An Interview with Michael McDaniel, MD at Emory University

What are compression stockings?

Compression stockings are a specialized hosiery that use compression to ease or prevent various thrombotic conditions such as deep vein thrombosis (DVT) and post thrombotic syndrome (PTS). The stockings are worn just as one would wear regular knee-high socks.

There are two main types of compression stockings: uniform and graduated. Uniform stockings use the same amount of pressure around the covered area. Graduated stockings, on the other hand, have the most pressure at the ankle, which gradually decrease as it moves up the leg.

Who needs to wear compression stockings?

Individuals who have suffered a blood clot, have leg swelling, suffer from PTS, fly frequently, or are on their feet for long periods of time benefit from wearing compression stockings.  Patients who have suffered a DVT or are at high risk for developing DVT and patients with PTS are typically given a prescription by their physician for compression stockings which specifies the gradient of pressure the stockings should be.

What are the benefits of compression stockings?

The benefits of compression stocking are numerous, when used for short term and long term. Some of the short term benefits include increased blood flow, pain relief in aching legs, decreased swelling in legs, and prevention of blood clots. The major long term benefit of compression stockings is preventing DVT and complications from DVT, such as PTS, from occurring.

How do I know what size compression stocking to buy?

The process of finding compression stockings that fit correctly can be challenging. First, one has to measure various parts of the leg, depending on what areas the stockings are meant to cover. For knee high compression stockings, one must measure the width of the ankle, the width of the calf, and the length of the calf. For thigh-high compression stockings, one should measure the width of the ankle, width of the calf, width of the thigh and the length of the legs. The measurements must be accurate in order to get all the benefits from the compression stockings. Another important thing to remember is making sure the pressure is correct. Pressure ranges from light support in (8-15 mm Hg), 15-20 mm Hg, 20-30 mm Hg, 30-40 mm Hg, and finally 40 -50 mm Hg. Providing too much pressure can cause skin changes, edema or ulcers; while too little support will not have the desired results.  Speak with your healthcare provider to determine which pressure is best for you.

Medical supply stores carry compression stockings and often have staff on hand to help measure you for compression stockings.

Putting compression stockings on can be tough! Any tips to make this easier?

Make sure the skin is dry, use rubber gloves (such as dishwashing gloves), do not bunch the stocking up, and turn most of the stocking inside out before pulling up the calf. Compression stockings may cause initial discomfort, which should subside over time.

How often do I need to purchase new compression stockings?

Compression stockings should be replaced every 5-6 months for adequate compression. Compression stockings can be costly, but your insurance provider may cover a significant part of the cost.

What is PTS or Post-Thrombotic Syndrome?

Post-thrombotic syndrome is the development of symptoms and signs of chronic venous insufficiency (poor blood flow) following deep vein thrombosis (DVT).

Symptoms of PTS include:

  • chronic swelling
  • chronic (or waxing and waning) pain
  • unspecific discomfort of the extremity
  • diffuse aching
  • heaviness, tiredness and cramping of extremity

PTS can be painful and costly.  If you think you might have PTS, speak with your healthcare provider as
soon as possible.

Originally published in The Beat- Fall 2016
By Rajath Bappanad, NATF 2016 Summer Intern