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What You Need to Know About Compression Socks Before You Buy

Vein specialist Dr. Eugene Ichinose is a firm believer in compression socks – not only for patients but also for himself. He once stood on a chair during a presentation to model the compression socks he wears to help improve circulation as he stands throughout the day.

Compression socks work by promoting improved blood flow in your legs. The compression of the socks gently pushes blood flow up the leg, helping to prevent swelling and even blood clots. If you have noticed your legs swelling or the appearance of varicose veins, for example, you may wonder if compression socks would be a good idea. Many people can benefit from compression socks after surgery, during pregnancy or as legs start feeling achy, swollen or heavy. However, before heading out to the store or browsing online, here are some things you should consider to make sure you are getting the maximum benefit from compression socks.

All compression socks are NOT created equal. “The quality of the material, the sizing, the durability and the amount of compression or pressure the garment provides all culminate into the final product,” explains Dr. Ichinose. “Some very economical support hose are not sized by careful measurement of your leg.  They are labeled small, medium and large, however the amount of compression provided is not known.”

Consider the size and amount of compression. Dr. Ichinose advises patients to know the size and the amount of compression you need. Your healthcare provider will advise you on the compression level you need, as well as measure your leg to make sure you are fitted in a proper compression sock. However, you can also measure yourself for compression socks. In the morning before swelling occurs, measure the circumference of your ankle (around your ankle), the circumference of your calf and the length of your calf (from the knee to the heel sitting with your legs at a 90-degree angle). Use the sizing guide on the compression sock packaging to find the right fit for you. There are three main compression levels:

  • Mild compression - 15-20mm Hg. Prevention and relief of minor to moderate varicose veins, relief of tired aching legs, relief of minor swelling of feet and legs
  • Moderate compression 20-30mm Hg. Prevention and relief of moderate to severe varicose veins, treatment of moderate to severe lymphatic edema and management of active ulcers or post-thrombotic syndrome
  • Firm compression 30-40mm Hg. Ulcer management, post-thrombotic syndrome

“The amount of compression provided by a pair of socks will vary depending on the size of the leg in relation to the size of the garment,” says Dr. Ichinose. “Patients commonly complain that the compression socks cut into their leg. This usually happens when a large leg was placed in a garment too small for the leg.”

Consider quality first instead of price. “Many socks are chosen based on economics,” says Dr. Ichinose. “However, they give up quality material and workmanship in order to be economical. Unfortunately, many times you get what you pay for. There are four main companies that have been providing compression socks for decades - Juzo, Sigvaris, Medi and Jobst. These companies have made medical-grade compression socks for decades. The quality and workmanship make them high-grade.”

Compression socks are NOT recommended for some patients. “If you have peripheral vascular disease affecting your lower extremities, you should not wear compression socks,” he says. “The pressure provided by compression socks may make ischemic disease worse. Diabetic patients can be at increased risk of complications since neuropathy prevents them from feeling the changes in their feet.”

Dr. Ichinose tells his patients to pay close attention to the color of their toes and report any differences in the color of their toes from the foot or leg to your health care provider. “Also, watch for bunching of the hose. This may make a tourniquet effect, which may interfere with circulation. Make notes about the color, sensation, swelling and temperature of the toes before putting on the compression socks. Open-toe hose/socks may make monitoring more practical.”

Dr. Eugene Ichinose, Dr. Robert Smith and Dr. Stanley K. Zimmerman lead the Oklahoma Heart Institute Center for the Treatment of Venous Disease, treating patients with peripheral venous disease including varicose veins, deep vein thrombosis and venous insufficiency. To schedule an appointment, please call 918-592-0999 or click visit our web page.