Compression Stockings
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Compression Stockings
Medically Reviewed by Carol DerSarkissian, MD on July 28, 2021
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People wear compression stockings for comfort, to do better in sports, and to help prevent serious medical conditions.
Basically, they improve your blood flow. They can lessen pain and swelling in your legs. They can also lower your chances of getting deep vein thrombosis (DVT) , a kind of blood clot , and other circulation problems.
They come in different sizes and strengths, so you or your doctor will need to decide which option will work best.
Compression stockings are specially made, snug-fitting, stretchy socks that gently squeeze your leg. Graduated compression or pressure stockings are tighter around your ankle and get looser as they move up your leg. Compression sleeves are just the tube part, without the foot.
You can buy them over the counter, but if your doctor prescribes them, your insurance may cover the cost.
You can buy them at medical supply companies, online, and in many drug stores. They can cost from around $10 to as much as $100 per pair, depending on what kind you get.
The pressure these stockings put on your legs helps your blood vessels work better. The arteries that take oxygen-rich blood to your muscles can relax, so blood flows freely. The veins get a boost pushing blood back to your heart .
Compression stockings can keep your legs from getting tired and achy. They can also ease swelling in your feet and ankles as well as help prevent and treat spider and varicose veins . They may even stop you from feeling light-headed or dizzy when you stand up.
Because the blood keeps moving, it's harder for it to pool in your veins and make a clot. If one forms and breaks free, it can travel with your blood and get stuck somewhere dangerous, like your lungs . Clots also make it harder for blood to flow around them, and that can cause swelling, discolored skin , and other problems.
Some athletes, including runners, basketball players, and triathletes, wear compression socks and sleeves on their legs and arms. The theory is that, during activity, better blood flow will help get oxygen to their muscles, and the support will help prevent tissue damage. And afterward, the beefed-up blood and lymph circulation will help their muscles recover quickly. They won't be as sore, and they won't cramp as much.
Studies show the gear has little to no effect on athletic performance, but some people swear by it. Maybe thinking they have an edge gives them one. The evidence for faster recovery is better, but not enough to make a difference for weekend warriors.
Socks and sleeves come in different lengths to cover different parts of your body. For DVT, most stockings go to just below the knee , but you can get thigh-highs and tights, too.
They also have different levels of pressure, measured in mmHg. Stockings should feel snug, but not painfully tight. Mild compression, with lower numbers, is usually enough to keep you comfortable on your feet at work. You'll need higher numbers with a firmer fit to prevent DVT .
Thrombo-embolic deterrent (TED) hose, or anti-embolism stockings, are designed for after surgery and when you need to stay in bed. If you can stand and move around, graduated compression stockings are better.
If you need the stockings for medical reasons, your doctor will measure your legs and prescribe the right ones for you.
Smooth out the stockings so they lie flat against your skin. Avoid bunching.
Make sure they aren't too long. Don't fold or roll the tops down, because that can make them too tight. It could cause blood flow problems or cut off your circulation like a tourniquet.
If your doctor told you to wear them, you'll probably want to keep them on most of the time. But you can take them off to shower or bathe. You can wear socks, slippers, and shoes over compression stockings. Check with your doctor about how often and how long you need to use them.
Cleveland Clinic: "Deep Vein Thrombosis (DVT) Prevention."
CDC: "Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) - Blood Clot Forming in a Vein."
Johns Hopkins University: "Varicose Vein Treatment."
Examiner: "Do compression socks work? New study suggests not for running."
Laymon, A. Indiana University, 2010.
Competitor: "How Compression Apparel Works," "Do Compression Socks Really Work?"
Absolute Medical: "Buyers Guide for Compression Stockings."
A visual guide to deep vein thrombosis.
These could raise your risk of blood clots.
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WebMD does not provide medical advice, diagnosis or treatment.
From Wikipedia, the free encyclopedia
Wikimedia Commons has media related to Compression stockings .
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Compression stockings ( Flight Socks , Support Bandage ) are a specialized hosiery designed to help prevent the occurrence of, and guard against further progression of, venous disorders [1] such as edema , phlebitis and thrombosis . Compression stockings are elastic compression garments worn around the leg, compressing the limb. This reduces the diameter of distended veins and increases venous blood flow velocity and valve effectiveness. Compression therapy helps decrease venous pressure, prevents venous stasis and impairments of venous walls, and relieves heavy and aching legs.
Knee-high compression stockings are used not only to help increase circulation, but also to help prevent the formation of blood clots in the lower legs. They also aid in the treatment of ulcers of the lower legs.
Unlike traditional dress or athletic stockings and socks, compression stockings use stronger elastics to create significant pressure on the legs, ankles and feet. Compression stockings are tightest at the ankles and gradually become less constrictive toward the knees and thighs. By compressing the surface veins, arteries and muscles, they force circulating blood through narrower channels. As a result, the arterial pressure is increased, which causes more blood to return to the heart and less blood to pool in the feet.
There are two types of compression stockings, gradient and anti-embolism. [2]
Treatment is usually prescribed by a physician to relieve all manifestations of chronic venous disease and prevent venous troubles. Compression stockings are recommended under the following conditions:
Edema is a condition where the opposing forces that occur in the small blood vessels and capillaries cause a net ultrafiltration of plasma water into the soft tissues.
Chronic peripheral venous insufficiency is when the veins cannot pump deoxygenated blood back to the heart.
Varicose veins are saccular and distended veins which can expand considerably and may cause painful venous inflammation. Once developed, they will not disappear on their own. The formation of varicose veins is an externally visible sign of venous weakness.
Deep vein thrombosis occurs when blood flow decreases (especially in the lower extremities), causing blood to pool in the legs and leading to blood clot (thrombus) formation. Evidence does not suggest a benefit in post thrombotic syndrome rates following DVT. [3] Compression stockings are beneficial in reducing symptomless deep vein thrombosis among airline passengers flying for 7 hours or more. [4]
Pharmacological ( warfarin , unfractionated heparin , low molecular weight heparin) and mechanical measures (graded compression stockings, intermittent pneumatic compression devices, and venous foot pumps) are used to prevent venous thromboembolism (VTE) in clinical practice. For cases in which the bleeding risk is high and pharmacologic measures are contraindicated, the use of mechanical prophylaxis is recommended. [5] Graduated compression stockings can effectively prevent VTE in hospitalized patients by applying different pressure to the leg. The meta-analysis of general surgical patients revealed that graduated compression stockings decreased their risk of developing VTE by 68% compared to placebo. [6]
Twenty randomized controlled trials analyzed the effectiveness of graduated compression stockings alone or with other additional prophylaxis in prevention of deep vein thrombosis. These trials included 1,681 patients after general surgery, orthopedic surgery, and medical patients. They concluded that graduated compression stockings are effective in deep vein thrombosis prophylaxis in patients who have undergone general and orthopedic surgery. [7]
Combining graduated compression stockings with other mechanical and pharmacological measures can increase the effectiveness of VTE prophylaxis by 60%. [8] However, another study performed in France involved 407 ICU patients and showed no difference in the effectiveness of the VTE prevention for patients who used compression stockings alone or in combination with intermittent pneumatic devices. [9]
Lymphedema occurs when a body part swells due to an abnormal accumulation of lymph fluid, occurring when there is interference with the normal drainage of lymph fluid back into the blood, commonly swelling the arm, leg, neck or abdomen.
Phlebitis is the term used when inflammation and clotting occurs in a vein, most often a leg vein, due to infection, inflammation, or trauma. People with varicose veins are more often affected. Inflammation occurs suddenly, causing the thrombus to adhere firmly to the vein wall and risking clogging a superficial vein.
Lipodermatosclerosis is the term used to refer to the inflammation of subcutaneous fat, a form of panniculitis.
Hormones released during pregnancy and the expanding uterus (pressure on the inferior vena cava – the major vein returning blood up to the heart) can affect leg veins. [10]
The use of elastic compression stockings can reduce volumetric variations during standing hours. The use of stockings for the entire day is more effective than just half the day or not using compression stockings at all. [11]
Many physicians and vein specialists recommend wearing compression stockings after varicose vein stripping, but studies show that wearing an elastic compression stocking has no additional benefit after the application of elastic bandaging for three days in post-operative care following the stripping of the great saphenous vein as assessed by control of limb, edema, pain, complications and return to work. [12]
Caution should be used in those with advanced peripheral obstructive arterial disease, heart failure , septic phlebitis, oozing dermatitis and advanced peripheral neuropathy in regard to wearing compression stockings. [13]
In the clinical setting the applying of the antiembolism stockings is performed by physicians, nurses and other trained personnel. First the proper size stocking is determined by measuring the legs. Aseptic technique is not necessary unless the skin is open. The person is placed in the supine position in bed for fifteen minutes prior to measuring for fit. This allows for venous return and stability before measuring. [14] : 745
Stockings are best applied upon waking before the person has gotten out of bed, has been sitting or standing and before venous stasis or edema has had a chance to develop. [14] : 745
Fit is critical to the therapeutic effect of compression stockings. A study listed in the American Journal of Nursing in August 2008 showed that compression stockings were incorrectly sized in just under 30% of the cases studied. It found that additional education was needed not only for patients, but also for medical staff. [15]
These stockings are designed to remedy impaired "musculovenous pump" performance caused by incompetent leg vein valves. They are woven in such a way that the compression level is highest around the ankle and lessens towards the top of the hose.
Doctors will typically recommend these stockings for those who are prone to blood clots, lower limb edema, and blood pooling in the legs and feet from prolonged periods of sitting or inactivity. They are also frequently used to address complications caused by diabetes , lymphedema , thrombosis , cellulitis , and other conditions. [16]
They are worn by those who are ambulatory in most cases, helping calf muscles to perform their pumping action more efficiently to return blood to the heart. In some cases, they are worn by those at increased risk of circulatory problems, such as diabetics, whose legs are prone to excessive swelling. A common indicator for the prescription of such stockings is chronic peripheral venous insufficiency , caused by incompetent perforator veins. Low-pressure compression stockings are available without prescription in most countries, and may be purchased at a pharmacy or medical supply store. Stockings with a higher pressure gradient, say, above 25–30 mmHg, may require a prescription from a doctor. [ citation needed ]
There are several crucial cautionary steps that need to be taken before using compression stockings:
Vascular doctors and nurses may use special pads to ensure uniform higher pressure around the circumference of the ankle (to smooth out the irregular cross-sectional profile.)
Self-prescription is reasonably safe assuming that the compression gradient is 15–20 mmHg, the ABI (for both legs) is >1.0 and that the sto
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