Compression socks are specially designed socks that apply pressure to the legs to help improve blood circulation. They may be recommended to help prevent or treat varicose veins, chronic venous insufficiency, and lymphedema.
There are different types of compression socks, which vary by compression level and length. Some cover only the feet and lower legs, while others extend to the thigh or cover the entire leg and abdomen.
The most appropriate type depends on the reason for treatment and a person's overall health. For this reason, compression socks should be prescribed by a cardiologist, angiologist, or vascular surgeon.
Benefits of compression socks
The main benefits of compression socks include:
- Reducing swelling in the legs;
- Reducing blood pooling in the lower legs;
- Improving some symptoms of chronic venous disease;
- Helping manage certain venous circulation problems;
- Reducing the risk of some venous ulcer recurrences;
- Reducing asymptomatic deep vein thrombosis during some long flights;
- Reducing leg swelling during pregnancy in some women.
Compression socks do not have the same benefits for everyone. Evidence is stronger for some conditions, such as leg swelling and certain types of venous disease, than for routine use in healthy people.
There is also not enough evidence to say that compression socks can prevent all types of venous disease or completely prevent blood clots.
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Compression socks work by applying pressure to the legs. This pressure helps reduce blood pooling in the lower limbs and supports blood flow back toward the heart.
In a randomized study involving three hours of sitting, people wearing compression stockings had less blood pooling in their legs compared with those who did not wear them.
This effect helps explain why compression socks may reduce swelling and some symptoms linked to poor venous circulation or long periods of sitting.
However, compression socks do not prevent every circulation change caused by sitting for long periods.
Indications for use
Compression socks help improve blood and lymphatic circulation by applying graduated pressure to the legs. This pressure helps blood flow from the legs back toward the heart, which can reduce swelling and a feeling of heaviness in the legs.
Compression socks may be recommended for:
- Chronic venous insufficiency, with or without ulcers;
- Varicose veins;
- A history of thrombosis;
- Deep vein thrombosis or post-thrombotic syndrome;
- Lymphedema;
- Pregnancy;
- Postoperative recovery, especially when sitting or lying down for most of the day;
- Older adults, as blood circulation may become more impaired;
- A feeling of heaviness, pain, or swelling in the legs.
Compression socks may also be recommended for people who spend most of the day sitting or standing, as these situations can affect blood circulation.
They may also be suggested for long trips, when a person may remain seated for many hours.
Frequently asked questions
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Compression socks may be recommended for air travel, especially on long flights, as they can help reduce leg swelling and lower the risk of asymptomatic deep vein thrombosis (DVT).
However, it's important to note that compression socks do not guarantee protection against blood clots during air travel.
Read more: Blood Clot Symptoms (in the Legs, Brain, Lungs and More)
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Compression socks may help reduce leg swelling and improve some changes in venous blood flow during pregnancy.
However, current evidence does not show that compression socks can fully prevent serious complications, such as deep vein thrombosis (DVT), during pregnancy.
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Compression socks can be good for certain people when there is a clear reason to use them.
Research supports their use for reducing leg swelling, improving some symptoms of venous disease, and helping prevent certain venous complications in specific groups of people.
However, not everyone needs compression socks.
Therefore, whether compression socks are beneficial depends on the person's health, why the socks are being used, and the amount of compression needed.
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There is not enough evidence to show that compression socks for women and men need different compression levels based only on sex.
The most important factors when choosing compression socks are the reason for using them, the compression level, leg measurements, proper fit, and possible medical contraindications.
Types of compression socks
There are different types of compression socks, which vary according to their compression level and length, as shown below:
The amount of pressure applied can be affected by factors such as the elasticity and stiffness of the sock material, the size and shape of the person's legs, and their movements and activities throughout the day.
Compression socks are also available in different lengths. Some cover only the feet and lower legs, others extend to the thigh, and others cover the entire leg and abdomen, depending on the treatment need.
How to use
Compression socks should be put on in the morning after getting out of bed and removed at night before going to sleep.
They should also be removed before bathing and put back on afterward.
How long should you wear compression socks?
There is no exact number of hours that compression socks should be worn each day.
How long they should be worn depends on why they are being used, such as for leg swelling, chronic venous disease, ulcer prevention, or recovery after a medical procedure.
Because the recommended wearing time can vary from person to person, general advice such as wearing compression socks for exactly eight hours a day does not apply to everyone.
Can you sleep in compression socks?
In general, sleeping in compression socks is not routinely recommended.
Guidance from Guy's and St Thomas' NHS Foundation Trust states that compression stockings should normally not be worn in bed unless a doctor or specialist nurse recommends it.
There are some medical situations in which compression may be used continuously for a limited period.
For example, a healthcare professional may recommend continuous compression after certain vein procedures.
Because of this, there is no general recommendation that everyone should sleep in compression socks.
Whether they should be worn overnight depends on the medical condition and the reason they were prescribed.
When they are not recommended
Compression socks are contraindicated in the following situations:
- Ischemia;
- Uncontrolled heart failure;
- Infections or wounds on the legs or in areas covered by the socks;
- Skin infections;
- Allergy to the materials used in the socks.
Although compression socks may be recommended for people who spend much of the day sitting or lying down, they are not recommended for bedridden people who are unable to get out of bed, as they may increase the risk of blood clots.
Possible side effects
Compression socks are generally safe to use. Possible side effects include allergic skin reactions and, in rare cases, skin necrosis.
