Yes, compression socks can help varicose veins. They can help with the symptoms, medical socks can help reduce swelling and medical compression can treat the complications of varicose veins.
- What is medical compression?
- What is medical compression used for?
- Who should wear medical compression?
- Where can you get medical compression?
What is Medical Compression?
Medical Compression is graduated and exerts the greatest degree of compression (amount of squeeze) at the ankle, and the level of compression gradually decreases up the garment. It is designed for people who are mobile (those who can walk about) and it is manufactured under strict medical and technical specifications, including consistency and durability, to provide a specific level of ankle pressure and graduation of compression.
Medical Compression varies in the degree of compression measured at the ankle (described as “Class”), length (below knee or thigh length), colour, and whether it encloses the whole foot or stops just before the toes (closed or open toe).
Medical Compression prescribed in the UK follows the British Standard for class of compression:
- Class 1 stockings (light compression) exert a pressure of 14–17 mmHg.
- Class 2 stockings (medium compression) exert a pressure of 18–24 mmHg.
- Class 3 stockings (high compression) exert a pressure of 25–35 mmHg
Flight Socks and Support Tights do not provide Medical Compression. Flight socks and support stockings or tights are a type of non-medical support hosiery. These are often used to provide relief of tired, heavy and aching legs. The compression (degree of squeeze) is much less than Medical Compression and it is uniform. This means that the amount of squeeze is quite low and therefore less effective and it is not graduated – the degree of squeeze at the ankle is roughly the same as at the knee.
What is Medical Compression Used For?
Medical Compression is used clinically in order to:
- Reduce ache and swelling
- Reduce the risk of deterioration of varicose veins
- Reduce the risk of varicose vein recurrence after treatment
- Reduce the risk of venous leg ulcer recurrence after healing
- Prevent DVT
- Treat Superficial Vein Thrombosis (Phlebitis)
- Treat Varicose Veins in Pregnancy
- To treat the leg complications of a DVT
Who Should Wear Medical Compression?
Medical Compression should be worn only on the advice of a HealthCare Professional.
Medical Compression provides the a high amount of squeeze and needs to be carefully measured and fitted. It is not suitable for people with poor circulation (peripheral artery disease), those with neuropathy (a frequent problem among diabetics), those with some skin conditions, those with massive swelling or those with extreme deformity. If worn by the “wrong person” for whom they are not appropriate or if they are poorly fitting, Medical Compression can cause complications. The type and strength of stocking which best suits the individual is often a difficult judgement made between the healthcare professional and the individual. As part of the assessment for Medical Compression, the circulation should be checked by a healthcare professional. The healthcare professiona will check the circulation by feeling the pulses at the ankle and in some patients by performing an ankle-brachial pressure index with Doppler.
Where Can You Get Medical Compression?
Once you have had medical compression prescribed by a healthcare professional, the compression socks can be dispensed by a pharmacy or by your GPs surgery. I usually tell my patients to visit the U.K.’s largest online supplier of medical compression: www.daylong.co.uk
It is vital that the following information is given to all people who are about to receive medical compression:
- The reason why graduated compression stockings have been prescribed
- The benefits of wearing them regularly
- How to apply them correctly
- How long to wear them each day
- When to take them off
- When to replace them
- Daily hygiene
- How to recognize potential problems
- What to do or whom to contact if problems occur
What is the right compression for me and what type of stocking should I wear?
This is probably the most frequently asked question about medical compression. I always say to my patients that “compression socks and stockings only work when they’re on your leg. Compression socks do not work when they are in the drawer.”
That sounds pretty obvious doesn’t? However one of the most frequent problems with compression hosiery is “non-compliance”. This means that compression socks are prescribed by healthcare professionals and they are never put one. This can happen for a variety of reasons.
For example last week I saw a patient in her 70s. She had very severe varicose veins. Her GP took one look at them and said “you need to be wearing compression.“ She waited several weeks for a Doppler test. Thereafter she waited a few weeks before her compression hosiery was dispensed from the surgery. Surprisingly, she was simply handed a box with some compression stockings in them. When she got them home she didn’t have sufficient strength in her hands to pull them over a foot. She simply put her compression stockings back in the box and put them in the drawer.
For elderly patients, it is very important to assess whether the patient has sufficient strength in their hands to actually get the stockings on. In some cases, patients may need an application aid.
Some patients may require a lower level of compression than is ideal, simply to be able to get them on. When choosing a compression sock, consider the style and the colour that you would like. Wear the highest level of compression that you can easily get on and off and which feels comfortable. If you’re in doubt, start with a lower level of compression. And do remember that a below knee compression sock is sufficient in nearly every case of venous disease.
For my patients, I usually recommend a Class 2 below knee medical compression sock. I recommend wearing these if you are awaiting treatment, if you have a complication from your veins, if you have severe symptoms and swelling and as maintenance after treatment.
Medical Compression Can "Reverse" Varicose Eczema
Recently, I treated a patient with severe varicose veins complicated by varicose eczema. His duplex ultrasound scan confirmed that he had serious superficial venous reflux in both legs. I recommended that he undergo treatment by Endovenous Laser Ablation.
His procedure was delayed by the COVID-19 pandemic. As an interim measure, I recommended that he wear below knee graduated medical compression. He was carefully measured by one of our team and he was given instructions on how to put his compression socks on and how to take them off. He was advised to put his socks on first thing in the morning and take them off last thing at night. He was also advised to moisturise his legs in the evening before going to bed.
When he finally came to the clinic to have his veins treated, I was delighted to hear that his symptoms of ache and swelling had been completely controlled by wearing his medical socks. I was rather surprised to see that his varicose eczema was much improved. The inflammation had settled completely. His case demonstrates that regular use of medical grade compression hosiery does indeed control symptoms, reduce aches and in his case it was able to reverse his varicose eczema to a great extent.
Of course, medical grade compression does not “cure“ varicose veins or varicose eczema. Medical socks only work while they are worn. For a long-lasting, long-term solution the superficial venous reflux has to be eradicated. Most specialists now recommend Endothermal Venous Ablation in line with NICE Clinical Guideline CG168