What Are Compression Socks?

Compression socks are specially designed, snug-fitting, stretchy socks that gently squeeze your legs to promote blood circulation. They are tight stockings that put pressure on your legs, with some extending just to the knee, others above the knee, and some going all the way up to your abdomen.

Compression socks work by squeezing your legs and the blood vessels in your legs, which improves circulation and reduces swelling. They help leg vein valves work properly against gravity by increasing pressure in the tissues beneath your skin. This prevents blood and fluid from pooling in your legs and reduces the ability of superficial veins to expand and fill with blood.

Graduated compression socks are tighter around the ankle and gradually become looser higher up the leg, which helps push blood back toward the heart. Uniform compression stockings apply the same level of pressure throughout the leg. Graduated compression is more common and generally more effective for circulation.

Types and Compression Levels

Compression levels are measured in mmHg (millimeters of mercury):
• 8-15 mmHg (Mild/Low): Lightest form, good for maintaining leg health, energizing legs, relieving minor swelling.
• 15-20 mmHg (Medium): For mild circulation issues, minor swelling, preventive care.
• 20-30 mmHg (Medium): Helps those with DVT or varicose veins control swelling and pain.
• 30-40 mmHg (Moderate to high): Best for severe pain or swelling.
• 40-50 mmHg (Firm): For severe vein problems or blood clots, often requires prescription.

Graduated compression socks are the most common type, available in various compression levels and tighter around the ankle. Anti-embolism stockings (TED hose) are more specific in purpose, designed to maintain circulation and prevent blood clots, particularly for patients confined to bed after surgery.

Medical Benefits and Uses

Compression socks provide several medical benefits:
• Increase circulation and blood flow in legs
• Decrease swelling in legs and ankles
• Prevent blood from pooling in veins
• Prevent blood clots (deep vein thrombosis)
• Improve lymphatic drainage
• Help reduce pain and discomfort
• Treat chronic venous insufficiency, varicose veins, and leg edema

Compression socks may benefit people who:
• Are at risk for circulation problems (DVT, varicose veins, diabetes)
• Are recovering from surgery
• Have or are at risk for lymphedema
• Are bedridden or have difficulty moving legs
• Sit or stand all day at work
• Are pregnant
• Spend long periods on airplanes
• Are obese
• Have previous blood clots or leg injuries
• Have chronic venous insufficiency or varicose veins

The evidence for athletic performance benefits is limited. While popular among athletes, there's not convincing scientific data to support their use for improving performance. However, some evidence suggests they may help with recovery. An Australian study found compression socks could possibly have a positive impact on subsequent running performance.

Safety and Contraindications

Compression socks should NOT be worn by people with:
• Severe peripheral artery disease (PAD) - reduced blood flow in legs
• Advanced arterial disease or ischemia
• Uncontrolled congestive heart failure
• Untreated septic phlebitis
• Existing deep vein thrombosis (DVT)
• Severe arterial blood flow disorders
• Serious heart conditions

Potential side effects include:
• Pain or discomfort if wrong size is worn
• Circulation being cut off if too tight
• Minor bruising or skin ulcers
• Dry skin, redness, and itching
• Skin irritation and temporary skin dents
• Chafing, scraping, cuts, or bruises
• Bacterial or fungal infections if not kept clean
• Swelling of lower foot and toe area.
Most side effects occur when wearing the wrong size or improperly fitted socks.

Most compression socks are safe to wear for several hours. Prescribed compression stockings are often safe to wear all day and sometimes even all night, but you should consult with your doctor about duration. You should NOT sleep in compression socks unless specifically advised by a healthcare provider, as legs need time to rest.

Sizing and Fitting

To find the right size:
1. Measure the circumference of your ankle at its narrowest point (just above ankle bones)
2. Measure your calf circumference at the widest point
3. For thigh-high socks, measure thigh circumference and length
4. Measure when legs are least swollen (typically in the morning)
5. Consult the manufacturer's sizing chart with your measurements

The choice depends on your needs and body type:
• Knee-high: Most common, suitable for most conditions
• Thigh-high: Better if you have thicker calf muscles, as the extra material can create more comfort at the top of your calf
• Consult with a healthcare provider for medical conditions

If over-the-counter socks aren't effective, you may need prescription-grade compression stockings. Companies have no regulations on compression amounts for over-the-counter products, so descriptions like 'mild' or 'moderate' aren't standardized. Medical-grade compression provides precise, measured compression levels.

How to Wear Compression Socks

Put on compression socks when you first wake up and your legs are least swollen. This is typically in the morning before getting out of bed or shortly after waking.

Tips for putting on compression socks:
• Bunch the socks up and turn the toe inside out
• Put your foot in, pull the sock over your heel
• Work the rest of the sock up your leg gradually
• Use powder (cornstarch or baby powder) to absorb moisture
• Wear rubber gloves for better grip
• Trim toenails and smooth rough skin patches
• Consider using a 'donner' device that holds socks open

Duration depends on your specific needs:
• For medical conditions: Often all day, as prescribed by doctor
• For travel: During flights and for a few hours after
• For athletics: 3-4 hours during and after exercise
• For work: Throughout your shift if standing/sitting all day
• Always remove at night unless specifically instructed otherwise by a healthcare provider

Care and Maintenance

Machine washing: Use delicate cycle with cold water (maximum 40°C/104°F), wash after each use, use mild detergent without brightener agents, avoid hot water. Hand washing: Use cold water in sink or bathtub, soak for 20-30 minutes with detergent if needed, rinse thoroughly. What to avoid: Never use bleach or chlorine, avoid fabric softeners, don't use tough action detergents or stain removers, never tumble dry.

Always air dry compression socks by hanging them up. They can dry indoors or outdoors. Avoid tumble dryers as heat can cause shrinking and damage the compression fibers. Natural drying helps maintain their shape and compression properties.

Wash compression socks after each wear. Daily washing is preferred, but wash at least every 2 days. Regular washing preserves elasticity and ensures proper compression levels are maintained. Merino wool compression socks can last up to 2 days maximum between washes.

With proper care and daily wear, compression socks typically last 3-6 months. Medical compression stockings that are worn and washed daily maintain their effectiveness for about 6 months. Replace them when they no longer provide the therapeutic pressure you need or show signs of wear.

Common Concerns and Troubleshooting

Discomfort can result from:
• Wrong size (too tight or too loose)
• Incorrect compression level for your needs
• Poor quality socks
• Not adjusting gradually to wearing them
• Underlying medical conditions.
If first-time wearing, it's okay to take them off and adjust gradually, like breaking in new shoes.

Compression socks are generally safe when properly fitted and used as directed. They can be harmful if:
• Wrong size is worn (too tight can cut off circulation)
• Worn by people with contraindicated conditions
• Not kept clean (can cause infections)
• Worn for too long without medical supervision

Not always. You can purchase mild to moderate compression socks (8-30 mmHg) over-the-counter at medical supply stores and pharmacies. You may need a prescription for:
• Higher compression levels (30+ mmHg)
• Severe edema cases
• Insurance coverage
• Custom fitting and measurements

Yes, compression socks are often recommended during pregnancy to help with swelling and circulation issues. However, consult with your healthcare provider about the appropriate compression level and duration of wear during pregnancy.

Generally, no. You should remove compression socks at night while sleeping unless specifically instructed by a healthcare provider. Your legs need time to rest, and compression socks are less effective when lying down.

Yes, compression socks are commonly worn during long flights to help prevent swelling and reduce the risk of blood clots. However, scientific evidence for preventing blood clots in healthy individuals is limited, except for those already at high risk.