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DEAR MAYO CLINIC: My doctor prescribed compression stockings to prevent my legs from swelling during the day. How will that help, and are they all the same?
ANSWER: Compression stockings aren’t like regular stockings. They’re typically prescribed with certain specifications and require professional fitting. A number of tips and tricks can help to properly use and care for them so that they provide the intended therapeutic benefit with minimal risk of side effects.
Compression stockings — sometimes referred to as pressure socks — gently squeeze your legs in a way that helps promote blood flow from the legs back toward the heart. Thigh or waist-high stockings help reduce pooling of blood in the legs and help prevent lightheadedness or falling when you stand up (orthostatic hypotension). Stockings that rise to just below the knee help limit lower leg swelling due to fluid buildup. They may also help prevent venous ulcers and can prevent the development of blood clots in the leg — especially if used after surgery or when you may be inactive for a while. In addition, compression stockings can help lessen the pain caused by varicose veins.
Compression stockings with a small amount of compression are sold without a prescription. Stronger compression stockings are prescribed by your care provider with certain specifications — such as strength of compression and length of stocking — based on the condition being treated. There are also a number of personal preference features, such as having a closed or open toe and stocking color, as well as numerous brands from which to choose.
Typically, your prescription is filled by trained staff at a medical supply store where your legs are properly measured for fit. A key factor is measuring your legs when they are at their least swollen — typically early in the morning. If your legs are severely swollen, you may need to wrap them with compression bandages leading up to your fitting to keep swelling to a minimum.
Compression stockings are designed to provide the strongest pressure around your ankle, with decreasing pressure as the stocking goes up the leg. Putting on, or donning, a compression stocking can be done a few different ways. One way involves gently pulling the unbunched, unrolled stocking over the foot until it fits well over the foot and heel. You also can do this with the stocking rolled down or folded inside out to the ankle level. Then you pull or unroll the rest of the stocking up the leg to the proper height, smoothing as you go. A device called a stocking donner can help you get a compression stocking on and can be particularly helpful if a condition such as arthritis makes it hard to grasp and pull.
For best results, make sure your skin is dry, especially after applying lotion. Moisture makes it harder to pull stockings on. Sitting in a chair for stability as you put on the stocking also may help. Once the stocking is on, check that seams run straight up the leg and that there’s no bunching or wrinkling, especially at the ankles. Don’t fold the top of the stocking down.
You can protect your compression stockings from damage by wearing socks, slippers or shoes over them, and being careful not to snag toenails, fingernails or jewelry on the stockings. A tear or run likely means it needs to be replaced. Stockings also may need to be replaced if they begin to bunch up, wrinkle or slide down, or if they stretch out over time.
Be sure to wear the stockings as prescribed, whether putting them on as soon as possible in the morning and wearing them until bedtime, or wearing them for the entire day and night. If you forget to wear them, your legs may swell, making it difficult or impossible to get the stockings on again. If your legs do swell, you’ll need to take steps to diminish swelling, such as lying down with your feet elevated or wearing compression bandages overnight. Contact your health care provider if swelling persists for more than a couple of days or to discuss other options if you are having trouble wearing the stockings.
Finally, it’s important that while you wear compression stockings you check your legs daily for areas of skin irritation, redness or other color or skin changes. These may be signs that your stockings don’t fit correctly or that you have an infection. Contact your health care team if this occurs. (adapted from Mayo Clinic Health Letter) — Dr. Paul Takahashi, Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota