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Compression Stockings

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Medical Disclaimer

Whilst every effort has been made to ensure that the information contained on this site is accurate, it is not a substitute for medical advice or treatment, and Mr A. Abu-Own recommends consultation with a doctor or healthcare professional. The information provided is intended to support patients, not to provide personal medical advice.  Please see our Terms and Conditions for more information.

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Graduated Compression Stockings

What are compression stockings?

Medical compression stockings, also known as compression hosiery or thromboembolic deterrent stockings ('TEDs'), are a treatment aid commonly used for problems with the veins. They are used to prevent getting a blood clot in the leg (DVT) whilst in hospital and to help manage the symptoms of post-thrombotic syndrome. Stockings work by applying pressure from outside the veins to help squeeze the blood in the veins back up the legs. Obviously they will only help if you use them. And often people choose not to use them for a variety of reasons:

  • They are the wrong type of stocking
  • They are not comfortable
  • They are too tight or too loose
  • They are too big or too small and do not fit well
  • They look ugly
  • They do not fit your personal needs
  • They are not easy to get on



Types of stockings

Approved medical compression stockings have to satisfy demanding technical specifications and are the result of a manufacturing process aimed at guaranteeing that you receive the appropriate treatment. Medical stockings have:

  • A certain level of compression (pressure) at the ankle
  • Graduated compression (less at the top of the stocking)
  • They keep their pressure up over the lifetime of the stocking - they don't get soggy!

It is important to remember that the level of compression used is directly linked to your measurements. So it is important that you are measured by a qualified professional to make sure the stocking fits you correctly.



Classes of compression

The European Classes for stockings is most popular and commonly used by manufacturers:

  • Class I 18-21mmHg
  • Class II 23-32mmHg
  • Class III 34-46mmHg
The UK Standard of compression are as follows:
  • Class I 14-17mmHg
  • Class II 18-24mmHg
  • Class III 25-35mmHg
Because compression classes vary between different countries, it is best to measure compression according to the amount of compression in millimetres of mercury (mmHg, a unit of pressure). The reference measurement for the stockings is around the ankle. Most guidelines recommend 20mmHg compression (Class I, 18-21mmHg) at the ankle to prevent hospital-acquired DVT. These types of stockings would also help relieve the symptoms of:
  • Varicose veins
  • Reversible leg swelling
  • Leg swelling and discomfort in pregnancy.
Strong compression stockings (Class II, 23-32mmHg) are suitable for:
  • Severe venous insufficiency
  • Varicose eczema
  • Post-thrombotic syndrome
  • Permanent (chronic) leg swelling
  • Following treatment for varicose veins:
    • Surgery (vein stripping and phlebectomies), Radiofrequency or Laser Ablation and Foam sclerotherapy.
    • For most treatments, Mr Abu-Own often uses a bandage for two days followed by stockings for two weeks.
    • For foam sclerotherapy, he uses a combination of a bandage and a stocking for 3-5 days followed by a bandage only for one week.
  • Patients who have leg sweling after a deep vein thrombosis.
  • Patients with mild/moderate lymphodema.
​ Very strong compression stockings (Class III, 34-46mmHg) are only used for those with advanced cases of:
  • Severe venous insufficiency
  • Venous stasis ulcers
  • Severe post-thrombotic syndrome
  • Severe lymphodema
These are difficult to use and are often not well tolerated, particularly in older age groups. Often, a compromise has to be made between what can be tolerated and what is most effective as treatment. This often results in these not being used commonly.



Measuring and fitting

Proper measurement and fitting is absolutely vital. You should only be measured by trained professionals who, when fitting or choosing the stockings, will take account of your needs. If you are experiencing leg swelling at the time of the first measurement, a second measurement along with a new set of stockings should be provided once the swelling has resolved.



Closed or open toe ​

There are open or closed toe options available. Open toe stockings may be useful if: ​

  • You have painful toes due to arthritis or infection
  • You have large feet
  • You want to wear socks over your support stockings
  • You prefer them.​



How easy are they are to put on

If you cannot put your stockings on, obviously you will not benefit. Modern technology, especially with the introduction of new yarns into graduated compression stockings, allows manufacturers to produce stockings that are much easier to put on while still having the necessary level of compression for medical treatment. Support stocking applicator aids are available if you are unable to get them on. You can discuss this with your pharmacist or nurse. In some cases a family member may provide help.



When to put them on

Generally, they should be removed at bedtime and put on first thing in the morning. It is important to put them on before your legs start to swell in the mornings. When Class I stockings are used to prevent DVTs, they are safe to use day and night for the time prescribed (except for showering, or when they are to be replaced with a washed or new pair).



Comfort

Comfort is absolutely fundamental. If the stockings are not comfortable, you are not going to wear them all day. Modem technology allows manufacturers to produce stockings that are more comfortable.



Your needs

There are two specific things to consider - firstly your shape, and secondly your lifestyle.

  • Shape: Men tend to have larger feet, wider calves and thinner thighs than women. Some manufacturers deal with this by providing graduated compression stockings that take this into account rather than providing a unisex product which would have implications for fit and comfort for both men and women.
  • Lifestyle: Everyone has different needs in terms of their jobs, how active they are and the clothing they may need (or want) to wear. Compression stockings are available in a wide range of fashionable colours and styles, so we encourage you to look for the right pair for you.



​Washing

You should always have at least two pairs prescribed so that one pair can be washed and dried while the other is worn. Do not tumble dry support stockings, as this may damage the fabric.



When to replace them

Stockings should be replaced every 3-6 months. Each time you should be measured again, just in case the size needs to be changed.



When stockings should be avoided

You should not wear compression stockings if you have:

  • Significant peripheral arterial disease and any leg graft bypass
  • Congestive heart failure
  • Infected phlebitis
  • An oozing skin rash
  • An allergy to the material they are made from - if so try another fabric
  • Loss of feeling in the legs such as peripheral neuropathy due to conditions such as diabetes

If you are considering stockings, please speak to your doctor first to make sure that there are no reasons for you not to wear them. You may need to have a test called a Doppler to measure the pressure in your arteries in your legs to ensure that the arterial circulation in your legs will not be compromised by the stocking.