Prevent leg swelling pain and fatigue with compression

Preventing swelling and achiness when I go to nursing conferences.

When “they” say that wearing compression stockings are good for your legs, who are “they”? On what authority? For which specific issues? And why should I care?  These may be a few questions you have when you are considering compression for leg swelling, pain, and fatigue.

Many experts in the field recommend compression for a variety of reasons.  In this article, I will be introducing you to the ICC – the International Compression Club.  This particular club includes experts from France, Germany, the UK, the Netherlands, Switzerland, Austria, Poland, and Italy.  This group specializes in dermatology, angiology and phlebology, and vascular surgery.  In this article, the authors performed a literature review to coalesce their findings into one succinct article.  Rabe et al. (2018) made a series of rated recommendations based on the strength of evidence from their findings.  For those of us who don’t just love reading massive quantities of studies on single issues, these lit reviews are real time savers.

For which symptoms is compression effective for pain, swelling, and fatigue?

Their first recommendation is probably the most relevant and likely includes you.  When addressing the needs of healthy people and/or those with chronic venous symptoms, wearing graded compression (15-20 mmHg) provided significant relief to those who spent long hours on their feet or those who sit for extended periods of time.  Compression is effective for many symptoms including leg heaviness, pain, swelling, leg cramps, and restlessness.  These studies included randomized controlled trials that addressed physical symptoms of chronic venous disease, alleviation of said symptoms, prevention of leg swelling in individuals without chronic venous disease, and overall quality of life.  Additionally, the authors also addressed the use of compression in conjunction with sitting during long-distance travel.  When used for the same problems, compression is an effective intervention.  The authors noted that compression should be used in conjunction with regular ‘mobilisation’ for travel benefits.

How strong are these findings?

This literature review uses a rating scale range from 1A to 2C.  1A findings are of the highest quality.  The studies included are randomized control trials that are well planned, implemented, with statistically significant and trustworthy findings.  1A findings are almost always safe to be recommended to the general public for high benefit to risk ratios.  The findings listed above are considered 1B findings: moderate to high quality studies have found significant findings that still maintain high benefit to risk ratios.  1B findings are significant findings that can safely be recommended to the majority of the public with the expectation of clear benefits.

For comparison, 2C ratings have weak evidence.  Sometimes this is due to only having case studies (professional anecdotes of efficacy), studies that are poorly performed, or studies that found weak or conflicting evidence.  This does not mean that studies with 1C ratings should be discarded entirely.  Sometimes it only implies that we need more studies to prove (or disprove) the strong hunches and experiential findings of professionals.

Venous Leg Ulcers (VLU), Lymphedema, and Swelling

The authors made four important 1A recommendations based on their findings.  Three of these findings addressed various aspects of venous leg ulcers.  Compression is highly effective for reducing discomfort due to VLU, improving the speed of healing, and preventing the reoccurrence of VLU.  If you have suffered from VLU, our compression stockings and sleeves may be just the item to reduce your pain, increase healing rate, and keep you healthy!

The fourth 1A recommendation is for maintenance therapy when addressing chronic lymphedema.  However, as the researchers also addressed upper extremity edema after breast cancer surgery in this section, this finding is not quite within our scope here.  That said – if you would be interested in compression sleeves for upper extremities – let us know!

Deep Vein Thrombosis (DVTs) and Pain

Other important 1B findings from this study include using compression to help patients get up and walking after a DVT.  Please note, in Europe, in home-based therapy after acute DVT, compression over a DVT is not contra-indicated*.  Rabe et al. (2018) recommend using compression to decrease pain when walking as well as to decrease swelling.  Being able to walk (instead of maintaining bedrest) is not only an important quality of life factor but helps prevent other conditions caused or exacerbated by bedrest.  Additionally, the authors also recommended compression both to prevent and treat post-thrombotic syndrome (PTS).  PTS is venous system damage after a DVT and this damage can turn into chronic inflammation due to poor venous return.  PTS symptoms can look very similar to chronic venous symptoms.

*talk to your doctor before using compression on the effected leg if you have a DVT

Conclusion – Do You Have Legs You Use Regularly?

If you are on your feet for extended periods of time, compression can help you. When you have the bone-tired exhaustion that comes from a busy shift that kept you running all day, compression can help you.  If you have swollen, achy legs that require some quality time in a recliner to recover, compression can help you.  Anecdotally (this is some 2C evidence for you), it is the days that I wear compression that I am able to keep my same energy level all day.  With my Pod-Sox, I am able to finish my day with only tiredness instead of the exhaustion that comes with swollen, achy legs.

If you have suffered from venous leg ulcers, compression can help you heal and can help prevent future problems.  Compression can help you if you have suffered from a DVT*. If you are suffering from PTS, compression can help.

In conclusion, use compression for leg swelling, pain, and fatigue to improve your quality of life!

*talk to your doctor before using compression on the effected leg if you have a DVT

 

 

Rabe, E., Partsch, H., Hafner, J., Lattimer, C., Mosti, G., Neumann, M., . . . Carpentier, P. (2018). Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology, 33(3), 163-184. doi:10.1177/0268355516689631