Compression Garments for Lipoedema
Expert advice on how compression garments can help people with Lipoedema, plus advice on sourcing, fitting and applying them.
Compression garments are medical garments made from firm, elasticated fabric designed to improve circulation and apply pressure and reduce oedema. Compression garments will not change the size or shape of the areas affected by Lipoedema. However, for people with Lipoedema, compression garments can:
- Help reduce discomfort and heaviness, and in turn improve mobility
- Support tissues and joints, providing a more even shape/silhouette over the limbs
- Reduce swelling in cases where there is fluid retention or secondary lymphoedema present
- Form part of conservative (i.e. non-surgical) treatment
For some patients who also have varicose veins or a secondary lymphoedema, wearing compression garments can be helpful in improving vascular and lymphatic function and prevent a worsening of these conditions.
Compression garments come in many forms and styles, including tights, stockings, wraps, sleeves and night-time compression. Compression companies are specialists in their fabrics, and can offer guidance and information to take to your healthcare provider. Individual company websites are mines of information about their ranges of products and how to care for them. These companies’ websites offer remote support with tips for measuring to get the best fabric and fit.
Sometimes made-to-measure garments (rather than off the shelf) are required in Lipoedema management. This means that the garments are specifically made for individuals and should be a perfect fit and comfortable.
In the early stages of Lipoedema, circular, round-knit garments may be suitable. These should generally be in a tights or legging style, but be advised by a specialist trained in compression who can also measure and either prescribe or request a prescription from the GP.
In the later stages of Lipoedema, where there may be skin folds or ‘ankle cuffing’, it is important that a made-to-measure, flat-knit garment is provided.
Wearing a medically prescribed compression garment should improve symptoms of pain and heaviness, reduce odema and be comfortable to wear. They should not cut into the flesh or cut off circulation and it is important to remove them if they do. For some individuals with very sensitive skin, wearing compression can be particularly challenging. Supportive and sports wear (‘active wear’) is generally less compressive than a prescribed compression garment. Non-medical garments offer a lighter support and may be helpful for some people, especially for young people or those in the early stages of Lipoedema.
Compression garments are available on prescription in the UK. Measuring and fitting should be done by a trained nurse, therapist, lymphoedema clinic, private clinician or pharmacist. Individual compression garment manufacturers often have their own measuring charts and there are many different options available from a variety of companies. It is important that any compression requirements are prescribed by a healthcare provider (a GP, practice nurse or specialist practitioner) who is aware of any relevant medical history, because sometimes compression is contraindicated.
When you collect your compression garment, always check that the garment corresponds to the item on your prescription and has not been substituted with an item from a different manufacturer or by a garment with a different code. The first time you put on a compression garment can be very challenging and there are various ‘donning and doffing’ appliances available to make it easier which may be recommended by your trained therapist. A pair of rubber gloves can also help gripping the fabric and making it easier to pull garments up and smooth them into place. Rubber gloves and will also prevent snagging from rings and prolong the life of the garments. Always follow the manufacturer’s care and washing garments. Frequent washing keeps the garments in shape and maintains their effectiveness.
For made-to-measure options, numerous length and circumference measurements will be recorded on a form, and this will be sent away with the prescription.
If you are purchasing extra garments following assessment, the price of made-to-measure garments will be more expensive. It is useful to check eligibility for VAT exemption with your GP, specialist nurse/therapist.
Referral to a specialist Lymphoedema Clinic
NHS Clinics
Individuals with Lipoedema may be referred by their GP to a local Lymphoedema Clinic as there are no specialist Lipoedema clinics in the NHS. It is important to be assessed and treated with appropriate non-surgical treatments, such as the right compression garments and advice. Your GP can also refer you to other services if appropriate, such as weight management or psychological services. The GP may refer you to the practice nurse to measure and fit you for compression, but this is dependent on what training and skills the practice nurse has in this area.
The British Lymphology Society (BLS) holds a list of UK Lymphoedema Clinics, but not all accept patients with Lipoedema. UK lymphoedema services are inconsistent, and many parts of the UK have no provision at all. A number of lymphoedema clinics accept out-of-area and private patients for diagnosis and treatment.
Out of Area & Tertiary Clinics
The UK has two outstanding Lymphoedema specialist hospitals – St George’s University Hospitals NHS Foundation Trust and The University Hospitals of Derby & Burton NHS Foundation Trust. Your GP cannot refer you directly to either of these specialist services as consultations are only available via a consultant to consultant referral. Most specialist Lymphoedema Clinics do not routinely recommend and prescribe compression garments without evidence of oedema.
Private Therapists & Clinics
There are some private therapists and clinics that may be able to diagnose and offer advice and support, such as measuring for compression and providing pre and post operative liposuction treatments. Most are also qualified in manual lymphatic drainage (MLD) and other therapies which may relieve some of the symptoms of Lipoedema. The MLD UK website www.mlduk.org.uk ‘Find a Therapist’ page has a search function to enable you find your nearest therapist. Please check the individual therapists’ credentials and that they are qualified, and experienced, to treat lymphoedema and lipoedema.
What our members tell us about their experiences with compression garments
- When you receive your compression garments, check that the packaging has the correct information regarding the company, style, size and class of compression. If you collect them from a pharmacy, it is important to check you have the right garment before you walk out of the door.
- A garment applicator (donning and doffing aid) can make the application of the stockings easier and some can help you get them off, too. Ask your GP for a prescription for a suitable device, although you may want to research online and purchase your own through a compression-garment supplier’s website.
- Specially designed gloves are available from compression companies to help with getting your garment on – but a pair of rubber washing-up gloves can also help!
- Long fingernails can easily go through the expensive garment material, so gloves can be helpful to prevent this, too.
- Check the fit and feedback to your specialist who recommended or prescribed them. Quite often initially only 1 pair will be requested to ensure that the fit is good and comfortable.
- Garments are usually applied first thing in the morning and taken off in the evening.
- According to the NHS, anyone prescribed with compression stockings should have their legs remeasured and garments replaced every four to six months.
- It’s time to get a replacement if you find loose threads or holes, or if you have lost or gained weight, and if the garments feel too loose or too tight. Do not wear your hosiery if it is causing your skin to mark excessively or is causing any numbness or is uncomfortable.
- Two garments will be required – one to wear and one to wash. Always check the manufacturer’s washing instructions, which usually recommend a lower temperature and hand-wash cycle with no fabric conditioner. The compressive properties of the garment can be affected if incorrectly washed.
- There are different specialist postal prescription services which stock various garments in an array of colours. If you choose to use one of these companies, they can explain how to set up repeat prescriptions to enable you to have compression delivered to your home.
- Compression should be snug without causing any discomfort or other issues, such as excess bunching. Numbness, tingling, bruising, blistering and rubbing are common complaints of ill-fitting garments and among the warning signs to look out for. In this case, remove the garments immediately and get in touch with your GP or the healthcare professional who recommended or prescribed them as soon as possible.
- If the weather is hot, wearing compression can be a challenge – but try keeping your spare pair in the fridge or freezer so they are nice and cool to apply!
Lipoedema UK is grateful for the support of the companies listed below, which provide professional-grade medical products that are suitable for patients with Lipoedema. Following a diagnosis, these products can be obtained through prescriptions issued by a qualified healthcare professional, your GP or your practice or community nurse, and are often available on the NHS. Some of these companies also provide made-to-measure or standard-size compression products via their online shops, and have helplines to offer support relating to queries regarding their products.
