Compression stockings are specialized elastic garments designed to be worn on the legs, exerting a mechanical force on the limbs. This external pressure helps to gently squeeze the leg tissues and underlying veins. The primary purpose of this applied pressure is to assist the body in moving blood back toward the heart, counteracting the effects of gravity.
When to Wear Them for Chronic Health Issues
Compression therapy is a primary management strategy for long-term circulatory problems, starting with Chronic Venous Insufficiency (CVI). CVI occurs when damaged vein valves cause blood to leak backward and pool, leading to chronic swelling, skin changes, and discomfort. Compression stockings mechanically support weakened vein walls, reducing the vein diameter so the valves can function more effectively.
The required pressure level is specific to the diagnosis and is measured in millimeters of mercury (mmHg). For moderate CVI or significant varicose veins, a range of 20 to 30 mmHg is often prescribed. These higher-grade garments are classified as medical devices and require a professional fitting and prescription.
More severe conditions, such as post-thrombotic syndrome following a deep vein thrombosis (DVT), require stronger support to manage venous hypertension. Patients managing lymphedema, a chronic swelling caused by lymphatic system obstruction, also depend on high-level compression. For these cases, pressures often range from 30 to 40 mmHg or higher, demanding careful medical supervision. Following a DVT, this therapeutic use is usually maintained for a year or more.
Even for less severe chronic issues like spider veins or minor varicose veins, compression is beneficial. Lower pressures, often 15 to 20 mmHg, are used for symptom relief and to slow the progression of the underlying venous disease.
When to Wear Them for Situational Prevention
Compression garments are widely used for situations involving long periods of immobility, such as flights lasting four hours or more or extended car journeys. When a person sits without moving, the calf muscle pump—which naturally aids circulation—is inactive, increasing the risk of blood pooling in the lower legs. Prophylactic stockings, typically in the 8 to 15 mmHg range, help mitigate this pooling and reduce the risk of travel-related swelling.
Many occupations require long periods of standing or sitting, creating a consistent challenge for the circulatory system. Nurses, teachers, retail workers, and desk workers often experience leg fatigue and minor swelling by the end of the workday. Using light compression, usually 15 to 20 mmHg, throughout the workday can alleviate these symptoms and improve comfort.
Pregnancy places increased pressure on the major veins in the pelvis and abdomen, which slows blood return from the legs and often leads to significant edema. Wearing compression during the day helps manage this fluid retention and can also reduce the risk of developing varicose veins that may appear during gestation. The use often begins early in the second trimester and continues until after delivery, when the pressure on the pelvic veins is relieved.
Athletes frequently incorporate compression stockings into their routine, particularly for post-exercise recovery rather than during the activity itself. The pressure is theorized to aid in the clearance of metabolic waste products, such as lactate, and reduce delayed-onset muscle soreness. This preventative use typically involves pressures between 15 and 20 mmHg, applied immediately after strenuous workouts to support the muscle tissue and circulation.
Practical Rules for Timing and Safety
Timing of Application
The most effective time to apply compression stockings is first thing in the morning, immediately after waking up and before the legs have had a chance to swell. Gravity causes fluid to accumulate quickly once a person stands or sits upright, making it much harder to put the stockings on later in the day.
Stockings should generally be removed before going to bed unless a physician has specifically instructed otherwise. While sleeping, the legs are usually elevated to the level of the heart, which minimizes the force of gravity on circulation. Wearing compression garments unnecessarily overnight can sometimes lead to skin irritation or discomfort.
Safety and Contraindications
Before beginning any compression therapy, particularly using higher-pressure garments, it is necessary to rule out certain underlying conditions. A primary concern is the presence of significant Peripheral Artery Disease (PAD), where the arteries cannot adequately deliver blood to the lower limbs. Applying external pressure in these cases can further restrict arterial blood flow, potentially leading to tissue damage or ulcers.
Other safety concerns include severe, decompensated heart failure, where the body’s inability to manage fluid volume makes compression potentially problematic. The garments should also not be worn over existing severe skin infections, such as cellulitis, or areas with advanced peripheral neuropathy. A physician must perform an assessment, often including an Ankle-Brachial Index (ABI) test, before prescribing use.
Proper Sizing and Fit
Proper sizing is paramount to both the effectiveness and safety of the garment. A stocking that is too tight or too long can cut off circulation, while one that is too loose will not provide the intended therapeutic pressure gradient. Incorrect application, such as allowing the material to bunch or fold behind the knee or at the ankle, creates a tourniquet effect that can be detrimental to circulation.
Professional Consultation
Because of the risks associated with improper use, especially with medical-grade pressures, professional consultation is always necessary when a chronic condition is involved. A doctor or certified fitter ensures the correct pressure, length, and style are selected based on precise leg measurements. They also provide guidance on the necessary duration of therapy, which can range from temporary to lifelong use.