As a therapist, the easiest way I can help ease pain, inflammation and swelling for my patients is by fitting them for some sort of compressive glove, sleeve or wrap.
It’s cheap, easy and has a pretty immediate effect. But how is such a simple intervention such a powerful tool?
How does it work?
The most obvious and primary function of compression is to restrict blood flow to an area and increase pressure in the area being compressed so that swelling is pushed out.
The hands especially are so far removed from the heart that the circulatory system is not very efficient at pushing fluid out of the area and the lymphatic system becomes overwhelmed very quickly.
People are often caught off guard by how diffuse swelling can become in the hand after an injury and how long it takes for the swelling to resolve. Edema (excess fluid trapped in an area of the body) gets into the small joint spaces of our fingers and wrists and can cause a fair amount of discomfort and stiffness.
If you wear a compression glove then it will increase the internal pressure of your hand relative to your forearm which will encourage the fluid in your hands and fingers to travel proximally up your arms where it can be more efficiently transported by your lymphatic system and eventually processed by your circulatory system.
Flushing out inflammatory agents
By increasing the velocity of the blood that flows through our blood vessels, compression also decreases the presence of malingering inflammatory agents and other pain-causing cells that like to nestle in our joints and tissues.
Because external compression narrows the diameter of blood vessels, it can increase local blood pressure (not systemic blood pressure!) much like putting your thumb over the end of a hose will increase the velocity of water coming out.
This increased velocity of flow can help flush out the cells proteins that may be taking up space but our lymphatic system is too overwhelmed to transport out.
Finally, compression can help reduce pain directly by firing nerve receptors in the area that can interfere with the transmission of nerve impulses that cause pain, called “nociceptors”.
It’s basically the reason that our first impulse when we bang our shins on a table our first instinct is to press and rub our shin.
The “gate-theory” of pain control posits that the route taken by impulse from nociceptive nerve pathways are interfered with when we activate the larger receptors that sense pressure in the same area that painful stimuli is coming from.
This can be exceedingly helpful for people with a chronic pain issue, like arthritis, that wants fairly quick relief from pain to stay functional and to keep moving.
Don't overdo it
As with most things, compression can be overdone so make sure any compression garments or wraps you try aren’t causing numbness, pain, or excessive swelling somewhere else. This can be a particular problem with compressive sleeves for elbow pain and swelling.
When in doubt, consult your physician or schedule an appointment with a physical or occupational therapist to find the right fit for you.