of compression garment is the compression sock. While there are ankle/crew compression socks available, most people opt for a knee-high sock that extends up the calf so they can get the benefits of compression in their lower legs as well as their feet. Of course, the socks come in basic, solid neutrals like nude, grey, black and navy, perfect for blending in with your office wardrobe. However, there are also plenty of eye-catching designs available if you like to make a statement with your socks. In particular, SockWell makes really fun (and uber comfortable) compression socks that look like the hippest designs you’d find in a sporting goods store.

Thigh High Stockings

For those who’d like to get compression benefits in their thighs as well as their calves, we recommend thigh high stockings. The stockings come in closed toe and open toe designs, and most brands feature a silicone band at the top to keep the stockings from rolling downward as you move around. If you only need compression for one leg (say, you only suffer from lymphedema on one side of your body), chap-style stockings with a waist belt will get you set up perfectly. If you prefer the look of a stocking over a sock but don’t need a garment that covers your thighs, check out knee-high stockings instead. As for brands that we like, we recommend Sigvaris compression stockings and, of course, Jobst compression stockings as well.

Pantyhose and Tights

If you need the benefits of compression from your waist to your toes, then compression pantyhose are what you want. This garment looks like a regular pair of tights but provides compression for your entire lower body. With tights, you don’t have to worry about the garment rolling down since the waistband keeps everything in place. Compression pantyhose are available in both sheer and opaque fabrics, and they also come in closed toe, open toe, footless designs just like thigh high stockings. Expectant mothers will want to look at maternity pantyhose, which are meant to accommodate a growing belly and help manage swelling in the tummy area as well as the legs.

Armsleeves

Most people struggle with circulation and swelling in their lower bodies, hence why many best-selling compression products are designed for the legs. However, the legs don’t have a monopoly on venous issues, and some people struggle with poor blood flow and swelling in their upper body–especially their arms. Armsleeves offer graduated compression for your arms, and they can also be paired with a gauntlet to provide compression benefits to the hands as well. Armsleeves come in standard neutral colors and Juzo also makes a really fun line of printed armsleeves as well if you’d like to add a pop of color to your compression gear.

Understanding Compression Levels

There are five main levels of compression garments: 8-15 mmHg, 15-20 mmHg, 20-30 mmHg, 30-40 mmHg and 40-50 mmHg. Most people can wear the first two levels without any major issues, which is why they’re available over the counter. However, you should talk to your doctor before wearing compression hosiery if you have any of the following conditions: ischemia, untreated septic thrombophlebitis, uncontrolled congestive heart failure, phlegmasia coerulea dolens, concomitant dermatoses, advanced peripheral neuropathy and arthritis.

8-15 mmHg (mild)

The lightest level of compression available, 8-15 mmHg garments help maintain already healthy circulation and alleviate mild symptoms and swelling. If you don’t have venous issues but spend a lot of time sitting or standing (and experience heavy, aching legs as a result), mild compression can help your lower body stay energized and fight fatigue. Early on in pregnancy, these compression stockings can also help the symptoms of varicose and spider veins to be manageable, though you’ll likely want to increase the compression level as your pregnancy progresses.

15-20 mmHg (medium)

If you’ve never worn compression socks before, most doctors will recommend that you start with 15-20 mmHg, which is one of the many reasons why it’s the most common entry level of compression socks. Like mild compression, medium compression garments will help fight swelling and tired, aching limbs. They can also help relieve pain from other venous issues such as varicose and spider veins and deep vein thrombosis (DVT), a condition that occurs when a blood clot forms in the veins deep in the body, often in the legs. If a DVT clot breaks loose and travels to the lungs, it can result in a pulmonary embolism, which can be life-threatening. People who sit or stand all day—from nurses to frequent flyers to seniors with mobility issues—are at greater risk for developing DVT, which is why doctors often recommend this level of compression to them.

20-30 mmHg (firm)You’ll want a recommendation from your doctor before you upgrade beyond 20 mmHg compression wear, as these compression garments are meant to be used for more serious venous issues, including: moderate to severe edema or lymphatic edema (aka swelling); orthostatic hypotension, a sudden fall in blood pressure that occurs

when you stand up; the management of active ulcers and manifestations of post-thrombotic syndrome (PTS), a long-term condition that results from DVT; and superficial thrombophlebitis, an inflammatory condition caused by a blood clot just below the skin. Of course, this level of compression offers the same benefits as the first two levels as well, and will help address more minor complaints such as swelling and varicose or spider veins.

30-40 mmHg (extra firm)

Same as the 20-30 mmHg products, you shouldn’t wear this higher level of compression unless your doctor has instructed you to. This level of compression helps to better manage symptoms of lymphedema and more severe versions of the same conditions as the 20-30 mmHg product.

40-50 mmHg

This is the highest level of compression and it is only used to manage the most serious venous issues. Compression products with this level of compression should only be used if recommended by a doctor.

Compression socks help manage pain, swelling and symptoms for many patients who had no other treatment options before compression therapy was invented. While they can’t cure venous issues, compression garments can significantly improve your quality of life and help you better manage your conditions. We’re certainly thankful that compression socks were invented, and we know many of our customers are, too.

What are intermittent pneumatic compression devices?

Intermittent pneumatic compression (IPC) devices are used to help prevent blood clots in the deep veins of the legs. The devices use cuffs around the legs that fill with air and squeeze your legs. This increases blood flow through the veins of your legs and helps prevent blood clots.

Veins are the blood vessels that bring oxygen-poor blood and waste products back to the heart. Arteries are the blood vessels that bring oxygen-rich blood and nutrients from the heart to the body. Deep vein thrombosis (DVT) is a blood clot that forms in a vein deep inside the body. In most cases, this clot forms inside one of the deep veins of the thigh or lower leg.

The veins in your legs have tiny valves that help keep blood moving back up toward the heart. But a DVT may damage one or more of these valves. This causes them to weaken or become leaky. When this happens, blood starts to pool in your legs. This can also happen if you are immobile for a long period of time. Normally, muscles in the leg help blood move up in the veins when the muscles contract. When blood flows very slowly through the veins, this increases the risk that cells in the blood will stick together and form a clot.

DVT is a common condition. It’s a higher risk in people older than 65. Post-thrombotic syndrome affects a large number of people who have had DVT. It can happen in people of any gender or age.

DVT is a serious medical condition that can cause swelling, pain, and soreness in your leg. In some cases, a deep clot in a leg vein can break free and travel through the bloodstream to the lungs. This can cause a blockage in the vessel called a pulmonary embolism. Pulmonary embolism can cause severe shortness of breath and even sudden death.

While using an IPC device, your calf or whole leg is enclosed in a cuff. The cuff fills with air and squeezes the leg, much like a blood pressure cuff. Then the cuff deflates and relaxes. The process then repeats over and over. The compression helps move blood through your veins towards your heart. IPC also promotes the natural release of substances in your body that help prevent clots. Between compressions, the cuffs of the device relax, and oxygen-rich blood continues to flow in the arteries of your leg.

Why might I need to use intermittent pneumatic compression devices?

You might need to use IPC devices if you have a high risk of getting a DVT. Anything that slows the movement of blood through your veins increases your risk of DVT. A variety of conditions can increase your chance of getting a DVT, such as:

  • Recent surgery, which decreases your mobility and increases inflammation in the body, which can lead to clotting
  • Health conditions that limit how much you can move, such as an injury or stroke
  • Long periods of travel, which limit how much you can move
  • Injury to a deep vein
  • Inherited blood disorders that increase clotting
  • Pregnancy
  • Cancer treatment
  • Smoking
  • Obesity
  • Older age

IPC is one way to help prevent DVT. A blood-thinning medicine such as warfarin is also used to treat people who are at high risk for DVT. These medicines may work better than compression devices in preventing DVT. But they have other risks. If you have a high risk of excess bleeding from a blood thinner, your healthcare provider may be more likely to advise IPC instead. In some cases, your provider might advise both blood thinners and IPC.

IPC is used most often for people who have just had surgery. It may also be used after a stroke or to help treat lymphedema.

What are the risks of using intermittent pneumatic compression devices?

All procedures have risks. The risks of this procedure include:

  • Discomfort, warmth, or sweating beneath the cuff
  • Skin breakdown
  • Nerve damage (rare)
  • Pressure injury (rare)

Careful attention to skin care can help prevent these complications. It’s also important that your cuff size is correct.

Some people with certain health conditions should not use IPC devices. For example, people with leg ulcers, burns, or peripheral vascular disease have a higher risk for problems. Older adults may be more at risk for skin breakdown. Talk with your provider about the risks that most apply to you and any concerns you may have.

How do I get ready for using intermittent pneumatic compression devices?

A healthcare provider may measure your leg, to make sure you get the right size cuff. If you are to use the device at home, you will also be instructed how to correctly put on the cuff. Be sure to ask any questions you have about the device or why it’s being used.

What happens during the use of intermittent pneumatic compression devices?

In most cases, an IPC is used in the hospital. Or you may be instructed how to use it at home.

There are many types of IPC devices. Yours might cover your calf, or it might go around your whole leg. Some inflate all over the leg with the same pressure. Others may first apply pressure to the lower and then the upper part of the leg. Some inflate quickly, and others inflate slowly.

A healthcare provider will show you how to put on your IPC cuff. They often use Velcro straps to close. The cuff can be put on over or under your clothes, whichever is more comfortable. When fastened around your leg, the cuff should feel snug, but it shouldn’t hurt. You should be able to place a finger between the cuff and your leg.

Next, you attach the cuff to the compression machine. This machine will cycle between inflating and deflating the cuff. This may feel a little strange at first. Let your healthcare provider know if it is too uncomfortable. Changing the cuff to stop discomfort can help prevent complications.

You can remove your IPC cuff when you need to shower. Check your skin when the device is off and alert your provider if there are any areas of pain, swelling, warmth, redness, or skin breakdown. Make sure to put it back on as soon as possible. The more you use it, the more you will lower your risk of DVT and pulmonary embolism.

Your healthcare team may give you other instructions about what to do with your IPC device.

What happens after using intermittent pneumatic compression devices?

Your healthcare provider will tell you when you can stop using the device. This will be at the point where your risk of DVT goes down. If you have just had surgery, try to get up and move as soon as possible. With increased mobility, your risk of DVT will go down.

Your provider may give you other instructions about ways to prevent DVT. These may include drinking plenty of water and getting physical activity. Follow all your healthcare provider’s instructions.

Call your healthcare provider right away if you have any of these:

  • Swelling in your leg
  • A warm area on your leg
  • Pain in your leg or on the skin under your cuff
  • A sore on the skin under your cuff

At BIOVISTA PHARMA we provide all levels of Compression therapy from head to toe. Whether you are looking for Anti-Embolic stockings, compression stockings below the knee, above the knee or panty hose, compression arm sleeves and Intermittent Pneumatic Compression devices.

We are a one stop shop for all your  compression therapy  products.