For physicians, therapists and patients
Compression is safe and effective for most people, but for some patients it can cause harm. Checking for a few key conditions before prescribing or fitting compression protects patients.
Conditions that need caution
Peripheral artery disease (PAD)
Compression squeezes the leg, which can reduce blood flow in patients whose arteries are already narrowed. In severe PAD, this can cause pain, skin breakdown or tissue damage.
Check an ankle-brachial index (ABI) in patients with risk factors such as diabetes, smoking, high blood pressure or weak pulses.
Severe PAD generally rules out standard compression.
Mild to moderate PAD may allow reduced compression under close supervision.
Heart failure
Compression moves fluid from the legs back into circulation, which adds work for the heart.
Uncontrolled or decompensated heart failure is a reason to avoid compression until the patient is stable.
Well-controlled heart failure may allow compression with the cardiologist's approval, often starting at lower pressure.
Peripheral neuropathy
Patients with reduced feeling in their feet, often from diabetes, may not notice if a garment is too tight or rubbing.
Use extra caution with compression level and fit.
Teach patients or caregivers to check skin daily for redness, marks or sores.
Other situations to watch
Active skin infection such as cellulitis, until treated, as directed by the provider
Fragile skin or open wounds, unless the product is designed for wound care
Allergy to garment materials such as latex
New, unexplained swelling, which should be evaluated for DVT, heart, kidney or liver causes before compression
Warning signs for patients
Take the garment off and call your provider if you notice:
Pain, numbness or tingling
Toes or fingers turning pale, blue or cold
Blisters, sores or deep marks that don't fade
Shortness of breath or chest discomfort
How Midwest Compression can help
We review each prescription and patient history before fitting and will reach out to the provider if we have concerns. Email customersupport@midwestcompression.com or call 800-883-1549.
Need forms? Find every measurement form, sizing guide and order form on our Measurement & Sizing Forms page, and manufacturer charts on our Size Charts page.
This article is general information and not a substitute for medical advice or clinical judgment.
