Varicose veins are more than just a cosmetic concern; they signal a circulatory issue known as chronic venous insufficiency (CVI). This common condition occurs when the valves in the leg veins weaken, allowing blood to pool instead of flowing efficiently back to the heart. This pooling leads to the swollen, twisted appearance of varicose veins, often accompanied by pain, heaviness, and fatigue in the legs.
Compression stockings for varicose veins are the gold standard non-surgical management, and for good reason. They are simple, highly effective, and essential for managing symptoms and slowing the progression of the disease.
How Compression Works on Your Veins:
- External Support: The stockings provide graduated pressure—tightest at the ankle and gradually decreasing further up the leg. This external squeeze mechanically assists the weakened vein walls, helping the valves close properly.
- Improved Velocity: By reducing the diameter of the veins, the compression increases the speed (velocity) of blood flow back toward the heart. This prevents stagnation and pooling.
- Reduced Swelling: The pressure also helps prevent fluid leakage from the capillaries into the surrounding tissue, effectively reducing the uncomfortable swelling and heaviness associated with venous disease.
This mechanism makes compression wear the most effective, non-invasive treatment available for symptom management.
Choosing the Right Prescription: Understanding Your mmHg:
When your doctor recommends compression, they are prescribing a specific level of pressure, measured in millimeters of mercury (mmHg). This is the most crucial factor for effective treatment.
| Compression Level | Pressure (mmHg) | Doctor Recommended For | Where to Find It |
| Mild | 8–15 mmHg | General fatigue, minor spider veins, travel prophylaxis. | Most over-the-counter (OTC) pharmacies. |
| Moderate | 15–20 mmHg | Mild varicose veins, minor edema (swelling), pregnancy-related swelling. | OTC and medical supply store products. |
| Firm | 20–30 mmHg | Moderate to severe varicose veins, significant edema, post-sclerotherapy, CVI management. | Requires a doctor's recommendation; found at medical suppliers. |
| Extra Firm | 30–40+ mmHg | Severe venous disease, active venous ulcers, deep vein thrombosis (DVT) management. | Requires prescription and professional fitting. |
Crucial Note: For established varicose veins, a 20–30 mmHg compression stocking is often the minimum effective starting point, as prescribed by your physician. Do not simply rely on non-specific "support hose" from a retail store; always seek medical grade compression socks that meet certified pressure standards.
📐 The Patient's Fitting Checklist:
- Time of Day: Measurements must be taken first thing in the morning when swelling is at its lowest.
- Key Measurements: Your doctor or supplier will measure the circumference of your:
- Ankle (narrowest point): This is where the highest pressure must be applied.
- Calf (widest point).
- Thigh (for thigh-high models).
- Length: From the floor to the knee or groin.
3. Style: Choose a style that covers the affected area. If your veins and swelling extend past the calf, you will need a thigh-high compression stocking. If they are confined to the lower leg, knee-high compression socks are generally more comfortable and sufficient.
Daily Usage and Maintenance Tips
Consistent wear is the key to success. Compression is a therapeutic garment that must be worn daily while you are active and upright.
- When to Wear: Put them on immediately after waking up and before swelling begins, and remove them only when you are going to bed.
- Donning/Doffing Tools: If you struggle with the stiffness of 20–30 mmHg compression stockings, use specialized donning aids or rubber gloves to grip the material and slide them on smoothly. Never roll the top down, as this creates a tourniquet effect.
- Cleaning: Hand wash daily with mild soap and hang or lay flat to air dry. Heat destroys the elasticity that creates the compression power. Never put them in a dryer.
- Replacement: Compression stockings lose their effective pressure over time—typically every 4 to 6 months—depending on the frequency of wear and washing. If they feel easier to put on or the swelling returns, it's time for a replacement.
Compression therapy is not a temporary solution; it is a vital part of managing chronic venous disease. By choosing the correct medical grade compression socks and wearing them consistently, you are actively helping your circulatory system, reducing pain, and supporting your daily comfort and mobility. Always follow your physician's specific advice on pressure level and usage.