Compression Stockings and Pneumantic Pumps for Swelling

We frequently have patients ask us at, what is the difference between a compression garment and a lymphedema pump? The simple answer is that these are two different solutions to reduce swelling in your arms and legs. As an example, let’s begin with the knowledge that humans have stretchy skin and that lymphedema is the result of the body’s retention of fluids which causes swelling of the legs and arms. In order to get rid of excess fluid in the limbs, first a controlled, external pressure must be applied to the limb, which can be accomplished with both solutions. When compression garments are utilized, several layers of materials including compression bandages, plain or paste bandages, multi-layer bandage regimens, and finally compression stockings, gantlets and gloves are placed on Caresia Bandage Liner transitions from a reduction tool to night time garement for lymphedemathe affected extremity. The number of layers required can be reduced by using the Caresia Bandage Liners under the bandages. Our good friends at tell us that there are two phases to each pump treatment.  “The preparatory phase, which must be performed first, is Manual Lymph Drainage to prepare the lymphatic vessels to receive the fluid that will be moved by the drainage action of a pumping. When the preparatory phase is not completed properly, the lymphatic system is not ready to receive and transport the lymph that is moved by the pump. When this happens, the lymph is forced into the surrounding tissues where it can cause additional damage.A pneumatic pump is sometimes necessary to maintain control lin ymphedema

In a home setting, the preparatory phase is performed by the patient as self-massage, or by a caregiver as Simple Lymph Drainage (SLD). This preparation must be carefully completed to prevent any damage to the tissues.

In the drainage phase, the pump settings are adjusted to the appropriate pressure level before the garment is donned. Then the pump is activated for the appropriate period of time while the patient rests comfortably with the affected limb in the recommended position.

The movement of the pump stimulates the flow of the excess lymph out of the affected limb as if were flowing following the movements of the muscles. When the lymphatic system has been properly prepared, this fluid will flow into the lymphatic vessels and eventually be returned to the bloodstream.

After a session on the pump is finished there are still two more step to be completed:

First: Remove the pump garment and then perform a brief M-L-D session on yourself by working from the end of the treated limb upward toward the terminus to help the released fluid return to the cardiovascular system.

Second: Put on a compression garment. If you use the pump in the evening, put on your night compression garment (the Caresia Bandage Liner transitions to a night time garment or a JoViPak garment). If you use the pump during the day, put on the knit compression garment that you wear when you are active.

Lymphedema garments are necessary after reduction of swellingUnless you complete these steps, the fluid released by the pump will flow back into the tissues instead of draining properly as it returns to the circulatory system. And, unless you don a compression garment, the tissues will soon be swollen again.”  This is simply what many of us must do in order to maintain limb size. You can take a barrel full of water pills, but excess fluid will never leave your limbs without applying external pressure.

There are many different reasons a limb or other body part can swell. If constant compressive forces are applied to a limb so as to produce higher levels of compression at some sites on the limb, and lower compression at other sites, the compression is termed gradient compression. We carry the top four major manufacturers of gradient compression stockings – Jobst, Mediven, Sigvaris and Juzo. True gradient compression stockings have the greatest compression at the ankle with the compression gradually decreasing up the limb, thus improving circulation, helping to maintain limb size, keeping excess fluid from accumulating in the limbs, and improving overall health.  Keeping the fluid off your extremities by maintaining constant compression  helps your heart, lungs, and kidneys not to be compromised. The effectiveness of compression therapy depends mainly on the exerted pressure and the knitted material the garments are made from. This is the reason that some people need flat-knit garments rather than round-knit (circular knit) products, for more static stiffness. Don’t confuse static stiffness with stiff material, as most high-end compression garments, like the Jobst, Mediven, Sigvaris, and Juzo products we carry at are soft to the touch.

What is the fluid, when I swell? This is another common question. Some refer to swelling as water retention, when in fact, what you are retaining is water and lymph fluid. Lymph fluid contains water and waste fluid, so it is of the utmost importance to rid your body of these excess fluids to maintain a healthy body and immune system. Compression stockings can help you do this.

So in order to maintain limb size, a constant force is necessary throughout the day, every day, and a lymphedema pump, or pneumatic compression device is not a constant force, is very expensive, at best only partially covered by insurance plans, and is not mobile. Perhaps in conjunction with properly fitted compression garments, a pump might be helpful but it is not constant enough in order to maintain correct limb size, and keep your limbs from swelling. Therefore the most practical way of maintaining your reduction is to wear properly sized, comfortable compression garments daily.

If you feel you are experiencing signs of undiagnosed lymphedema, consult your physician or lymphedema specialist and then call us for assistance.

Shop at for the Best in Compression Garments

Or call us at 1-800-515-4271, and one of our Certified Fitters will be happy to help you.

Vanda and the Support Hose Store Team

10 Responses

  1. I went through compression therapy a couple of years ago. It worked well. I went on to use the Jobst stockings (knee high). I tried for about six months but found the stockings to be so uncomfortable. I am overweight and the stockings cut deeply into my ankles and at my knee. Slowly the fluid returned and I am back where I started. Is there any way to deal with the discomfort? I tried putting wraps under the stockings and even over the stockings. My job requires me to sit all day and the pain of the stockings was too much to bear.

    • Hi Ronnie,
      Apparently the stocking was not a good fit. Sounds as though you are back where you started. You really do need to be bandaged again to reduce, but another choice might be the Medi CircAid. We have used this product at times to replace bandages and then used it for a night time garment when the patient transfers to a compression sock. I hope you still have a good relationship with a therapist and can discuss this with the therapist.

  2. I used to wear compression knee highs all the time. I nursed for 27 years and felt it was really important to take care of my legs. The first pair I bought are my favorite. I should probably wear them daily. I don’t know what brand they are and can’t seem to find any like them. They are white and have the extra room in the toe. I’ve bought three other pair of different ones, which I don’t care for. The reason is, I am only 5 feet tall and have a 6 and 1/2 shoe size. Almost every pair of knee highs are to long and if I keep them flat, they roll behind my knee and are really uncomfortable and the heel of the sock is up behind the back of my ankle. I can’t seem to find any for people with shorter legs. I often have a problem getting shoes to fit as well. There is usually the standard size 7 and up. Any ideas??

    • Hi Donna,
      We do carry many garments for shorter people. They start at a 15-20mmHg compression and are very comfortable. Please call our customer service at 1-844-472-8807 with your measurements and our fitters will be pleased to guide you to a product which will be more comfortable for you!

  3. Hello,

    I appreciate your knowledge. I have lymphedema in my right leg only for unknown reasons. I wear the compression hose (thigh high) all day and do the pump every morning for 30 minutes. The swelling is less than it was. I was in the hospital 3 times 2 years ago with infections. I’m 51 years of age, low in excess body fat and exercise most mornings for 25 min on the machine at the club.

    Any ideas what I can do or change? I read that you advise to do the MDL after the pump – maybe you can explain more about that.

    Thank you,


    • Hi Sherry,

      Thank you for asking. A person does not have to be heavy to have lymphedema as you can attest. Have you ever seen a lymphedema therapist? MLD is usually taught to patients by MLD Therapists as each person is different an requires a different program. Usually there is a preparatory phase of MLD to prepare the lymphatic vessels to receive the fluid that will be moved by by the pump. After pumping there is once again MLD to release the lymph into the circulatory system. I encourage you to visit a lypmhedema therapist to learn MLD.

  4. Getting ready to order more compression hose soon. I usually buy Jobst knee high 20-30 but my arthritic hands are making it harder and harder to put on even with the foot sleeve. I have had 2 DVT blood clots & 2 superficial in the past and probably should wear 30-40 but can’t get them on at all. I like Jobst, but are any others easier to put on?
    Thank you, Cecile

    • Hi Cecile,
      The Jobst Opaque and the Mediven Comfort are both stockings that are easier to get on, but they are not sheer like you have been wearing. They are both available in open toe.
      You might want to consider the Jobst Stocking Donner to don your stockings.

      Thanks so much, Vanda

    • In addition to the foot sleeve I have found the donning gloves a complete necessity for ease in putting stocking on. Do you have these special gloves?

      • Hi Mary Lou, Thanks for contacting Support Hose Plus. We do have the special gloves. I like to call them my magic green gloves! Here is the link to the Sigvaris Donning Gloves. I could not put on my stockings without them. Vanda

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