While many people are familiar with compression socks and stockings, there are also compression garments for the upper extremities. Similar to those for the legs, compression sleeves, gloves and gauntlets create a graduated pressure in the arm and/or hand that can reduce swelling (edema), pain and fluid retention. They can also increase lymph flow. They’re primarily used for medical conditions that cause blockage in the lymphatic system like lymphedema and for some circulatory system disorders.
A compression sleeve is a fabric tube in a flexible material, usually a seamless circular knit. Depending on style, some feel softer, others will be firmer. The sleeve is tighter at the bottom, closer to the hand, than it is at the top. This is called graduated compression and it helps lymph move in the right direction, towards the heart. It also improves circulation. The sleeve attaches either with a shoulder strap, or with an elastic or silicone top band. The silicone band, which has dots of silicone that act as grippers, is the best way to keep a sleeve in place. Elastic works well, too, for those who can’t wear silicone. To add pressure in the hands, a doctor may recommend a gauntlet, which goes from the wrist to right below the fingers, or a glove, which is shaped just like the type of fingerless glove many people wear in winter.
Like other compression garments, arm sleeves are offered in several levels of compression. You’ll see pressure measured in mmHG, millimeter of mercury. Compression usually ranges from 15 mmHg through 40 mmHg. The lower the number, the milder the pressure.
Most manufacturers offer sleeves, gauntlets and gloves in skin tones, and some brands, like Lymphedivas, are known for making a fashion statement as well, with vivid colors and bold patterns. So you have the style choice of blending in or standing out.
Some people will find that wearing a sleeve or sleeve/gauntlet combination during the day doesn’t control symptoms enough. In that case, your healthcare professional may recommend a nighttime sleeve. These are made somewhat differently. They’re bulkier than daytime sleeves because mobility isn’t a factor during sleep. Nighttime sleeves are made of padded material and foam and held on with straps that adjust the pressure. They look similar to an air cast.
Breastcancer.org describes disagreement among experts as to whether it’s a good idea to wear daytime sleeves at night. Some feel the lighter daytime sleeve could shift or bunch up during sleep, while others think it works just fine.
With the various compression levels, materials and construction of compression sleeves, it has become much easier to customize treatment to control symptoms like swelling and pain.
What do compression sleeves do?
The compression in the sleeve helps reduce swelling and also applies the pressure needed to improve the flow of lymph fluids. Compression increases the ability of your muscles to pump efficiently, which encourages lymph flow. Compression sleeves can also prevent the development of swollen and painful arms and hands if worn proactively. Research that shows that graduated compression also puts pressure on blood vessels, which adds oxygen and aids circulation.
What are they used for?
The most common reason to use an arm sleeve is Lymphedema.
Your lymphatic system is a one-way system that moves lymph fluid up towards the neck. On the way, it removes debris, dead blood cells, excess fluids, viruses, toxins, cancer cells and other waste. Lymph nodes filter the waste products and excess fluid and then send lymph on its way to the subclavian veins at the base of the neck. Lymph vessels allow immune cells to move through the system to wherever they’re needed. Lymphedema, the swelling in an arm or leg, is caused by a blockage of the lymphatic system that slows or stops the process.
According to the Mayo Clinic, there are two types of lymphedema, primary and secondary.
Primary lymphedema is very rare and is an inherited condition. It’s typically brought on by a few (also very rare) diseases:
- Milroy’s Disease, which causes abnormal development of the lymph nodes
- Miege’s Disease causes lymph system to develop without valves, so the body can’t properly drain lymph fluid from arms and legs.
- Late onset lymphedema–extremely rare, begins after age 35
The much more common lymphedema is secondary lymphedema and there are several causes. The most common is removal of the lymph nodes or damage to either nodes or lymph vessels.
The main causes of secondary lymphedema:
- Infection of the lymph nodes, which is more common in the topics and subtropics
- Cancer, such as a tumor growing near a node or vessels
- Radiation treatment for cancer which can cause inflammation or scar lymph nodes
- Surgery that includes cutting or removing lymph vessels or nodes. Surgery for breast cancer may involve removing lymph nodes in the armpit, which can cause lymphedema.
The damage to lymph nodes or the lymph vessels can’t be cured, but it can be controlled and that’s where compression arm sleeves come in.
When lymph can’t drain normally, it accumulates and results in swelling and pain. A compression sleeve provides pressure that increases the pumping efficiency of muscles and keeps lymph moving in the right direction.
Lymphedema and Breast Cancer
According to the National Institutes of Health, mastectomy and removal of underarm lymph tissue is the most common cause of lymphedema, affecting 10-15% of patients. Along with manual lymph drainage and range of motion exercises, the use of compression bandages and garments is recommended to treat the chronic swelling that lymphedema causes. For more detailed information about breast cancer and lymphedema, check out BreastCancer.org.
The need for compression sleeves and gauntlets is so great that there are even some resources out there that offer free compression sleeves and gauntlets to low-income breast cancer patients and survivors.
Other Medical Uses of Compression Sleeves
Along with blockage of the lymph system, other conditions can cause swelling of the arm and hand. Inflammation of a vein—phlebitis—is caused by a blood clot and usually affects superficial veins, close to the surface. A deep vein thrombosis (DVT) however can be serious, in some cases leading to a pulmonary embolism. Along with medication for pain and inflammation, your doctor may also recommend the use of a graduated compression arm sleeve to put pressure on veins and boost circulation.
Compression Sleeves and Sports
There’s a lot of debate about the benefits of compression sleeves in sports. The theory, as explained in Competitor.com is that pressure on the blood vessels forces more oxygen and helps discard waste: the greater the blood flow, the more oxygen reaches the muscles. Compression sleeves saw a big boost in popularity when Allen Iverson wore an arm sleeve after elbow surgery in the 2000-2001 NBA season. Compression kept his muscles flexible and warm and protected his arm against further injury. Now commonly known as a shooting arm sleeve, you’ll see compression sleeves on almost any basketball court.
How to Wear Compression Sleeves
Like compression hosiery, there are specific ways to use compression sleeves, including when and how to wear them. The sleeves are available in different weights, different levels of compression and styles, including sleeves with or without gauntlets. Your healthcare professional will help you determine which type of sleeve is best for you.
In cases of lymphedema, you may need to wear a sleeve all day to control symptoms. For people who have no symptoms, but are at risk for lymphedema, a sleeve may be recommended only under conditions that increase lymph production, like vigorous exercise, activities that require repetitive motion and even during air travel.
As we mentioned before, there’s some disagreement about the use of daytime sleeves overnight, but you and your healthcare professional can make that decision.
How Do I Put It On?
Because of the compression, arm sleeves don’t just glide up your arm like shirtsleeves. They need to be eased up over the hand, not pulled from the top. Keep the sleeve from rolling or bunching as you go. Some people find it helpful to wear a rubber glove on the opposite hand to help ease and smooth out the sleeve. It’s a good idea to have two sleeves and wear each every other day. With proper care, a compression sleeve will last about 4-6 months.
When NOT to Wear Compression Sleeves
There are several contraindications for wearing compression sleeves. An ill-fitting sleeve won’t reduce swelling and can damage skin. MacMillan Cancer Support lists several conditions to be aware of:
- Skin is fragile or shows damage like pitting or folding
- Skin is leaking lymph fluids
- Arm is very large or irregularly shaped
In some cases, your doctor may recommend lymphedema bandages, which are special multi-layered bandages with lining and padding. These need to be put on every day, usually by a lymphedema therapist. A regimen of bandaging and lymphatic drainage massage can reduce limb volume enough to use a compression sleeve. BreastCancer.org has a good discussion of the difference between compression bandages and compression sleeves.
There are so many styles and compression levels of arm sleeves on the market that you and your doctor should easily find a ready-made sleeve that will be effective for you. Ames Walker has arm sleeves, including gauntlets, from various manufacturers, so it’s a good place to find what you need.