From the Guidelines
Your client is likely wearing compression socks to alleviate symptoms of post-thrombotic syndrome (PTS) or to improve blood circulation in their legs, despite recent guidelines suggesting against their routine use for preventing PTS in patients with acute DVT of the leg. Compression socks apply gentle pressure to the legs and ankles, which helps blood flow back to the heart more efficiently and prevents blood from pooling in the veins. These socks are commonly recommended for people who have conditions like deep vein thrombosis, varicose veins, or lymphedema. They're also beneficial for individuals who stand or sit for long periods, pregnant women, athletes, and people recovering from surgery.
Key Points to Consider
- Compression socks work by creating a pressure gradient that's strongest at the ankle and gradually decreases up the leg, which physically assists the normal pumping action of the veins.
- The compression level typically ranges from 8-15 mmHg for mild support to 30-40 mmHg for medical-grade compression, with the appropriate level depending on the specific condition being addressed.
- Recent studies, such as the one published in 2021 1, suggest against the routine use of compression stockings to prevent PTS in patients with acute DVT of the leg, due to low-certainty evidence.
- However, a more recent study from 2024 1 found that compression sleeves or socks were associated with lower PTS severity at follow-up in pediatric patients, highlighting the potential benefits of compression therapy in certain populations.
- The decision to use compression socks should be based on individual patient needs and preferences, taking into account the potential benefits and drawbacks of compression therapy, as well as the latest evidence from high-quality studies like the one published in 2024 1.
Practical Considerations
- For best results, compression socks should be put on in the morning before swelling occurs and removed before sleeping.
- Patients should be educated on the proper use and care of compression socks to enhance adherence to therapy.
- Specialized care and follow-up may be necessary to ensure that patients are using compression socks effectively and to address any concerns or issues that may arise.
From the Research
Reasons for Wearing Compression Socks
- Compression socks are often prescribed to patients with chronic venous disease (CVD) to improve venous return and reduce pressure in the legs 2.
- They are also used to prevent recurrence of venous ulcers, with EU class 3 compression stockings showing potential in reducing reulceration compared to no compression over six months 3.
- Additionally, compression socks can increase lower limb venous blood flow, which may reduce the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) during prolonged seated immobility 4.
Benefits of Compression Socks
- Compression socks can improve symptoms of varicose veins, such as pain and swelling, although the evidence is largely subjective and based on low-certainty studies 5.
- They can also reduce ankle and calf circumference, indicating a potential reduction in lower limb swelling 4.
- However, compliance with compression sock use can be low due to factors such as discomfort, poor cosmetic appearance, and difficulty applying the socks 2.
Types of Compression Socks
- Different types of compression socks are available, including knee-length and full-length stockings, as well as varying pressures (e.g., 10 mmHg to 50 mmHg) 5.
- The optimal length and pressure of compression socks for treating varicose veins are unclear, with no conclusive results from existing studies 5.
- Merino wool graduated compression stockings have been shown to increase lower limb venous blood flow and may be a suitable option for reducing the risk of DVT and PE during prolonged seated immobility 4.