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How to Choose and Use Compression Stockings

Medically Reviewed by Carol DerSarkissian, MD on December 09, 2022

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.

What Are Compression Stockings?

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 drugstores. They can cost from around $10 to as much as $100 per pair, depending on what kind you get.

Who Should Use Compression Stockings?

  • People with or at risk for circulation problems, like DVT, varicose veins, or diabetes
  • People who've just gotten surgery
  • Those who can't leave their bed or have a hard time moving their legs
  • People who stand all day at work
  • Athletes
  • Pregnant women
  • People who spend long stretches of time on airplanes, like pilots

How Do Compression Stockings Work?

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.

What Kinds Of Compression Stockings Are There?

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 waist-length tights, too.

They also have different levels of pressure, measured in mmHg (millimeters of mercury). 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.

Graduated compression stockings. This type is more common. You can find them in a wide range of tightness. They tend to be tighter around your ankles and get looser the higher they’re pulled.

Thrombo-embolic deterrent (TED) hose or anti-embolism stockings. These are designed for after surgery and when you need to stay in bed. They can help maintain blood circulation and lower the odds of severe swelling. 

If you need the stockings for medical reasons, your doctor will measure your legs and prescribe the right ones for you.

How to Pick Compression Stockings

If it’s your first time trying compression socks or stockings, here are some tips on how to choose what works best for you.

Pick the right type. To get the most of out of compression socks, find ones that fit you well and are the correct length. For example, if you buy graduated compression stockings from a store but they aren’t working well enough, you might need to upgrade to prescription-grade stockings. Or, you might need to adjust or wear them properly. Talk to your doctor about it. They can help you figure out the right fit and pressure. 

Choose the correct compression level. How much compression you need on your legs will depend on the type of condition you have. The manufacturer labels them based on a range of compression in mmHg.

Your options include:

  • Low compression. These provide less than 20 mmHg. You can buy these stockings or socks online or at your local pharmacy. 
  • Medium compression. These provide tightness between 20 and 30 mmHg. It will help those who’ve had a DVT or varicose veins control swelling and pain. 
  • Moderate to high compression. These provide between 30 and 40 mmHg. It’s best for those who have severe pain or swelling.
  • Firm compression. This type gives between 40 and 50 mmHg. It’s usually used by people who have a history of severe vein problems or blood clots. 

Pick one that fits right. Before you pick a stocking, measure the length and girth of your ankle, calves, and leg if you’re opting for thigh-high or waist-high leggings. 

For prescription-grade compression wear, trained staff at a medical supply store will most likely take your measurements and find you the right fit. They’ll also teach you how to wear the stockings and take them off. It’s best to get your measurements taken when your legs are least swollen.

If you’re not able to or can’t reach your feet, there are devices called "stocking aid" that can help you roll them on. You can also ask a close friend or family member to help you out. 

How to Wear Compression Stockings

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.

Tips for First-Time Compression Stocking Users

For easy use, you should:

  • Wear the stockings first thing in the morning when your legs are less likely to be swollen.
  • Roll out the stockings inside out till the ankle part. Slip your feet in and slowly roll them back up your legs and smooth out the fabric as you do to avoid snags.
  • If you’re about to wear thigh-highs or leggings, stand up to pull them up past your knee.
  • Use rubber gloves to put on the stockings. This will you give you a better grip. 
  • Try not to wear any jewelry that could tear or snag the compression socks. 
  • Avoid applying lotion or oils right before you wear the stockings. 
  • If you just bought a new pair of stockings, wash them with mild soap. This will make the fabric pliable and easy to wear. 
  • If you’re able to, buy more than one pair so you have an extra pair on hand if one tears or gets dirty. 

When you first put them on, compression socks or stockings might feel uncomfortable and cause you to feel sore or achy. This is normal, and you’ll get used to them after a few uses. But if they’re unbearably painful or your legs or feet look discolored, tell your doctor right away. 

 

Show Sources

SOURCES:

Cleveland Clinic: "Deep Vein Thrombosis (DVT) Prevention," "What You Should Know About Compression Stockings." 

CDC: "Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) – Blood Clot Forming in a Vein."

Johns Hopkins University: "Varicose Vein Treatment."

NIH MedlinePlus, spring 2011.

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."

Mayo Clinic: "Mayo Clinic Q and A: Tips for using compression stockings."

Vascularcures.org: “What you need to know about compression therapy for DVT and PTS.”

National American Thrombosis Forum: “Under Pressure: Compression Stockings 101.”

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