Compression therapy is a non-pharmacological approach that offers relief to individuals managing arthritis, which is characterized by joint inflammation, pain, and stiffness. This therapy involves applying specialized garments to exert gentle, controlled pressure on an affected joint. For people with various forms of arthritis, including osteoarthritis and rheumatoid arthritis, compression is considered beneficial for managing discomfort and improving daily function.
The Physiological Mechanism of Compression
Compression garments mitigate swelling associated with arthritic flare-ups by working on the body’s fluid dynamics. The controlled external pressure prevents the excessive pooling of interstitial fluid, known as edema, in the joint space. By gently squeezing the tissue, the garment aids in pushing this fluid back into the venous and lymphatic systems. This promotes efficient circulation and drainage away from the inflamed area, reducing the volume of swelling and lessening pressure on pain-sensitive structures.
Beyond fluid management, compression provides a neuro-mechanical benefit by enhancing proprioception. Proprioception is the body’s ability to sense its position and movement in space. The continuous pressure from the garment provides sensory input, which helps stabilize the joint during movement. This stabilization reduces erratic or stressful motions that can trigger pain. The constant, non-painful pressure can also dampen pain signals by providing a competing sensation to the brain, sometimes called the “gate control” effect.
Compression also preserves local warmth around the joint. Sleeves and gloves help contain the body’s natural heat, which offers a temporary analgesic effect on stiff joints. The combination of reduced swelling, improved stability, and slight warming contributes to decreased overall pain perception and stiffness.
Selecting the Right Compression Gear
The selection of compression gear depends on the specific joints affected by arthritis.
- Compression gloves are used for the hands and fingers, often designed to be fingerless to allow for dexterity and reduce morning stiffness.
- Sleeves are the common choice for larger hinge joints like the knees and elbows, offering support while allowing a full range of motion.
- Socks and anklets are available for the feet and ankles, which frequently experience swelling due to gravity.
The pressure applied by the garment is measured in millimeters of mercury (mmHg) and must be appropriate for the individual’s condition. For general arthritis management, mild to moderate compression levels (8–15 mmHg or 15–20 mmHg) are usually sufficient and available over the counter. Higher, medical-grade compression (such as 20–30 mmHg) should only be worn with the direct recommendation of a healthcare provider.
Material choice is another consideration, with most garments made from a blend of nylon and elastane for stretch and moisture-wicking properties. Some products are infused with copper, often marketed for anti-inflammatory properties. While compression is scientifically supported for relief, the primary benefit of copper-infused fabrics is their antimicrobial properties, which help reduce odor and bacterial growth.
Guidelines for Safe and Effective Use
Achieving the intended benefits requires careful attention to the garment’s fit. Proper sizing is paramount, as a loose garment will not apply therapeutic pressure, while one that is too tight can restrict blood flow or cause nerve irritation. The fit should be snug but comfortable, distributing pressure evenly across the joint without causing numbness or tingling.
The duration of wear varies based on individual needs and the joint being treated. Many people wear the garments during the day, especially when performing activities that strain the joint, like typing or walking. Wearing compression gear overnight can reduce morning stiffness, but it must be removed if it causes discomfort. It is recommended to remove the garment periodically to allow the skin to breathe and check for irritation.
Maintaining the gear’s elasticity and cleanliness is important for long-term effectiveness. Garments should be washed using a mild detergent on a gentle cycle and air-dried to prevent the breakdown of elastic fibers. Since the material loses effectiveness over time (usually around six months), having a second pair allows for continuous use. Consulting a doctor or physical therapist before starting regular use ensures the therapy is integrated safely into the overall management plan.
When Compression Therapy is Not Recommended
While compression is generally safe, its use can be detrimental and should be avoided in specific medical conditions. Individuals with Peripheral Arterial Disease (PAD) have compromised blood flow to the limbs. External pressure from a compression garment can further restrict arterial circulation, worsening pain and potentially leading to tissue damage and ischemia.
Conditions Requiring Caution
Compression therapy should be avoided in several situations:
- Active Deep Vein Thrombosis (DVT), as the pressure could potentially dislodge the blood clot.
- Severe skin infections, such as cellulitis, or open wounds near the joint.
- Advanced peripheral neuropathy or congestive heart failure, which require careful medical assessment before starting a regimen.
Immediate signs to remove the compression garment include the onset of numbness, tingling, increased pain, or a change in skin color. These symptoms indicate the garment may be too tight or that an underlying condition is being aggravated. Consulting a healthcare provider is necessary if these signs appear.