Compression Stockings

What are graduated compression stockings?

When calf muscles contract they squeeze deep major veins in the leg (the popliteal and tibial veins) forcing blood up the legs to the heart. Blood flows along the tibial vein in the lower limb and joins the popliteal vein from the knee upwards.

Compression stockings help increase blood flow in these veins by applying graduated pressure to the leg, improving performance of the calf muscle pump. The pressure is graduated and is greatest around the ankle, decreasing further up the leg.

Uses

Compression stockings can be used to help treat conditions associated with poor blood flow in the veins (chronic venous insufficiency).

Conditions which may benefit from medical compression stockings include:

  • Spider Veins (telangiectasia)
  • Varicose Veins
  • Venous Eczema
  • Venous Ulcers
  • Lipodermatosclerosis (gradual hardening/thickening of the fatty tissue below the skin due to high pressure in surrounding veins)
  • Lymphedema
  • DVT Prevention (deep vein thrombosis)
  • PTS (post-thrombotic syndrome)
  • Swelling (edema)
  • Burn Scars
  • Aching, tired legs

Medical Compression Stockings Classes

Compression stockings are classified according to their tightness when fitted around the leg.

There may be variation in pressure classification between different standards. For example a European standard class 2 medical stocking has a stronger gradual compression compared to a UK standard Class 2. Medical compression stockings are available through prescription, however lower pressure and support stockings can be bought over the counter which require no prescription.

Table: Compression Stocking Classes
Over the counter Prescription Europe & some
Custom Fittings
UK
10 – 15 mmHG 20 – 30mmHG 18 – 21 mmHG Class 1 - Light Compression
15 – 20 mmHG 30 – 40mmHG 23 – 32 mmHG Class 2 - Medium Compression
  40 – 50mmHG 34 – 46 mmHG Class 3 - High Compression
  50+ mmHG 50 mmHG  

Varieties

Graduated compression stockings are usually available in 2 different lengths; below the knee and thigh length stockings. Pantyhose versions are also available.

Each style has a different product code:

  • AD – Knee High
  • AG – Thigh High
  • AT - Pantyhose

Below the knee stockings are the most popular length. They are fitted over the lower leg and directly enhance the calf muscle pumps ability to pump blood up through the veins

Thigh length stockings are not always necessary and if they are found difficult to use, below knee stockings should be tried as an alternative. Thigh length stockings tend to be used when swelling extends above the knee or when varicose veins are very large.

Toe Fittings

Compression stockings may also be available with open or closed toe fittings.

Open toe stockings may be preferred by those who need more breathe ability (particularly if they have a fungal infection on their toe) or by those with arthritic or clawed toes.

Open toe stockings may also be of benefit to those with long feet compared to the length of their calves and to people who wish to wear a sock over the stocking.
See also 'Compression Stocking Fitting'.

Colors

As parts of the stocking are usually visible, compression stockings are normally available in a range of colors. Females often prefer the skin tone colors whilst men tend to opt for the darker colors (black is popular).

Materials & Construction

Compression stockings are elasticated and are usually made from rubber or elastic fibres which help compress the leg, improving circulation.

Some manufacturers produce stockings with silver textiles fibres. Silver has medical antimicrobial qualities which inhibits the growth of microbes including bacteria, fungi and viruses.

Flat knit graduated compression stockings are usually created for higher compression classes and have a seam which can be made into almost any shape or size.

Some manufacturers offer circular knit stockings which are seamless and have greater aesthetic qualities.

See also manufacturing of a medical stocking.