Compression stockings are specialized garments designed to manage symptoms of venous conditions like varicose veins. They function by delivering mechanical support through graduated compression, where the pressure is strongest at the ankle and progressively decreases up the leg toward the knee or thigh. This controlled pressure gradient helps counteract gravity and supports vein walls. By gently squeezing the leg tissues, the stocking reduces vein diameter and increases the velocity of blood flow back toward the heart, preventing the pooling of blood that causes swelling and discomfort.
Selecting the Proper Stocking Type and Size
Choosing the appropriate compression stocking is necessary, as the correct fit and pressure level maximize therapeutic benefit and comfort. Compression strength is measured in millimeters of mercury (mmHg) and is categorized into different classes. Mild compression, typically 8–15 mmHg or 15–20 mmHg, is often available over-the-counter and can help with minor swelling and leg fatigue.
Higher pressure levels, such as 20–30 mmHg or 30–40 mmHg, are considered medical-grade and are generally reserved for more moderate or severe varicose veins and chronic venous disease. These higher-strength stockings usually require a prescription and should only be worn under the direction of a healthcare provider.
Compression stockings are available in various lengths, including knee-high, thigh-high, and pantyhose styles. Knee-high stockings are often sufficient if the venous disease symptoms are confined to the lower leg, but they should end just below the bend of the knee. Thigh-high or pantyhose styles are appropriate when varicose veins extend above the knee or when more comprehensive support is needed throughout the entire leg.
Accurate measurement is required for the graduated compression to work correctly. Measurements must be taken when the legs are least swollen, ideally first thing in the morning before getting out of bed. Key circumference measurements must be taken, including the narrowest point of the ankle, the widest part of the calf, and, for thigh-high styles, the widest part of the thigh.
Step-by-Step Guide to Application and Removal
The process of putting on compression stockings, known as donning, requires a specific technique due to the garment’s tight elastic nature. Preparing the stocking by turning the top part inside out down to the heel pocket allows the foot to be inserted first. Placing the foot into the stocking and carefully aligning the heel in the designated heel pocket is the initial step for a proper fit.
Once the heel is correctly situated, the fabric should be unrolled or pulled up the leg gradually, section by section. Use the palms of the hands or specialized rubber donning gloves to distribute the fabric evenly and prevent excessive pulling or tearing. The fabric must be smoothed out completely as it moves up the leg, ensuring there are no wrinkles or bunches, which can create uneven pressure and restrict circulation.
To manage friction, applying a small amount of cornstarch or baby powder to the leg before donning helps the stocking slide on more easily. Never fold over the top band of the stocking, as this creates a tourniquet effect that can impair blood flow. The top of a knee-high stocking should rest approximately two finger-widths below the crease at the back of the knee.
When removing the stockings, known as doffing, a similar gentle approach is necessary. The top band should be peeled down, rolling the stocking inside out toward the ankle. Continue to roll the material down over the heel, using the thumb to work the heel out of the pocket with care, allowing the stocking to slide off the foot.
Daily Usage Schedule and Care
Compression stockings are most effective when applied first thing in the morning, before any significant daily swelling has occurred. This timing prevents fluid from accumulating in the lower limbs throughout the day. They should generally be worn all day long, providing continuous support while a person is upright and active.
The stockings are typically removed right before going to bed, as the legs are elevated and the calf muscle pump is inactive during sleep. Exceptions may apply, particularly following certain medical procedures, so instructions from a healthcare provider regarding overnight wear should be followed precisely. Consistent daily wear provides the greatest benefit for managing symptoms of varicose veins.
Daily washing is recommended, preferably by hand, using a mild soap or detergent without fabric softeners, bleach, or harsh additives. This routine cleaning removes skin oils and dead cells that can break down the elastic fibers of the material.
The stockings should be rinsed thoroughly and air-dried away from direct heat or sunlight, as high temperatures degrade the elastic. Never place them in a machine dryer, which significantly shortens their lifespan and ruins the compression gradient. Manufacturers recommend replacing medical-grade stockings every three to six months to maintain optimal therapeutic pressure.