Compression stockings are specialized garments that apply pressure to the legs and ankles. They utilize graduated compression, meaning the pressure is strongest at the ankle and gradually decreases further up the leg. This controlled pressure helps support the veins and prevents blood from pooling in the lower extremities, improving blood flow back toward the heart and reducing symptoms like swelling and fatigue.
Understanding Compression Levels
The therapeutic strength of a compression stocking is measured in millimeters of mercury (mmHg). This measurement represents the maximum pressure exerted at the ankle. Choosing the correct level is a medical consideration that directly correlates with the condition being treated.
Over-the-counter (OTC) stockings typically range from 8–15 mmHg or 15–20 mmHg, offering mild support for general leg fatigue, minor swelling, or preventative use during long periods of sitting or standing. The 15–20 mmHg range is often recommended as a starting point for daily wear and for travel to help prevent deep vein thrombosis (DVT). These milder levels are safe for anyone to use without medical consultation.
Higher grades, such as 20–30 mmHg and 30–40 mmHg, are considered medical-grade and are used for more significant circulatory conditions. The 20–30 mmHg range is commonly prescribed for moderate varicose veins, moderate edema, and after certain surgical procedures. The 30–40 mmHg level addresses severe lymphedema, chronic venous insufficiency, and active venous ulcers. Stockings with compression greater than 20 mmHg should only be selected after consulting a healthcare provider to ensure appropriate medical management.
Ensuring Proper Measurement and Fit
The effectiveness of graduated compression relies completely on an accurate fit, determined by precise measurements of the limb’s circumference and length. An improper fit, whether too loose or too tight, will either fail to provide the intended therapeutic pressure or, worse, restrict circulation. It is most effective to take these measurements first thing in the morning when the legs are least swollen.
The two most critical circumference measurements are the ankle, taken at the narrowest point just above the bone, and the calf, measured at the widest point. For knee-high stockings, the length from the heel to the crease behind the knee must also be measured. Thigh-high and waist-high garments require additional circumference measurements at the mid-thigh and hip, along with corresponding length measurements.
Measurements must be taken directly against the bare skin using a flexible tape measure, ensuring the tape is snug without constricting the limb. These figures are then matched against the manufacturer’s specific sizing chart, which combines circumference and length to determine the correct size. A trained fitter can also assist in this process.
Selecting Stocking Length and Style
The choice of stocking length is determined by the location of the circulatory issue or swelling, as the garment must fully cover the affected area. Knee-high stockings are the most common choice, suitable for managing swelling, fatigue, and varicose veins contained below the knee. The top band should rest about two finger-widths below the crease of the knee to avoid bunching and cutting off circulation.
When swelling or venous issues extend above the knee, a thigh-high or waist-high style is necessary to apply pressure across the entire limb. Thigh-high stockings are secured by a silicone band at the top, while waist-high or pantyhose styles provide full coverage up to the waist. Open-toe and closed-toe styles are available. The open-toe version is preferred for breathability, easier inspection of the toes, or for individuals who prefer to wear sandals or specific footwear.
Material Considerations and Care
Compression stockings are constructed from a blend of materials, primarily nylon, spandex, and microfiber, with some options incorporating cotton or merino wool for comfort. The spandex (elastane) component is the elastic fiber responsible for providing the precise compression and stretch needed for the therapeutic effect. Nylon and microfiber contribute to durability and a smoother texture.
Proper care is necessary to maintain the integrity of the elastic fibers and preserve the prescribed compression level. Stockings should be washed daily, ideally by hand, using a mild detergent and lukewarm water. This removes body oils and helps the elastic return to its original shape. Machine washing is possible on a gentle cycle, but the garment should be placed in a mesh laundry bag for protection.
It is necessary to avoid chlorine bleach, fabric softeners, and harsh detergents, as these chemicals will break down the elastic fibers and compromise the compression. Stockings should never be put in a machine dryer or placed near a direct heat source, as high temperatures will permanently damage the elasticity. Instead, they must be air-dried flat or hung up away from direct sunlight.