Venous disease is one of the most common health problems in the U.S., affecting approximately 50 percent of the population. The condition includes varicose veins, spider veins, or deep vein thrombosis.
Today, there are several outpatient, minimally invasive treatments for vein issues. One alternative is compression therapy. Compression stockings can prevent vein problems from occurring, relieve venous symptoms such as leg swelling, fatigue or achiness and decrease the likelihood of a blood clot.
To better understand venous disease and how compression works, here’s a quick review of how veins work. Veins carry blood from all the extremities back to the heart. The blood in the legs travels up, against gravity, so when the valves in those veins become damaged, blood flows back into the legs to create a “pooling” effect.
Graduated, or gradient, compression stockings provide a gradient of pressure against the leg. The pressure is highest at the foot and ankle and gradually decreases as the garment rises up the leg. This makes it easier for the body to pump blood up towards the heart and more difficult for gravity to pull blood downward.
Patients wearing compression stockings frequently report that their symptoms are significantly improved, if not completely alleviated. Ample data proves that compression can reduce the recurrence of varicose veins and venous ulcers.
“TED hose” are not the same as graduated compression stockings. T.E.D. — an acronym for Thrombo Embolic Deterrent — hose are “anti-embolic” stockings often worn after surgery to help prevent deep vein thrombosis, a blood clot in the deep vein system, while patients are bed-bound. They work well for this purpose, but for patients who are up and walking, generally, TED hose will not stop the progression of venous disease.
Compression stockings require a prescription and can be purchased at many pharmacies, most major medical supply stores and specialty stores. Your doctor can tell you if you need knee-highs, thigh-highs, or a “pantyhose” style. These days, compression stockings are fashionable, comfortable, and come in a wide variety of styles and colors. Though modern compression stockings usually look like socks or tights, putting them on can be a challenge.
Here are some tips if you’re considering compression:
• Check with your doctor to see if compression therapy is appropriate for you, as well as what compression strength is right for your problem.
• A good fit is absolutely essential, so have someone (ideally a professional fitter) help measure your leg, including circumference.
• Different brands vary in size and length, so try them on if you can, and know the return policy.
• Never roll the stockings like a sock, which can create a tourniquet-like effect.
• Do not wear compression garments to bed, unless instructed to by a medical provider.
There are many benefits to graduated compression therapy, including reduced risk factors for deep vein thrombosis, but be sure to consult your physician. Compression is not appropriate for all patients and may adversely affect some patients with peripheral arterial disease.
Dr. Cindy Asbjornsen is the founder of the Vein Healthcare Center in South Portland and the Maine Phlebology Association.