What are the disadvantages of compression? A Comprehensive Guide

September 22, 2025 •

5 min read

While compression therapy is a beneficial tool for managing many circulatory issues, studies show that adverse events can occur, especially with incorrect usage. Understanding what are the disadvantages of compression is vital for all users, enabling you to recognize potential problems and use garments safely and effectively.

Quick Summary

Potential downsides of compression therapy include skin irritation, pain, impaired circulation, and nerve damage, primarily resulting from improper sizing or extended wear. It is crucial to monitor for adverse effects and follow a healthcare provider's guidance for safe application and usage.

Key Points

Improper Fit: The leading cause of compression disadvantages is wearing garments that are too tight or bunch up, restricting circulation instead of improving it.
Circulation Compromise: Incorrectly sized or worn compression can create a tourniquet effect, impeding blood flow and potentially causing numbness, tingling, and pain.
Skin Problems: Common side effects include irritation, chafing, itching, and an increased risk of bacterial or fungal infections, especially with extended wear or poor hygiene.
Nerve Damage Risk: Excessive and prolonged pressure, particularly over bony prominences, can compress nerves, potentially leading to permanent nerve damage in severe cases.
Contraindications: Individuals with conditions like severe peripheral arterial disease (PAD), uncontrolled heart failure, or severe diabetic neuropathy should avoid compression therapy unless specifically advised and monitored by a physician.
Pain and Discomfort: New or improperly fitting compression garments can cause significant discomfort, which often leads to poor patient compliance and discontinuation of treatment.
Regular Monitoring: Daily checks for skin changes, such as discoloration or irritation, are crucial for safe use and to prevent complications.

Introduction to the Risks of Compression Therapy

Compression garments, such as socks and bandages, are commonly used to improve blood circulation, reduce swelling, and manage conditions like varicose veins and lymphedema. However, this therapy is not without its risks. The most significant drawbacks often arise from using the wrong type of garment, improper sizing, or neglecting important health contraindications. Ignoring these factors can lead to discomfort or, in rare cases, serious complications. This guide delves into the specific disadvantages associated with compression and provides information on how to mitigate them.

Skin Issues and Irritation

One of the most frequently reported disadvantages of compression therapy is the range of skin-related issues that can occur. The constant, close contact with the fabric can lead to several problems, particularly for individuals with sensitive skin or pre-existing skin conditions. These issues include:

Skin irritation and redness: Friction caused by rubbing, especially in areas where the garment bunches or folds, can cause chafing, redness, and general discomfort.
Itching: Low-level irritation, moisture buildup, or a pre-existing skin condition can cause significant itchiness, which may be mistaken for an allergic reaction.
Bacterial and fungal infections: The warm, moist environment created under a tight garment can foster the growth of bacteria and fungi, leading to infections. This is particularly a risk in areas with high moisture, such as between the toes. Proper hygiene and changing garments daily are essential preventative measures.
Allergic reactions: Though rare with modern materials, some individuals may have a sensitivity to components in older or certain low-quality compression garments, such as latex or certain dyes.

Compromised Circulation and Nerve Damage

Counterintuitively, improperly worn compression can restrict blood flow rather than improve it. This is a critical risk that must be monitored closely.

Restricted blood flow: When a compression garment is too tight, or if the top rolls down and acts as a tourniquet, it can constrict blood vessels and impede circulation. This can cause numbness and tingling and can be particularly dangerous for individuals with pre-existing peripheral arterial disease (PAD).
Increased swelling: If compression ends abruptly at a joint (e.g., a knee-high sock on a patient with knee swelling), it can force fluid to pool above or below the garment, potentially worsening localized edema. Forefoot and toe edema can also occur if these areas are not properly compressed.
Nerve damage: Sustained, excessive pressure from an ill-fitting garment can compress nerves, leading to tingling, numbness, pain, or even nerve palsy. The common peroneal nerve at the fibular head is particularly susceptible to this type of injury, with foot drop being a possible outcome in severe cases.

Pain, Discomfort, and Patient Non-Compliance

Proper patient adherence is critical for the success of compression therapy, but certain disadvantages can hinder this process.

Discomfort and pain: The sensation of constant pressure can be uncomfortable for new users and may take time to get used to. If the garment causes sharp pain or significant discomfort, it is likely the wrong size or not applied correctly and should be adjusted immediately.
Difficulty applying and removing: High-pressure garments can be difficult to don and doff, requiring significant physical effort. This can be a barrier for elderly individuals or those with limited mobility, leading to poor compliance.
Impact on independence: Relying on assistance for daily tasks like putting on and taking off garments can reduce a person's sense of independence and overall quality of life.

Who Should Not Wear Compression?

It's important to be aware of contraindications and consult a healthcare professional before beginning compression therapy. Individuals with certain conditions should avoid or be extremely cautious with compression garments.

Severe Peripheral Arterial Disease (PAD): Compression can further reduce already limited arterial blood flow, potentially causing tissue damage or necrosis.
Severe Heart Failure (NYHA Class IV): In this condition, shifting fluid volume can place undue strain on the heart.
Severe Diabetic Neuropathy: Patients with reduced sensation may not feel pain or pressure points, increasing the risk of unnoticed tissue damage.
Active Infections: Compression should not be used over open, infected wounds as it can potentially spread the infection.

Comparing Different Compression Grades and Risks

Not all compression garments are the same. Their associated risks can vary based on the pressure level. The pressure is typically measured in millimeters of mercury (mmHg).


Compression Grade	Pressure Range (mmHg)	Typical Use	Associated Risks
Mild	8-15	Mild swelling, travel, minor fatigue	Low risk of side effects; typically limited to minor skin irritation from improper wear.
Moderate	15-20	Moderate swelling, post-exercise recovery	Increased risk of skin irritation and discomfort if not sized correctly. Still relatively low risk.
Firm	20-30	Varicose veins, moderate edema	Higher risk of circulatory issues, nerve compression, and tissue damage with incorrect fit. Requires proper sizing and monitoring.
Medical/High	30+	Severe venous disease, lymphedema	Requires medical supervision. Significant risk of severe complications like nerve and tissue damage if contraindications are ignored or application is incorrect.

Managing the Risks of Compression Therapy

To minimize the disadvantages, proper technique and monitoring are essential. Here are some key strategies:

Get a professional fitting: Always have a medical professional or trained technician measure you for medical-grade compression to ensure the correct size and pressure.
Regularly check your skin: Inspect your skin daily for any signs of redness, chafing, or irritation. Immediately address any concerns with your healthcare provider.
Ensure correct donning and doffing: Learn the proper technique for putting on and removing garments to prevent rolling or bunching, which can create dangerous pressure points.
Practice good hygiene: Wash your legs and garments daily to prevent bacterial or fungal infections.
Remove at night: Unless instructed otherwise by a doctor, remove compression garments at night to allow the skin to breathe and circulation to return to normal in a horizontal position.

For more information on venous conditions and related care, refer to authoritative health resources such as the American Vein and Lymphatic Society.

Conclusion

While compression therapy offers significant benefits for managing various circulatory conditions, the potential disadvantages highlight the importance of informed and careful application. Skin issues, discomfort, and risks of serious circulatory or nerve damage can be largely avoided through proper sizing, hygiene, and medical consultation. By being aware of these risks and taking preventative measures, individuals can safely leverage the positive effects of compression therapy.

Frequently Asked Questions

Yes, if they are not the correct size or are worn improperly, they can worsen swelling. For example, if a knee-high sock is too tight at the top, it can create a 'tourniquet' effect, causing fluid to pool below the constricted area and increasing lower leg and ankle swelling.

Signs include pain, numbness, or tingling in your extremities. Your skin may also become pale, blue, or discolored. If the garment leaves deep indentations in your skin or is difficult to put on, it is likely too tight.

Wearing compression socks for prolonged periods, including overnight (unless prescribed), can increase the risk of skin irritation, chafing, and infections due to moisture buildup. For most over-the-counter socks, they should be taken off at night.

People with certain medical conditions should avoid or use caution with compression. This includes those with severe peripheral arterial disease (PAD), uncontrolled congestive heart failure, severe diabetic neuropathy, or an active skin infection.

Yes, excessive or improperly applied compression, especially over bony areas like the fibular head, can lead to nerve damage, resulting in symptoms like numbness, tingling, or foot drop.

If your compression garment causes pain, you should remove it immediately. The pain is a clear sign that the fit is wrong or the pressure is too high. Consult your doctor or a fitting specialist to re-evaluate your sizing and compression needs.

To prevent irritation, ensure the garment is properly fitted and made of a breathable material. Maintain good skin hygiene by washing your skin and the garment daily. Regularly moisturize your legs and check for any signs of redness or chafing.