Compression Therapy Unit – What Is It For, How to Choose?

The compression therapy unit is known by several names in our country, such as pressure therapy device, wave therapy device, or compression therapy device. However, all these terms refer to the same equipment. They can be used in medical clinics, cosmetic-beauty practice, and for home treatment as well. In this article, I write about what you should know before purchasing a compression therapy unit.

The term "compression therapy unit" used in our country is misleading because the device is not only applicable for patients with lymphatic disorders but also for various conditions! For example, fat oedema (lipedema), venous insufficiency, pregnancy-related varicose complaints, post-thrombotic syndrome), limb swelling due to stroke, improvement of muscle regeneration, and wellness treatments are among these.

What Is Compression Therapy For?

Compression therapy, especially the mechanical compression therapy or pneumatic compression therapy, is a treatment method particularly useful for lymphoedema and several other (vascular-origin) circulation problems.

The mechanical compression therapy enhances the flow of lymph fluid in the lymphatic system and assists in draining excess fluid from the tissues. This reduces the extent of oedema and swelling.

The treatment acts not only on the lymphatic system but also supports blood circulation, which can be especially beneficial in venous insufficiency.

The compression therapy unit is not intended for strong muscle kneading, i.e., it does not replace a sports masseur! If you desire strong muscle kneading, visit a masseur! The compression therapy unit is a device for supporting and improving blood and lymph circulation, meaning a pressure of maximum 60-80 mmHg should be applied.

What Is the Compression Therapy Unit?

The compression therapy unit is essentially a medical air compressor. The pressure can be regulated very precisely according to medical treatment requirements.

Various treatment cuffs can be connected to it, which have air chambers into which the compressor pumps air. The individual chambers can be inflated separately, one by one, or simultaneously. The inflated air chamber creates the beneficial effect by compressing the tissues, which triggers the movement and direction of blood and lymph.

How to Choose the Right Setup for You?

You need to make several decisions.

1. Which compression therapy unit?
2. What type and size of cuff do you need?
3. Are additional accessories necessary?
   

1. Which Compression Therapy Unit Should You Choose?

You always need the device first; that is, decide which compression therapy unit to buy.

The main differences between devices are:

1. usage
2. number of treated air chambers
3. programmability and the precision of pressure regulation

1. Usage.

There are devices designed for home use and those for institutional use.

In lymphoedema clinics, robust devices designed for continuous all-day operation are generally used. Since the greatest precision is needed in these treatment centers, clinic devices use cuffs with 6, 8, or 12 air chambers. Such devices can cost one and a half to two million forints (Power Q-8120). Clinic assistants are familiar with these devices and often tell patients that only units with 6-12 air chambers are suitable, but that is not the case!

For home use, simpler devices designed for 1-2 hours of daily operation that are lightweight and typically have 4 air chambers are recommended. These are priced approximately between 150,000 to 300,000 forints, including necessary accessories.

An important consideration is the severity of your condition.

If symptoms are mild and you do not have complications (no wounds or ulcers), simple and affordable devices suffice (Power Q-1000 Plus and Power Q-2200). Furthermore, these inexpensive, simple devices are user-friendly, suitable even for older individuals less familiar with technology. For them, the simplest device is better than leaving oedema untreated.

Device Recommendation: Power Q-1000 Plus Compression Therapy Unit

If your lymphoedema is mild to moderate and you want a very simple-to-use compression therapy unit, then this device may be suitable for you.

Click here to learn all about the device! →

In cases of significant overweight, moderately severe to severe oedema, or ulcerated complications, the capabilities of basic devices are insufficient. In such situations, I recommend devices offering multiple configuration options and higher treatment precision (for example, Power Q-2200 or Power Q-1000 Premium). Also choose such a device if you suffer from heart disease, high blood pressure, or arrhythmia, because precise pressure treatment is very important in these cases.

Device Recommendation: Power Q-2200 Compression Therapy Unit

If you need a versatile device that offers multiple effective treatment programs, this device can be a suitable choice. It is especially recommended for wellness purposes.

Click here for more details! →

One more difference: the weight of the device.
Four-air-chamber devices designed for home use weigh about 2-3 kg and are portable, even suitable for travel.
Devices with 6-12 or more air chambers are significantly larger and can weigh 10 kg or more.

2. Number of Air Chambers

The number of chambers in the treatment cuff is important for treatment precision. The more chambers a cuff has, the more finely the lymph flow can be guided. More precise treatment ensures results with shorter treatment times.

However, increasing the number of air chambers steeply increases the price of the device and cuffs and makes operation and configuration more complex. If your budget allows, choose a device with as many air chambers as possible (Power Q-8120).

I am convinced, however, that for most patients, a 4-chamber device is fully adequate for daily home treatment.

3. Programmability

The device's programs are controlled by a pressure sensor. The compressor pumps air into an air chamber and stops once the set pressure is reached, then moves to the next chamber.

The simplest home devices (Power Q-1000 Plus) usually provide a single "program" that inflates the chambers from bottom to top (for foot cuff, starting at the ankle, then calf, then knee, then thigh). The pressure is the same in all chambers. On such a device, you can only set treatment pressure and duration. These simple devices can successfully treat mild oedema, varicose complaints, and post-thrombosis conditions.

If your oedema is more severe and longstanding, refilling rapidly or if complications (fluid discharge, ulcers) are present, basic devices are only a very compromised solution. If feasible, choose a higher-capability device. These are more effective than basic models but also pricier.

Intermediate compression therapy devices (Power Q-2200) provide several inflation programs, but the pressure in all cuff chambers is still set uniformly.

The most effective devices allow pressure to be individually set for each cuff air chamber, control pressure hold time, and adjust resting periods between inflation cycles. Medical studies indicate more effective lymphoedema treatment if higher pressure is applied to the lower chambers than moving upwards. Similarly, pressure hold time should be adjustable so that one cycle lasts at least 45 seconds.

Higher-quality models can set different pressures in each air chamber (Power Q-1000 Premium).

This is especially important for lower limb treatments. Treatment is more effective if a pressure gradient is applied, with higher pressure at the foot than upward, enabling faster lymph flow.

Additionally, on more precise models (Power Q-1000 Premium), pressure hold time is adjustable. Once the air chamber pressure reaches the set value, the device maintains that pressure for a preset duration, increasing the effectiveness of compression and lymph movement. Thus, treatment is more effective with adjustable pressure hold time.

Device Recommendation: Power Q-1000 Premium Compression Therapy Unit

If you want one of the best home compression therapy units, choose this device. It provides all the adjustment modes mentioned and recommended by current medical protocols. Only in rare cases is a more advanced device needed for home use. Feel confident choosing this for any severity of symptoms.

Click here for details! →

2. Treatment Cuffs

Another important aspect is selecting the treatment cuffs.

Obviously, you need to obtain cuffs suitable for your problem. Lymphoedema may affect different areas in each individual, and body type and size also influence your choice.

If your arm is oedematous, you will need an arm cuff in the appropriate size. For leg and torso treatment, other cuffs are used.

Most manufacturers generally offer arm, leg, waist, and pant cuffs for their devices, available in various sizes.

This illustration shows the variety of cuffs available – though not every manufacturer offers them all.

Choose the size that fits you! Measure your circumferences and compare them with the size chart.

Arm Cuff

Arm lymphoedema is typically unilateral, so one cuff may be sufficient. However, if you are purchasing the device as an athlete to improve muscle regeneration, buying 2 arm cuffs is advisable so you can treat both arms simultaneously. The arm cuff has a Velcro strap for fastening under the armpit of the opposite side.

Half-length Leg Cuff

This thigh-length cuff is specifically for treatment after thrombosis (post-thrombotic syndrome). Use can begin approximately 3-4 months after thrombosis to treat residual symptoms. This cuff is applicable for lymphoedema only if swelling extends to the foot or ankle at most. For higher swelling, a long cuff is needed.

Thigh-length Leg Cuff

This cuff is excellent for treating leg lymphoedema, varicose veins, and post-thrombosis conditions. Athletes can use it for muscle regeneration. Depending on whether one or both legs are affected, purchase one or a pair. If "basic" sizes do not fit, extenders can enlarge the size.

Waist Cuff

Purchase this if your lymphoedema extends up to the thigh. In this case, besides the leg, the torso also requires treatment. The cuff is worn like a belt, starting where the thigh cuff top ends. It is also used for cellulite treatments, although pants cuffs are more effective.

Pant Cuff

This enhances treatment of the upper thigh, buttocks, and lower abdomen. It is an optimal supplement to beauty treatments, especially for cellulite and post-cavitation therapy.

How Often Can Mechanical Compression Therapy Be Applied?

Mechanical compression therapy should be applied as needed. That means treating as soon as you feel tension or swelling.

If you wait for intense tightness and swelling, it will be much harder to reduce!

Depending on how fast swelling returns, you can treat multiple times a day! Usually, 20-30 minutes per session is sufficient, and the daily total treatment time (on the same limb) should not exceed 120 minutes.

Shorter, more frequent treatments are recommended rather than one long session.

Appropriate Treatment Pressure

As I mentioned earlier: the compression therapy unit is for improving lymph and blood circulation. Compression therapy does not substitute sports massage, i.e., strong, painful pressure should not be applied. The goal is to improve and stimulate venous and lymphatic circulation, which requires low pressure.

Most medical studies state that compression therapy treatment should be performed at pressures between 40 and 60 mmHg. Obviously, the lower the pressure, the longer it takes to achieve an effect. (If you're driving at 60 km/h, you arrive slower than at 120 km/h.)

High pressure, above 100 mmHg, will worsen your condition and can make lymphoedema untreatable over time!

Moreover, excessive pressure increases heart strain, so especially in heart disease, hypertension, lower than 60 mmHg is recommended. This low pressure is still effective for lymphoedema!

If your device allows it, set cuff pressures so that lower air chambers have higher pressure, decreasing upwards. For example, in a 4-chamber cuff: 60-50-50-40 mmHg (foot - calf - knee - thigh), and for 6 chambers: 60-60-50-50-40-40 mmHg per chamber.

Treatment session is 20-30 minutes. Usually, swelling reduces within 10-15 days.

However, this does not mean you can stop treatment! Swelling returns, so the compression therapy unit should be used daily for life to suppress swelling and avoid constant symptoms.

Recommended Treatment Pressure Ranges

The purpose of the compression therapy unit is to improve blood and lymph circulation, which does not require high pressure; in fact, high pressure is unfavorable. Perform treatments according to your doctor or therapist's instructions. If you have none, follow general guidelines.

Frequently Asked Questions

When is mechanical compression therapy contraindicated?

Mechanical compression therapy is contraindicated in some cases and should be applied with greater caution and lower pressure in others.

It must not be used in fresh deep vein thrombosis on the limb or body part where thrombosis developed. External pressure can "dislodge" the blood clot, leading to life-threatening pulmonary embolism.

In bacterial or fungal skin infections, massage may spread pathogens, worsening inflammation.

In heart failure, post-infarction states, cardiomyopathy, and uncontrolled hypertension, mechanical compression therapy can be used cautiously. Only one cuff should be used at a time to avoid overloading circulation; treatment will take longer but safer. Further, maximum pressure should be 40-50 mmHg, i.e., treat at lower pressure but longer duration ("slower progress but steady").

I have an old single-chamber compression device; can I use it for lymphoedema?

First-generation compression devices targeted arm, leg, or foot swelling. The cuff inflated and deflated entirely at once. They were included in basic lymphoedema treatments. However, it soon became evident that simultaneous full inflation creates excessive pressure, potentially damaging lymphatic vessels and nodes over years, especially in congenital lymphoedema. Thus, lymphoedema therapists prohibit using old-type pumps.

Modern devices inflate the cuff in segments and the pressure is precisely regulated and tailored to patient condition. Use up-to-date devices!

My therapist says mechanical compression therapy is forbidden. Is that true?

No medicine, device, or treatment method works identically for every patient.

There have always been clinicians, therapists, and patients who did not get good results with the device and do not recommend it. However, many successful treatments are recorded too. Devices are not appropriate for everyone, and successful treatment depends on the device's precision and settings used.

Incorrect settings can cause harm (too high pressure) or be ineffective (too simple device, short treatment duration, etc.).

THE KEY IS HIGH-QUALITY EQUIPMENT AND PROPERLY SET TREATMENT!

My therapist says the device worsens oedema and cannot start lymph flow. Is it true?

This statement is inaccurate in this form! As mentioned above, incorrect treatment can cause complications, but correct, state-appropriate settings do no harm.

The latest medical textbook (Evidence-Based Physiotherapy, Tamás Bender, 2017) states that manual lymphatic massage's effectiveness lacks medical evidence and is practiced out of tradition.

In contrast, many studies confirm the devices' effectiveness.

In my opinion, there is no single "perfect" method! Mechanical compression therapy alone can achieve 60-70% symptom reduction but requires additional methods such as bandaging, compression stockings, therapist-performed manual lymphatic drainage, self-massage, etc. This article discusses home treatment options.

All these contribute some percentage to overall improvement. The more methods you use, the closer you get to normal limb circumference.

It is wrong for a therapist to prohibit a treatment based on inaccurate or incomplete information that could help the patient. If lymphoedema is not treated properly, the patient suffers the consequences.

Facts confirm that properly set and good-quality mechanical compression therapy units provide effective symptom relief and incorrect information may discourage patients. Despite opposing opinions, clinical evidence affirms that well-configured devices help hundreds of thousands.

It is important to verify that your device has proper capabilities and to use it correctly! It's not complicated. You will find several articles and videos on my blog about this topic.

Can mechanical lymphatic drainage be used on children?

Compression devices are not recommended for infants and children under 6 years old. Here, general decongestive therapy (combining bandaging, compression stockings, and manual lymphatic drainage) should be applied.

How important is pressure gradient?

Devices that allow pressure gradient setting are the most suitable for reducing lymphoedema. A device without this feature is not ineffective but less efficient than those with it.

What is mechanical treatment comparable to?

Unlike blood vessels, the lymphatic system has no "built-in motor"—the heart pumps blood through blood vessels. The lymphatic system depends on muscles; muscle contraction keeps lymph moving. When a muscle contracts, it compresses the lymph vessel and lymph fluid moves upward. Alternating compression mimics natural lymph flow via muscle pumping.

I do not move at night. How does lymph flow then?

Muscles are regulated by your brain. A few percent of muscle fibers remain active during deep sleep, performing fine contractions. You don't feel or see this twitching but it maintains lymph and blood flow. Thus, flow does not cease even during sleep.

How to set appropriate treatment pressure for lymphoedema?

Your blood pressure measurement can be a good guideline. For example, if it's 120/80, the 120 represents the pressure when your heart contracts and pumps blood into arteries. The 80 is the pressure when the heart rests between beats.

NEVER set treatment pressure higher than the lower value! In fact, set it 20-30% below. So, for 120/80, the maximum pressure in the lower cuff should be 55-65 mmHg and decrease upwards toward thigh or upper arm.

Some therapists recommend even lower pressure for the arm, max 40-50 mmHg.

High pressure causes rapid fluid shift and overloads tissues above, worsening condition over time. Higher pressure is not better.

In cases like fibrosis, higher pressure may be needed to soften hardened tissue. Severe fibrotic conditions require treatment under professional therapist supervision.

How long should I use the device daily?

If you can only do one session daily, do it before bedtime. You may notice that swelling is considerably less in the morning (during sleep, fluid drains from your limb).

If possible, split treatment into two – one early afternoon, the other in the evening.

Session length can range from 20 minutes to an hour depending on desired effect. Lower pressure needs longer time. For most, half to two hours daily is sufficient. Use longer treatment only on therapist recommendation.

Multiple shorter sessions are better to prevent swelling fluctuations. If you wait too long with treatment and swelling is high, reduction is harder. Frequent treatment prevents excessive swelling.

Every case is different and requires tailored treatment! Only change your therapy if instructed by your lymphoedema therapist.

Can I use the compression therapy unit with ulcers or open wounds?

The compression therapy unit can be used for venous ulcers or open skin wounds if there is no infection and no signs of cellulitis. Wounds or ulcers must be covered with dressings during treatment. Treatment cuffs must be cleaned and disinfected after use.

In case of active skin infections or inflammation (e.g., erysipelas), compression massage is contraindicated as pressure may spread pathogens on skin or into bloodstream causing sepsis.

Signs of active infection: localized swelling, pain, redness, pus, red streaks on skin. If present, do not use the device and consult a doctor immediately. Antibiotic therapy is required.

My lymphoedema and leg ulcer doctor forbids compression therapy unit use. Why?

Probably the prohibition was not carefully considered or the doctor doesn't understand how compression devices work.

Lymphoedema causes swelling, representing a severe circulation problem. Slow circulation results in easy infection and poor healing of leg injuries in lymphoedema.

If swelling is not reduced – which the device treatment does – healing cannot be expected as poor circulation is the cause.

Therefore, ulcer healing is achievable by improving circulation and reducing tension – i.e., by mechanical massage.

I had a lymphoedema treatment at my beautician and afterward my leg stiffened and hurts. What caused this?

Beauticians are not authorized to treat lymphatic diseases; this is only a small part of the problem. The bigger issue is if they lack the knowledge and don't know what they're doing. Post-treatment pain and stiffness indicate inappropriate (too high) pressure.

A single poorly performed treatment may not cause lasting damage. But regular improper treatments can rapidly worsen your condition and make oedema untreatable within months.

Seek a qualified specialist!

I had a lymphoedema treatment at my beautician and afterward my varicose veins became inflamed and painful. What caused this?

Pain and inflammation of veins indicate the treatment was done at too high pressure and carelessly. Your dilated, tortuous veins were "roughly handled" by the device. Ice the area for 2-3 days and limit activity (no workouts, walking is allowed). Until superficial vein inflammation heals, avoid further mechanical or manual massage.

Instead of unqualified beauticians, see a lymphoedema therapist!

I had a headache during mechanical treatment! What caused this?

This results from too high treatment pressure or treating too large an area at once (e.g., both legs and torso). Blood is displaced from your legs and even torso, raising blood pressure. Headache is the first symptom! Continuing treatment at excessive pressure can lead to chest tightness, difficulty breathing, and in extreme cases, cardiac arrest!!!! Yes... incorrect mechanical compression therapy application can be fatal.

Find a treatment center that pays more attention to correct settings and treatment. Stop treatment immediately if you experience headache and inform the therapist.

Hypertension does not exclude mechanical treatment but pressure should be lower than usual and treatment area reduced. Treat one leg at a time, then the other, finally the torso. This means three separate sessions, tripled time but no symptoms.