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Do you ever recommend compression socks to your patients? Why or why not?

I recommend compression socks to my patients that have swelling in the lower extremity and associated pain or discomfort resulting from venous insufficiency, lymphatic damage, and/or injury.  

 

In your opinion, are there benefits to compression socks? If so, what are they? 

When worn correctly, compression socks are very beneficial in providing good circulation of the blood flow in the feet and legs.  The consistent pressure along the feet and legs along with movement promotes blood flow up from your ankles through the veins in your legs and back towards your heart.  This will reduce aches and pains usually caused by blood flow problems.  

 

Who should wear compression socks?

Compression socks should be worn by patients that have venous insufficiency, such as DVT, varicose veins and diabetes, post-operative patients, pregnant women, people who stand or sit for long periods of time, and athletes especially those who run for prolonged periods of time.

 

Who should not wear compression stocks?

Patients that have arterial insufficiency should not wear compression socks as it can cause restriction of blood flow to lower extremities.  Consult with your physician prior to wearing compression stockings.

 

What should someone look for in a pair of compression socks? What is the best way to gauge the amount of pressure in compression socks?

When looking for a pair of compression socks one should first measure the circumference of the ankle, calf, and thigh as well as the length from your knee or thigh to the floor with a tape measure to determine the size needed.  Once you determine the size, the next step is to determine the amount of compression based on your needs. Medical grade socks are usually graduated, which means they start tighter at the foot and ankle and gradually get looser towards the top.  The design helps prevent the socks from cutting off circulation.

Compression stockings come in five levels of pressure applied to the leg.  The higher the number the greater the compression. Under 15 mmHG socks are recommended for patients that stand or sit for long periods of time or healthy active patients to control minor swelling, energize your legs, and provide relief of discomfort. 15-20 mmHg socks provides mild compression and relief from minor to moderate swelling, aching, and varicose veins especially during pregnancy or in people with foot and ankle swelling who travel by plane to help prevent deep vein thrombosis.  20-30 mmHg socks is the category most frequently prescribed pressure by physicians sometimes used to provide relief from varicose veins, edema, deep vein thrombosis, and following vascular surgery. 30-40 mmHg socks are often prescribed to provide relief from severe edema, varicose veins, and DVTs and venous stasis ulcers. 40-50 mmHg socks have the highest level of compression available and should only be worn under medical supervision. This level is typically used to treat chronic venous insufficiency and DVTs. 

Can compression socks be worn overnight?

 

Compression socks should be used during the day when you are in a vertical position such as walking.  Also, if you sit for prolong periods of time the affects of gravity cause the fluid to accumulate in your lower extremities.  When you are sleeping you are in a horizontal position which means that the fluid in your body is in equilibrium throughout so it does not accumulate in your legs.  Therefore, wearing compression socks while sleeping is not recommended or required.

 

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