Compression Garments for Lymphoedema: A Complete Guide for Patients and Carers

If you or someone you care for has recently been diagnosed with lymphoedema, compression garments will likely become a central part of daily life. The idea of wearing a compression sleeve, stocking, or wrap every day can feel daunting at first, but with the right garment, the right fit, and a little guidance, most people adapt quickly and notice real improvements in comfort and swelling control.

This guide covers everything you need to know: how compression garments work, which types are available, how to care for them, and what to do if something doesn’t feel right. Wherever possible, recommendations here are grounded in the 2020 International Society of Lymphology (ISL) Consensus Document the gold standard for lymphoedema management globally.

How Do Compression Garments Work?

Lymphoedema occurs when the lymphatic system is damaged or unable to drain fluid properly, leading to a build-up of protein-rich fluid in the tissue. Left unmanaged, this can cause progressive swelling, skin changes, and discomfort.

Compression garments work by applying graduated pressure to the affected limb, meaning the pressure is greatest at the furthest point (such as the hand or foot) and gently decreases toward the body. This gradient encourages lymphatic fluid to move out of the swollen area and back toward functioning lymph channels.

Beyond fluid movement, compression also helps soften fibrous (hardened) tissue that can develop over time, and plays a critical role in maintaining any reductions achieved through hands-on treatment such as Manual Lymphatic Drainage (MLD).

Types of Compression Garments: Which One Is Right for You?

Not all compression garments are created equal. Your lymphoedema therapist will prescribe the most appropriate type based on your individual clinical picture, including the stage of your lymphoedema, the texture and condition of your tissue, how well your arteries are functioning, and your day-to-day tolerance. Here is a plain-language overview of the main categories:

Circular-Knit Garments

These are the most commonly prescribed garments for mild to moderate lymphoedema. They are machine-knitted in a seamless tube and are generally softer and easier to put on than flat-knit alternatives, making them popular for everyday wear. They are available in standard sizes and in made-to-measure options.

Flat-Knit Garments

Flat-knit garments are individually knitted and then sewn into shape, which means they can be made to match complex limb shapes more precisely. They tend to be stiffer than circular-knit options and are often recommended for moderate to high-grade lymphoedema, or where the limb has an irregular shape due to fibrosis or significant swelling. They may also have a textured inner surface to improve fluid movement.

Adjustable Wraps and Decongestive Wraps

These garments use hook-and-loop (Velcro-style) fastenings and can be self-adjusted throughout the day as swelling fluctuates. They can be particularly useful for people who struggle to apply traditional compression garments, or during periods when the limb volume is actively changing.

Night-Time Garments

While most compression garments are worn during the day and removed at night, some people with lymphoedema benefit from wearing a softer, lower-compression garment overnight. These night-time options may be adjustable or textured, and are distinct from the standard garments used during waking hours. Your therapist will advise you if night-time compression is appropriate for your situation.

Trunk Garments

For people with truncal lymphoedema, affecting the chest, abdomen, or genital area, specialised trunk garments are available. These typically provide low to moderate compression and may include textured panels to assist with fluid redirection.

When Should You Wear Your Compression Garment?

For most people with lymphoedema, compression garments are worn during the day and removed at night while sleeping. However, there are specific situations where you may be advised to wear compression even if you wouldn’t normally:

During exercise and sporting activities: Physical activity increases lymphatic load, so wearing your garment helps prevent swelling from worsening during exertion.
During long-haul flights or extended travel: Prolonged sitting and changes in cabin pressure can exacerbate lymphoedema. Speak with your therapist before you travel.
In hot weather: Heat can increase swelling, and many people find their lymphoedema is harder to manage in warmer months.

Always follow the individualised guidance of your lymphoedema therapist, as wearing schedules should be tailored to your specific condition and lifestyle.

How Often Should Compression Garments Be Replaced?

As a general guide, most compression garments should be replaced every six months. Over time, the elastic fibres break down, even with excellent care, and a garment that looks intact may no longer be providing adequate compression. Reduced compression means reduced effectiveness, which can allow swelling to return or progress.

You should seek a review sooner than six months if you notice the garment feels loose, is slipping, or your swelling has changed. This brings us to an important point about weight changes.

What to Do If Your Weight Changes

Weight fluctuations, either gains or losses, can significantly affect how your compression garment fits and functions. A garment that is too loose will not adequately control swelling; one that is too tight can restrict blood flow and potentially worsen your condition. If you experience a meaningful change in weight, inform your lymphoedema therapist promptly so your garment can be reassessed.

How to Care for Your Compression Garment

Good garment care is not just about hygiene, it directly affects how well your compression works and how long your garment lasts. Here are the key principles to follow:

Wash after every wear. Sweat, skin cells, and moisturisers accumulate in the fabric and weaken the elastic fibres over time. Washing regularly helps maintain compression strength.
Wash at low temperatures. Most garments should be washed at 30–40°C using a mild detergent. Avoid fabric softeners, which coat the fibres and reduce elasticity.
Check your specific garment’s care label. Washing and care instructions vary between brands and garment types. Always follow the manufacturer’s guidance.
Air dry only. Direct heat, tumble dryers, radiators, or direct sunlight can damage the elastic fibres and significantly reduce compression strength.
Most garments are machine washable. A laundry bag can help protect the garment during machine washing.

Caring well for your garment extends its life and ensures it continues to work effectively, which means better outcomes for your lymphoedema.

What If Your Compression Garment Feels Uncomfortable?

Some initial discomfort when you first start wearing a compression garment is common. The pressure can feel unfamiliar, particularly if you haven’t worn compression before. A helpful approach is to wear the garment during your most active periods first, as movement helps your body adapt to the sensation.

Gradually increase the amount of time you wear it each day as you adjust. Most people find that discomfort reduces significantly within a few weeks.

However, if discomfort persists, does not improve, or if you experience pain, increased swelling, skin changes, tingling, or numbness, do not continue wearing the garment and contact your lymphoedema therapist promptly. Persistent discomfort may indicate an incorrect fit, the wrong garment type, or an underlying issue that needs assessment.

Trouble Putting On or Removing Your Garment?

Donning (putting on) and doffing (removing) compression garments, particularly well-fitted, higher-compression ones, can be genuinely challenging. This is especially true for people with limited hand strength, reduced dexterity, or when managing an upper limb garment single-handed.

Your lymphoedema therapist will demonstrate the correct technique and practice with you until you feel confident. If you are still struggling after practice, there are a range of accessories designed specifically to help, including:

Easy-slide or silk inner liners that reduce friction when applying the garment
Donning gloves (rubber or grip gloves) that improve your hold on the fabric
Frame-based donning devices for lower limb garments

Don’t struggle in silence, let your therapist know, as the right accessory can make a significant difference to your independence and daily routine.

How Is the Right Level of Compression Determined?

There is no universal ‘correct’ compression level for lymphoedema and this is important to understand. According to the 2020 ISL Consensus Document, compression prescription must be individualised, taking into account a range of clinical and personal factors:

Clinical stage: Lymphoedema is classified from Stage I through to Stage III, with higher stages generally requiring greater or more complex compression.
Limb characteristics and tissue texture: The presence of fibrosis (hardening) or significant tissue changes influences both garment type and stiffness.
Arterial circulation: Compression is contraindicated or must be used cautiously in people with arterial insufficiency. Assessment of circulation is an important part of safe prescribing.
Phase of treatment: Compression requirements differ between the active treatment (intensive) phase and the long-term maintenance phase.
Patient tolerance: The best garment is one the patient will actually wear consistently. Tolerability and lifestyle factors always matter.

An important marker of effective compression is volume stabilisation, that is, the lymphoedema is not worsening over time. If you notice increasing swelling despite wearing your garment as directed, this warrants review.

Working With a Specialist Lymphoedema Therapist

Compression garments are a cornerstone of lymphoedema management, but they work best when they are correctly prescribed, properly fitted, and regularly reviewed by a therapist with specialist training in lymphoedema.

At ORSI, our lymphoedema therapists provide individualised assessment and garment prescription as part of a comprehensive approach to lymphoedema care. Whether you are newly diagnosed and navigating your options for the first time, or are an experienced garment wearer due for a review, we are here to support you.

To make an appointment or ask a question about your lymphoedema management, please contact us via (02) 8018 8240 or [email protected]