Everything You Need To Know About Compression Socks

In the abstract, it may sound ridiculous: Specially engineered socks and stockings can make a big difference in your vascular health.

But it’s true!

So, how do compression socks work, and could you benefit from wearing them? Cardiovascular specialist Douglas Joseph, DO, shares what you need to know.

What are compression socks?

Compression socks (or compression stockings) are socks of varying lengths that are designed to squeeze your legs and prevent blood from pooling. They vary in tightness from mild to extra-firm, medical-grade compression.

“We use compression socks to promote better blood circulation in your legs,” Dr. Joseph explains. “Nearly 90% of leg disorders originate within the veins. Compression socks are a practical but underutilized fix for a common problem.”

What do compression socks do?

Compression socks gently squeeze your calves to increase the pressure in the tissue beneath your skin and reduce fluid buildup. This improves blood flow to your heart, which can both reduce and help prevent swelling.

“When blood pools in your lower body, the veins in your legs can become so congested that blood flows backward through weakened valves,” Dr. Joseph explains. “This increases swelling and decreases the return of blood to your heart.”

When blood is pooling in your legs, you’ll probably notice that they feel tired, heavy or achy. Over time, poor circulation can contribute to:

• Chronic venous insufficiency (CVI)
• Skin changes
• Damage to vein walls and valves
• Inflammation of the veins
• Varicose veins
• Sometimes, blood clots

Compression stockings may not keep these conditions from developing, but they can reduce your risk. And if you already have vein issues, they can help ease your symptoms and help protect against complications.

Benefits of wearing them

While they’re a crucial part of treatment for people living with chronic venous insufficiency and other vein problems, the benefits of compression socks can extend to many people who wear them from time to time.

Pulling on a pair may:

• Increase circulation
• Decrease swelling
• Reduce blood pooling
• Lower risk of blood clots
• Improve lymphatic drainage
• Ease pain and discomfort

Wearing compression stockings can also be helpful for folks at both ends of the physical activity spectrum.

When you’re sitting for long periods of time — like on a long flight — your legs tend to retain more blood, which raises your risk for clots. For the same reason, your healthcare provider may suggest wearing compression socks if you’re pregnant or on bed rest (like after a surgery).

“On the other hand, if you’re an athlete or you’re on your feet all day long for work, compression socks may help your muscles recover from all that exercise,” Dr. Joseph says.

Another plus? To many people, they just feel good.

How long to wear compression socks

“To get the most out of your compression stockings, put them on in the morning, before your feet, legs and ankles start swelling and take them off before bed or after you’ve finished exercising,” Dr. Joseph advises.

Besides the occasional catnap, you shouldn’t sleep in them. What’s more, wearing compression socks nonstop isn’t great for your skin.

Some people find compression garments uncomfortable at first. If they start bothering you, it’s OK to shed them.

“Sometimes, you need to adjust to them,” he notes. “Kind of like when you break in a new pair of shoes.”

Safety and side effects

Compression stockings are safe for most people to wear, but there are some exceptions and important safety considerations to keep in mind.

Dr. Joseph warns against wearing compression socks or stockings if you have:

• Open wounds or skin infections
• Extremely fragile skin

You should also ask your provider before wearing compression socks if you have:

• Severe swelling: This goes for both sudden, unexplained swelling and swelling from a known medical condition, like heart failure or kidney disease.
• Peripheral artery disease (PAD): Dr. Joseph says you may benefit from wearing compression stockings, but you should only do so under your provider’s guidance and supervision. They may also recommend changes to the degree or style of compression based on your condition.
• Severely reduced sensation in your legs: If you’re living with peripheral neuropathy or diabetes-related neuropathy, your provider needs to weigh the risks and benefits of compression stockings carefully. You may also find them too uncomfortable to wear.

Your compression socks should provide a decent squeeze, but take them off if they feel uncomfortably tight. Also, remove them if you notice:

• Pain
• Numbness
• Tingling
• Skin discoloration or damage
• Worsening swelling

These are all reasons to call your provider. They’ll help you figure out whether the symptoms point to a medical concern, or if you simply need a different sock size.

How to pick them

There are two different types of compression socks on the market: graduated compression socks and anti-embolism stockings.

• Graduated compression socks are the most common compression garment. While available in a range of pressures, these socks are all tightest around the ankle, getting looser the higher up the leg they go.
• Anti-embolism stockings are designed to maintain circulation and prevent blood clots for people who are confined to a bed, especially after surgery. They provide more uniform pressure, but aren’t typically as tight as compression socks.

Compression socks generally come in two basic lengths — knee-high and thigh-high. But Dr. Joseph says that compression tights and leggings are growing more common, especially among athletes and people living with medical conditions, like postural orthostatic tachycardia syndrome (POTS).

“If you’re wearing compression clothing to address a medical concern, don’t just grab a random pair off the rack at the drug store or sporting goods shop,” he urges. “Get measured to be sure you’re getting the right size, and have your provider recommend a specific pressure level.”

Compression is measured in millimeters of mercury (mmHg). Common levels include:

• Mild (8-15 mmHg)
• Moderate (15-20 mmHg)
• Firm (20-30 mmHg)

Extra-firm products (30-40 mmHg) provide medical-grade compression. They are usually only available by prescription and should only be used under a doctor’s supervision.

Talk to your provider about what compression level will best fit your needs. If you’re not comfortable taking your own measurements, see a pharmacist or medical supply store specialist. They’ll help make sure you buy the right size.

They aren’t a magic bullet, but a good pair of compression socks just might help put a spring back in your step.