Controlling Swelling With Compression Stockings - Healogics

Compression Socks for Swelling: Benefits and Usage A Patient’s Guide to Compression Stockings for Swelling and Poor Circulation 

Compression stockings are specialized garments designed to apply gentle pressure to your legs and ankles. This pressure helps improve blood flow, reduce swelling (edema), and prevent the painful buildup of fluid in the tissues. They are a simple, non-invasive, and effective tool for managing symptoms associated with various circulatory issues. They are a key component in the care of many types of leg and foot wounds. 

How Do Compression Stockings Work? 

Compression stockings work by applying graduated pressure to the legs, meaning they are tightest at the ankle and gradually become less tight further up the leg. This design helps your circulatory system in two important ways: 

• Supporting Vein Function: The pressure helps to squeeze the leg tissues and vein walls, which support the tiny valves inside your veins that are responsible for pushing blood back up towards your heart. This counteracts the effects of gravity and prevents blood from pooling in the lower legs. 
• Reducing Fluid Leakage: By compressing the leg, the stockings reduce the amount of fluid that can leak from the capillaries into the surrounding tissue, which is the primary cause of swelling or edema. 

Who Can Benefit from Compression Stockings? 

Your healthcare provider may recommend compression stockings if you have or are at risk for certain conditions. They are commonly used to manage: 

• Chronic Venous Insufficiency (CVI): When leg veins have trouble sending blood back to the heart. 
• Edema: Swelling caused by excess fluid trapped in your body’s tissues. 
• Varicose Veins: Enlarged, swollen, and twisted veins, often appearing blue or dark purple. 
• Deep Vein Thrombosis (DVT): A blood clot that forms in a deep vein, usually in the legs. 
• Lymphedema: Swelling due to a buildup of lymph fluid in the body. 
• Post-Thrombotic Syndrome: A condition that can develop as a long-term complication of DVT. 
• Leg ulcers: To help with healing and prevent recurrence. 

They are also beneficial for people who spend long periods of time sitting or standing, pregnant women, and athletes. 

 Understanding Compression Levels (mmHg) 

Compression is measured in millimeters of mercury (mmHg). The right level of compression is crucial for both safety and effectiveness. Your doctor will determine the appropriate level for your specific condition. 

• Mild Compression (8-15 mmHg): This is the lowest level of compression and is typically used for providing relief for tired, aching legs and managing minor swelling. 
• Moderate Compression (15-20 mmHg): This level is often recommended for preventing DVT during travel and for managing minor varicose veins and swelling. 
• Firm Compression (20-30 mmHg): This is a medical-grade compression level used for managing moderate varicose veins, moderate edema, and for post-surgical recovery. 
• Extra-Firm Compression (30-40 mmHg): This higher level of compression is prescribed for more severe conditions, such as severe varicose veins, severe edema, and for the management and healing of venous ulcers. 

Types of Compression Stockings 

Beyond different pressure levels, compression stockings also come in various lengths and materials to suit different needs and preferences. The most common types include: 

• Knee-High Stockings: These are the most common type and are sufficient for managing swelling and circulation issues in the foot, ankle, and calf. They are often easier to put on and more comfortable for all-day wear. 
• Thigh-High Stockings: For patients with swelling that extends above the knee, thigh-high stockings provide compression up the entire leg. They are often held in place with a silicone band at the top. 
• Pantyhose/Waist-High: This style provides continuous compression from the foot to the waist and is used for more extensive swelling or circulation problems. They can also provide abdominal and hip support. 

Materials can range from sheer nylon to opaque and cotton blends, offering different levels of breathability and comfort. 

How to Use Your Compression Stockings Correctly 

To get the most benefit from your compression stockings, it is essential to use them correctly. Consistency is key to managing swelling effectively. 

When to Wear Them

Stockings should be put on first thing in the morning, before you get out of bed, when swelling is at its minimum. They should be worn all day and taken off before you go to sleep at night or before bathing. To help control swelling while you sleep, try to elevate your feet above the level of your heart. 

How to Put Them On

Properly applying compression stockings can be tricky, but it gets easier with practice. Never pull or tug on them, as this can damage the garment and your skin. 

1. Turn the stocking inside out, but leave the foot portion as is. 
2. Slide your foot into the stocking, ensuring your heel is correctly positioned in the heel pocket. 
3. Gradually pull the rest of the stocking up over your ankle and calf. Smooth out any wrinkles, as these can create pressure points and be harmful to your skin. 

If you have difficulty putting on your stockings, you can wear rubber kitchen gloves for a better grip. There are also special devices called donning aids (such as stocking sliders or frames) that can make the process much easier, especially if you have limited strength or mobility. 

Caring for Your Compression Stockings

Proper care will extend the life of your stockings and ensure they maintain their correct compression level. Always follow the manufacturer’s instructions for washing and drying. Generally, it is best to hand-wash them in cool water with a mild soap and hang them to air dry. You will typically need to replace your stockings every 3 to 6 months, as they lose their elasticity over time. 

When to Seek Immediate Medical Attention

While compression therapy is very safe, it’s important to be aware of potential complications. Take your stockings off right away and call your wound center or go to the emergency room if you experience any of the following: 

• New or worsening pain in your legs or feet 
• Numbness or tingling in your legs or feet 
• A change in the color or temperature of your toes (e.g., they become pale, blue, or cold) 
• Any new wound, blister, or skin irritation 

These symptoms may indicate that the stockings are too tight or that you have an underlying condition that requires urgent medical evaluation. 

Potential Side Effects and How to Avoid Them 

Improper use of compression stockings can lead to side effects. Being aware of these can help you avoid them: 

• Skin Irritation: This can occur from the material of the stocking or from moisture trapped against the skin. Ensure your legs are completely dry before putting on your stockings, and consider using a moisturizing lotion at night after you take them off. If irritation persists, you may need to try a different material. 
• Discomfort or Pain: If your stockings are causing you pain, they may be the wrong size or compression level. They should feel snug but not painfully tight. Wrinkles or bunching can also create painful pressure points, so always smooth them out. 
• Broken Skin: In rare cases, particularly in individuals with fragile skin or peripheral neuropathy, the pressure from the stockings can cause the skin to break down. Regular skin checks are vital. 

To avoid these issues, always ensure you have been professionally fitted for your stockings and follow your healthcare provider’s recommendations closely. 

Frequently Asked Questions (FAQs)

Can I wear compression stockings to bed?

It is generally not recommended to wear compression stockings while sleeping unless specifically instructed by your healthcare provider. Your circulatory system is not fighting against gravity when you are lying down, so the pressure is usually not needed and could potentially restrict blood flow in some individuals. 

What is the difference between compression socks and regular socks?

Compression socks are medical-grade devices that provide graduated pressure to the leg, while regular socks do not. This graduated pressure is essential for improving circulation and reducing swelling. Regular socks do not provide this therapeutic benefit. 

How do I know what size to get?

You should be measured by a trained professional to ensure you get the correct size and fit. Measurements are typically taken at the ankle, calf, and sometimes the thigh, and will determine the appropriate stocking size for you. An improper fit can be ineffective or even harmful. 

Can I buy compression stockings over the counter?

Yes, lower-strength compression stockings (typically 15-20 mmHg or less) are available over the counter. However, for higher compression levels, a prescription from a healthcare provider is required to ensure you are using the correct pressure for your medical condition. 

Get Expert Help with Compression Therapy

Properly using compression stockings is a critical step in managing swelling and supporting the healing of chronic wounds. If you have questions about whether compression therapy is right for you, or if you need help with fitting and use, the experts at Healogics are here to help. Find a Wound Care Center® near you.  

Sheffield, P., Smith, A, & Fife, C. (Eds.) (2004). Wound care practice. Flagstaff Best. Wound, Ostomy, and Continence Nurses Soceity. (2005). Guidelines for management of wounds in patients with lower-extremity venous disease. Glenview, IL WOCN