Compression stockings and varicose veins

Compression stockings are often prescribed for patients post varicose vein treatment. The point of compression stockings is to promote blood flow in your legs and to reduce pain and swelling. Throughout this post, we will take a look at what exactly they do for your legs and veins and how you can get the most out of them day to day. Compression hosiery comes in various forms, and it is important for you and your doctor to find the best grade and fit for you. Modern compression stockings as we know them were invented in 1950 by a German engineer named Conrad Jobst (who suffered from varicose veins himself), but variations are rumoured to have been used as early as the Roman era, when soldiers would wrap their lower legs in leather strapping to improve circulation during long marches. Thankfully, today’s iterations are less aggressive, like tights but thicker, and without the sheen, available in a variety of skin tones.

How exactly do they work

Compression stockings are at their tightest around the ankles, decreasing in pressure as they go up the leg. This encourages the flow of blood upwards towards your heart, pumping it up against the force of gravity if your own veins are struggling to do so. Varicose veins, as discussed in previous blog posts, occur when the valves in your leg veins are not working properly and the flow of blood back up your legs is not happening as it should. The blood then pools around your calves and ankles, sometimes causing the twisting, rope-like blue or purple-ish coloured surface veins we know as varicose veins.

By putting pressure on the legs using special hosiery, it compresses these surface veins and arteries, assisting the flow back inwards and upwards through your leg. For this reason, it is important to wear your compression stockings throughout the whole day, putting them straight on in the morning prior to lowering your legs as you get out of bed, and only removing them once they are raised again at the end of the day. This ensures maximum efficiency of the stockings, and helps to reduce the risk of reoccurrence.

Lie back and relax

Compared to sitting or standing, remaining fully horizontal allows the valves in your leg veins to function most effectively. As soon as gravity is involved, your blood flow has to fight its way up your legs, made all the more difficult if your valves are in any way damaged. This is why your legs may feel fine when you start your day in the morning, but your ankles and calves begin to feel heavy and swollen as you remain upright during the day.

Putting on your compression stockings before you swing your legs out of bed in the morning helps to keep your valves and veins in the right position and continue the good work done during the night while horizontal- or, even better, when you had your lower legs slightly raised on a pillow or cushions.

Once on in the morning, your stockings can assist in alleviating the following vein related symptoms:

• Heaviness or aching in the legs
• Swelling, especially in the ankles
• Pain or feelings of tiredness in the legs
• Cramping in the legs
• Swelling, particularly around the ankles

What are my options

NICE guidelines state that below-knee compression stockings are usually preferred, and thigh length stockings should be considered if there is severe varicose vein evident above the knee or swelling that extends above the knee. It also advises that, although stockings come in three grades of pressure, the compression used should be the highest that the person can tolerate. The gradings are as follows:

• Class 1 (light compression) – ankle pressure of 14-17 mmHg.
• Class 2 (medium compression) – ankle pressure of 18-24 mmHg.
• Class 3 (high compression) – ankle pressure of 25+ mmHg.

European standard stockings provide a stronger degree of compression for each of the above classes, and some hospitals may issue these.

Onwards and upwards

Due to the nature of compression stockings being incredibly tight, they can be difficult for some people to put on, especially if you suffer from arthritis. Most stockings come with instructions for how to put them on, and there are plenty of helpful videos on YouTube demonstrating this, as well as a number of devices that can help with getting them on and off. They can also cause some irritation or denting to the skin, and it is advised that if you remove your stockings during the night, you moisturise your skin and keep an eye out for any sores or irritations. It is important to stay aware of the condition of your legs and check when removing them at the end of the day for any signs of the above on your feet and legs. It can help to use a mirror (especially on a long handle) to assist you.

If you are pregnant and suffering from varicose veins, your healthcare professional may offer you stockings for the duration of the pregnancy, but it is advisable to wait for any other treatment until after pregnancy. We have a whole blog post dedicated to discussing varicose veins and pregnancy.

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Useful links:

• ‍Do compression stockings help to treat varicose veins?
• Treatment - Varicose veins
• How to use the stockings
• A Word of Thanks for My Compression Socks
• How To Put On Compression Stockings

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