What is compression therapy? A guide for beginners

For severe swelling and conditions due to poor circulation, compression therapy ranks as the top treatment option. Using specially made stockings and pneumatic pumps, compression therapy boosts blood flow and fluid drainage in the lower extremities to reduce swelling and pain.

The demand for compression therapy to treat vein disorders, leg ulcers, and lymphedema is expanding rapidly. Grand View Research estimates the global compression therapy market hit $4.25 billion in 2024, with a projected growth rate of 3.8 percent through 2030.

What is compression therapy?

By applying gentle, graduated pressure on leg veins, compression therapy speeds up blood flow from the legs to the heart. This is especially beneficial for those with chronic venous insufficiency (CVI), which occurs when leg veins can't efficiently return blood to the heart.

Because leg veins work hardest against gravity to push blood back up to the chest, compression therapy gives them the extra nudge they need. When blood doesn't circulate properly, it pools and causes swelling (edema) in the legs and ankles. Poor circulation can also lead to varicose veins and leg ulcers.

Compression therapy also reduces swelling from lymphedema, a chronic condition where lymph nodes don't drain excess fluid from tissues. It's used for congestive heart failure and to prevent blood clots in people who sit or stand for long periods.

This isn't a new treatment—compression therapy dates back to ancient times. It was noted as treatment for varicose veins in 1440, and the first compression stockings were manufactured in 19th century England.

Types of compression therapy

Static compression

Static compression includes socks, sleeves, stockings, bandages, and wraps. These items don't move once applied, providing consistent pressure.

Compression stockings come in different styles (knee or thigh length) and pressures, measured in millimeters of mercury (mmHg). The lowest pressure (under 20 mmHg) is available commercially. Higher pressures require a prescription.

For reducing leg swelling during long work days or flights, lower pressure works well. For persistent or extreme swelling, higher pressure may be needed. Your doctor will determine the right pressure for you.

Dynamic or intermittent compression

This uses boot-like devices that inflate and deflate to move blood or lymph fluid and reduce swelling. For lymphedema, a pneumatic pump may be used just an hour daily. These devices are often used after surgery to prevent blood clots in bedridden patients.

Cold compression

Cold compression (cryotherapy) uses ice packs to reduce pain and swelling after acute injuries like sprained ankles. It also helps with arthritis pain.

Cold temperatures block pain signals and decrease swelling. Never apply ice directly to skin—use a barrier like a thin towel. Apply for only 10-15 minutes several times daily.

Benefits of compression therapy

Improved circulation: Gentle pressure moves blood through veins, effectively treating CVI, varicose veins, and preventing blood clots.

Reduced muscle soreness: Popular with athletes for reducing post-workout soreness and shortening recovery time, though research shows mixed results on performance enhancement.

Decreased swelling: Effectively combats inflammation and promotes healing. For diabetic patients with leg wounds, compression bandages increase circulation and bring healing blood to wounds.

Enhanced lymphatic drainage: Both static and dynamic compression push lymph fluid out of tissues, reducing swelling in lymphedema patients.

Pain management: Accelerates blood flow to sore areas, stimulating healing and reducing inflammation and pain.

Who can benefit from compression therapy?

Athletes: May reduce muscle soreness and speed recovery, though performance enhancement remains debatable.

Post-injury/surgery patients: Cold therapy reduces acute injury swelling, while compression maintains blood flow and prevents clots in bedridden patients.

People with chronic conditions: The 10 million Americans with lymphedema and 10-35% with CVI can manage swelling effectively with compression therapy.

Office workers and sedentary individuals: Those who stand or sit for long periods can prevent leg swelling and maintain proper circulation.

Active individuals: Regular exercisers can optimize recovery with post-workout compression therapy.

Getting started with compression therapy

If swelling doesn't resolve within a few days of an injury or workout, see a specialist. During your first visit, a physical therapist will:

• Review your health history and examine the swelling
• Recommend the appropriate compression level for your condition
• Advise on frequency and duration of use

DIY vs. professional options: Commercial lower-grade stockings work fine for travel or work-related circulation needs. More severe edema requires stronger compression stockings or intermittent compression, which need a prescription.

Compression therapy at All Sports Physical Therapy

Our physical therapists often recommend the RICE method (Rest, Ice, Compression, Elevation) for minor injuries. Here's how we use compression:

Swelling reduction: We wrap affected joints with stretchy bandages to immediately reduce swelling, allowing better diagnosis and treatment.

Appropriate pressure: We ensure proper wrapping—too tight blocks blood flow, too loose is ineffective. We'll teach you proper technique for home use.

Customized treatment: Not every injury benefits from compression. We determine if it's right for your specific condition and how long to use it.

When to consider compression therapy

• Injury rehabilitation: Reduces swelling that limits mobility and enhances healing blood flow
• Chronic condition management: Helps with arthritis, diabetes, leg ulcers, and lymphedema
• Faster workout recovery: Benefits both professional athletes and weekend warriors
• Sedentary work: Prevents leg swelling in jobs requiring long sitting or standing
• Travel: Prevents blood clots during long flights

Important considerations

Compression therapy is safe for most patients, but may not be suitable for those with:

• Peripheral arterial disease or severe peripheral neuropathy (without doctor approval)
• Extremely fragile skin, cellulitis, numbness, or open sores
• Leg shapes that make proper garment fitting difficult

Getting the best results

Proper fit is crucial. Incorrectly fitted stockings can bunch up and cut off circulation. A physical therapist will measure your legs and show you proper application. Devices are available to help with putting on stockings if needed.

If compression feels too tight or uncomfortable, tell your therapist immediately for adjustments.

FAQs

How often should I use compression therapy? Your therapist will provide specific guidance. Stockings are typically worn during the day and removed at night. Intermittent compression is usually applied for an hour daily.

What's the difference between compression socks and pneumatic boots? Compression stockings are made of elastic materials with graduated pressure. Pneumatic boots attach to devices that inflate and deflate to push blood or lymph fluid along.

Can I do compression therapy at home? Yes, with proper guidance and prescription from your therapist, who will show you how to use the devices correctly.

How long until I see results? Improvement in pain and swelling may occur within days. For best results, apply stockings in the morning when legs are less swollen and use consistently.

Is it covered by insurance? Compression devices are considered "durable medical equipment" and are covered by insurance when deemed medically necessary. Medicare covers pneumatic devices for lymphedema, CVI, or leg ulcers. Always check with your insurance provider first.