Compression therapy uses controlled, gentle pressure to improve blood flow back to the heart and reduce swelling, which can lead to greater comfort for patients.
Compression therapy, such as the use of graded compression stockings, is often prescribed to:
- Manage varicose veins
- Manage lymphedema and swelling in the legs
- Assist with venous leg ulcer & wound healing
- Prevent blood clots after surgery
- Address pregnancy-related leg & vein symptoms
When used preventatively, compression therapy can help prevent:
- Worsening of venous insufficiency symptoms
- Leg swelling in those who stand or sit for long periods of time
- Development of venous thromboembolism due to immobility
- Recurrence of venous leg ulcers
Types of compression
Compression stockings are the most common method of compression therapy.
Most compression stockings are graduated, meaning they are tighter around the foot and ankle than at the knee or thigh. This is critical in most cases, since most leg swelling occurs by the ankle.
Compression stockings can be knee high, thigh high, or cover the pelvis depending on need. Open toe options are available as well.
- Compression wraps or bandages, like Unna Boots, are also used when indicated.
- Mechanical compression devices, like wearable compression boots or compressed air devices, are available for home or clinic use as well.
Levels of Compression
Some lighter use compression socks are available over the counter at drugstores or online. These are not considered to be medical grade can be purchased without a prescription. Higher degrees of compression often require a prescription.
Light Support Compression
(15–20 mm Hg)
- Mild foot and lower leg swelling
- Mild varicosities with minimal swelling
- Preventative support for work or travel
- Standing, sitting or traveling for extended periods of time
- Post surgical “anti-embolic” or TED hose provided by hospitals at the time of surgery
- Non ambulatory patients who are bed ridden
Moderate Compression
(20–30 mm Hg, Class I)
- Chronic leg fatigue and heaviness
- Ankle, foot and leg swelling
- Mild varicosities
- Preventative and treatment of swelling during pregnancy
- Superficial thrombophlebitis
- Post-vein treatment including sclerotherapy
Heavy Compression
(30–40 mm Hg, Class II)
- Moderate varicosities with advanced swelling
- Chronic Lymphatic edema
- Prevention and treatment of venous ulcers
How Does Compression Therapy Work?
Compression therapy helps to improve blood circulation in the lower legs, ankles and feet by applying the correct amount of pressure on a consistent basis. The goal is to reduce the amount of venous fluid filtered out from venous insufficiency, to help return the filtered lymphatic fluid back to the heart. Here’s how compression works for the different conditions it’s used for:
For chronic venous insufficiency, including varicose veins: Compression can help reduce the amount of venous blood pooling in the lower legs, thus reducing the amount of fluid that filters into the tissue as edema. This helps push blood to the deeper veins, where the leg muscles can pump the blood back toward the heart.
For deep vein thrombosis (DVT): With a DVT, blood flow to the heart can be obstructed by blood clotting in the veins. Compression therapy can help prevent blood from pooling and clotting, especially when coupled with an anticoagulant. However, it’s important to speak with your healthcare provider before starting compression therapy for DVT.
For swelling (edema):Compression therapy applies pressure circumferentially to the lower leg to help move fluid back to lymphatics, where it can be returned to the circulation.
For leg ulcers:Wounds do not heal well in the presence of high vein pressures from venous insufficiency and in the setting of swelling. Compression therapy can aid recovery from leg ulcers and wounds by encouraging blood flow.
Frequently Asked QuestionsCompression Therapy
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Can I wear athletic recovery stockings instead of graded compression stockings?
The popularity of compression socks has increased substantially among athletes in endurance events such as running and hiking. Whether athletic stockings will work for you all comes down to the reasons you are wearing compression. For more mild and preventive scenarios, athletic recovery stockings may be fine. For more advanced venous and lymphatic disease, they are not likely to be as effective. A consultation with a vein specialist can help guide you as to your needs and best options.
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Do I ever need to change the compression I use?
Because swelling goes down with time with frequent use, you should have your legs measured again and your stockings replaced every 3 to 6 months.
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How should I take care of my compression stockings?
You should generally obtain at least 2 stockings, or 2 pairs if you're wearing them on both legs. This means you can wear 1 stocking (or pair) while the other is being washed and dried. Follow any washing instructions provided with the socks at purchase. Many require hand washing, in which case it’s ideal to use warm water (comfortable hand temperature) and dry them away from direct heat.
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What is the difference between graduated and uniform compression stockings?
Uniform, or regular, compression socks maintain the same degree of compression throughout the length of the stocking. In contrast, graduated compression garments offer gradient pressure by providing a range of pressure, with more pressure closer to the feet and less pressure closer to the knees. Graduated compression socks are more effective at preventing blood and fluids from pooling in the lower legs and are better at reducing chronic swelling.
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What kind of compression socks do I need?
It depends on the reason you are wearing them. If you are wearing compression socks to prevent swelling on a long flight, or for work where you stand a lot, the lower degree of compression hose are usually all that you need (15 to 20 mmHg). If you have had a new DVT or a varicose vein treatment session, generally patients are prescribed to use compression in the mid-range (20 to 30 mmHg). For patients with more advanced chronic vein and lymphatic disorders with sevre skin changes, higher degrees of compression are often utilized to minimize the swelling as best they can (30 to 40 mmHg). A consultation with a vein care specialist can help determine the optimal degree of compression for your needs.
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Where can I buy compression socks locally?
Most communities have a variety of places where people can obtain compression hose. For patients who have been wearing compression for a while and know the brand, size and degree of compression they are looking for, online stores are a great option. For those new to compression, it often makes sense to see a professional to help measure you and advise on the size, degree of compression and a variety of different brands that might be best for your particular needs.
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Should I wear compression hose at night?
Generally not. Most experts agree that you should take off compression socks while you sleep since they provide the most benefit when you are up and walking. At night, swelling generally goes down on its own. However, if you do wear compression stockings at night, there should not be a problem. Adverse side effects from wearing compression socks are rare under most circumstances.
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Can wearing compression socks be harmful?
Severe complications of wearing compression socks are rare under most circumstances. However, some people should be cautious with compression, such as those with delicate or easily irritated skin. Patients with severe arterial disease should also seek medical advice before using compression, as in some extreme cases they are contra indicated. It’s also important that compression socks are properly fitted so they are not too tight. A consultation with a vascular or vein specialist can help guide you to what considerations are important in your particular case.
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What do compression socks do?
Compression stockings help alleviate the swelling and pain caused by varicose veins. Graded compression stockings can also help heal any skin inflammation or ulcerations due to venous insufficiency. They must fit properly to achieve these benefits.
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Get Started with Compression
The optimal degree of compression needed can vary depending on the patient & medical condition being treated, the type of compression being applied, and the material used in the compression garment.
Because of this, it’s important to make sure that you’re using the right stockings or other medical compression device for your particular condition. Your vein care provider can help you assess what kind of compression you need and discuss fitting options.
Book a consultation at any Inovia clinic to find out which compression therapy options may be right for you.
