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Compression Stockings for Edema

Wearing compression stockings can help reduce edema.
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Compression stockings are used to improve blood flow that is affected by poor circulation caused by edema. Edema is the clinical term for water retention, and it refers to abnormal buildup of fluid under the skin, which may often be noticed in the lower legs, around the ankles and feet. 

Some common causes of edema are sports injuries, humid weather, pregnancy, surgery, varicose veins, or sitting or standing for extended periods of time. Some underlying medical conditions may also lead to edema. 

Doctors may recommend edema patients to wear compression stockings to prevent fluid from building up in the tissues. These socks work well to create pressure on a patient’s legs and treat edema

The firmest socks are prescribed to people experiencing severe cases of lymphedema, also referred to as swelling and fluid retention in the body. 

What Are Compression Stockings?

Compression stockings are special hosiery intended to prevent or stop the progression of venous disorders such as edema, thrombosis and phlebitis.

They are elastic and provide measured pressure against the legs so as to reduce the size of distended veins, increase blood flow, prevent the stagnation of blood in the veins and the pooling of fluids in extracellular spaces.

Compression stockings exert their greatest pressure at the ankles. This pressure eases up all the way to the knees and thighs to provide graduated compression.

Usually only about 40% of the pressure at the ankles is supplied at the thigh and 70% at the calves. This pressure drives more blood to flow back to the heart so that less blood is pooled at the feet.

This process is known as compression therapy.

Compression therapy is used for chronic problems with fluid pooling in the legs, such as edema or chronic venous disease. Some people may have leg edema and not know it because the swelling is mild. However, common symptoms that coincide with swelling include a heavy feeling in the legs, aching legs, and legs that always feel tired.

The most important benefit of compression therapy is the application of pressure on the tissues under the skin. This prevents fluid from pooling in the legs and encourages it to move up toward the heart like it does with healthy circulation. The pressure helps keep fluid inside the blood vessels and prevents it from leaking out. Another benefit of compression stockings prevents blood from flowing backward and causing congestion in blood vessels. This congestion can lead to an increased risk for blood clots and other serious health complications. Most swelling, skin discoloration, and leg pain in a person with edema is caused by congestion in the blood vessels.

When Not to Use Compression Stockings

Not every case of edema should use compression stocking treatment. Although compression stockings are commonly used with edema patients, a few other conditions make it an unwise treatment option. Ultimately, your doctor will determine if compression stockings are right for your case of edema, but generally compression stockings are not used if the following conditions are present:

 

  • Uncontrolled congestive heart failure
  • Skin infections
  • Open wounds
  • Ischemia
  • Untreated septic phlebitis of the leg
  • Sensitivity in the legs
  • Immobility
  • Phlegmasia cerulea dolens

 

Are Compression Stockings Helpful?

Compression stockings are prescribed for a number of conditions, including edema, pregnancy, and diabetes. The stockings are known to effectively reduce mild leg swelling. They should be worn during the day but taken off at night. 

These socks are made of a strong, elastic fabric that often runs from the foot to the thigh at different pressures based on the amount of pressure required. They are available in a variety of colors and styles; and can be purchased over the counter or online. 

Gradient compression stockings are generally the most common type recommended for edema. Gradient compression stockings are tighter at the ankle and gradually loosen pressure toward the top of the stocking. This helps prevent fluid from pooling around the ankles, which is common in edema. Gradient stockings are also helpful for individuals with edema who have jobs requiring they sit or stand for long periods (like most American adults).

In addition to edema, compression stockings are helpful for the following health conditions:

What Conditions Need Compression Stockings
  • Edema
  • Aching legs
  • Leg swelling
  • Varicose veins
  • Venous insufficiency
  • Healed venous ulcer
  • Lymphedema
  • Active venous ulcer
  • Post-thrombotic syndrome 

 


Different Types of Compression Stockings 

Compression products are measured in millimeters of mercury, or mmHg. The measurements range from mild compression to extra-firm compression.

Mild compression (8-15 mmHg) can be used to get relief from tired and aching legs. This level of compression may also ease pain associated with mild varicose veins and help reduce minor swelling in the ankles and legs.

Moderate compression (15-20 mmHg) can be used reduce mild to moderate leg swelling, sore legs, and mild leg pain.

Firm compression (20-30 mmHg) can be used to reduce moderate swelling or edema and mild to moderate leg pain. It may also be used to prevent the reoccurrence of venous ulcers in the legs.

Extra firm compression socks (30-40 mmHg) may be used to heal severe circulatory disorders of the legs, including severe swelling or edema. Patients, especially those with diabetes, should consult their physician before using compression socks or stockings. 

How to Use Compression Stockings

Given they are meant to compress a limb, compression stockings are somewhat difficult to put on. The main challenge in getting compression stockings on is the ankle area. The area between your heel and ankle is much larger than the circumference of your ankle, making it challenging to slip the stockings over your foot. There are a few tricks to making the process easier.

  • Use rubber gloves to grab the stockings and pull them up.
  • Rub lotion into your leg before putting on the stockings.
  • Don't put the stockings on right after a shower.
  • Use both hands to gently pull the stockings into place.

How to Put On Compression Stockings

Put your stockings on the instant you wake, right after getting out of bed, if possible. This is the time of day when swelling is the lowest, which will make putting stockings on easier.

Sit on a chair with a back. Hold the top of the stocking in one hand and push your other arm through the stocking and grab the toe. Pull the toe up and turn the stocking wrong side out. Leave your fingers at the tip of the stocking.

Place your toes in the toe of the stocking where your fingers are. Gently roll and slide the stocking over your foot and heel. This will turn it right side out as you go along.

Gently roll the stocking up to its full height. Don't pull on the top of the stocking or it could tear, requiring the purchase of a new stocking.

In some cases, your doctor may prescribe multiple stockings to be worn at once.  Legs should be fitted for compression stockings in the morning, or after the leg has been elevated for about half an hour. This will reduce swelling in the area and ensure an appropriately tight fit that will prevent fluid build-up.

How Long Should I Wear Compression Stockings for Edema?

Your doctor will give an estimate on how long you will have to wear compression stockings. Every few weeks or months you will go in for an evaluation to determine if you no longer have to wear the stockings. However, in some cases, it is necessary to wear compression stockings for months, years, or even the rest of your life. If you can get edema under control with other treatments, like herbal supplements, diuretics, and prescription treatments, your duration of wearing compression stockings will be lessened. However, if you have weak veins that have been damaged in some way or that cannot prevent fluid from escaping, it can be dangerous to let edema continue. It is better to wear compression stockings for several months or years than endanger your health by removing them too early.

More Information on Compression Stockings

Before compression stockings are recommended, the prescribing physician should first calculate the patient’s ABI (Ankle Brachial Index).

Compression stockings are only needed for patients whose ABI scores exceed 1.0 per leg. These stockings will increase the risk of obstructing a patient’s arterial blood flow if worn over legs with ABI scores less than 1.0.

Unless an edema patient can ascertain that her legs have ABI scores greater than 1.0, that the stockings’ compression gradient is 15 – 20 mmHg and that they are a perfect fit, a doctor’s examination and prescription are necessary before using compression stockings.

Compression stockings can either by gradient or anti-embolism.

Gradient compression stockings are recommended for patients with edema in the lower limbs, those prone to blood clot or blood pooling after extended period of time spent sitting.

Anti-embolism compression stockings are used to stimulate the venous and lymphatic drainage of the legs. This type of compression stockings requires the pumping action of the calf muscles to improve blood and lymph circulation in the legs.

Anti-embolism compression stockings are mostly used for patients who will not be on their feet for some time especially after surgeries.

Compression stockings go by different names depending on their intended use. Support compression stockings are over-the-counter compression stockings providing mild compression and needing no doctor’s prescription to buy.

Lymphedema compression stockings are used to manage edema caused by impaired lymphatic system. Anti-embolism compression stockings are made for non-ambulatory patients to prevent thrombosis in the veins due to prolonged pooling of blood in the legs.

Circular knit compression stockings are embroidered to provide aesthetic appeal. Flat knit compression stockings are high compression stockings with seams that can be adapted to any shape or size.

Custom compression stockings are specially ordered stockings which are designed for specific individuals. Silver compression stockings have special silver fibers in the textile material; silver is included for its anti-microbial properties.

Compression stockings carry special designations to differentiate their length. Knee-high stockings are coded AD. AG is for thigh-high stockings and pantyhose compression stockings are labeled AT.

Care for Compression Stockings

If you are ordering compression stockings, it is important to take your measurements in the right way to ensure a perfect fit. The compression stockings should be snug against your skin and not too tight or too loose as to wrinkle or bunch.

You should take measurements early in the morning if your legs swell during the day, and measurements should be preferably taken while standing although a seated position is acceptable for non-ambulatory patients.

Leave on any wound dressing while taking these measurements and measure directly over skin and not over clothes.

Make sure to follow attached instructions when wearing compression stockings. Generally, you should hold each stocking by the heel then gently slide your foot in until the toes and heel are in place. Then pull the stocking by its top and roll over the calf up to where the length runs out.

Since compression stockings are made of elastic materials, they should be preferably hand washed in cold or lukewarm water. Heat should be avoided as much as possible. Therefore, ironing is also discouraged.

Dry out the stockings on a line spread in a shade. You should never wring compression stockings or bleach or machine-dry them.

When to Wear Compression Stockings 

You may wear compression socks to improve your circulation and reduce edema. These garments keep pressure on your legs to prevent excess fluid from collecting in the tissues.

Ask your doctor which compression level is suitable for your edema condition. Physicians may also prescribe diuretics for edema patients to force the kidneys to excrete more water and reduce fluid retention. 

Compression stockings should not be worn by edema patients who also suffer from congestive heart failure, septic phlebitis, oozing dermatitis, peripheral obstructive arterial disease and loss of sensation in the extremities.

Compression Stockings for Edema Provide Benefit

Compression stockings are one of the number one prescribed treatments for edema. The stockings work alongside other treatments, like herbal treatments to prevent edema from returning and diuretics to reduce swelling and edema temporarily. In some cases, compression stockings can be life-saving devices and are beneficial in multiple ways.

If you suffer from chronic edema, ask your doctor about whether compression stockings are right for you. In addition to provide benefit to everyone, compression stockings are particularly helpful for pregnant women with edema, as many common remedies for edema are not safe to use during pregnancy. 

For more information on edema and its treatment methods, read these articles: Edema Diet: Foods to Avoid, Leg Edema Treatment, and Types of Edema.

Next Article: Edema Diet: Foods to Avoid for Edema
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