Do Compression Socks Help With Swelling?

Swelling, also known as edema, can happen all over the body. For example, macular edema occurs when you have a buildup of fluids in the retina. Obviously, no matter how diligently you wear compression socks, they will not help to alleviate swelling in your eyes! So, to answer the question, "Do compression socks help with swelling?" we need to begin by narrowing in on the types of swelling that impact the lower legs, ankles, and feet.

Different types of edema include:

• Peripheral edema
• Pulmonary edema
• Cerebral edema
• Pedal edema
• Macular edema
• Lymphedema 
• Periorbital edema

Compression socks are particularly useful for alleviating the symptoms of peripheral edema (swelling of the lower legs), pedal edema (swelling of the feet), and lymphedema (swelling caused by the lymphatic system). For these types of edema, compression socks have been proven to prevent swelling and reduce discomfort. 

In some cases, advanced edema can cause stretched, shiny skin and ulcers. Compression garments have also been shown to relieve these secondary symptoms. For example, a 2019 study concluded, "The available evidence shows that, compared with usual care, compression stockings are effective in preventing venous leg ulcer recurrence and likely to be cost-effective." (Health) Beyond relieving pain and reducing swelling, compression therapy can also help to prevent problems that result from edema, like ulcers and skin changes.

How Do Compression Socks Prevent Swelling? 

Swelling in the lower legs, feet, and ankles is caused by dysfunctional lymphatic vessels or blood vessels; they leak, allowing fluid to build up in the surrounding tissue. The accumulation of fluid causes inflammation and bloating. By wearing compression socks, a person can prevent fluid from building up in the first place. Ideally, someone suffering from edema would put on compression socks before the affected area begins to swell. For many people who experience edema, this means that the best time to put on compression socks is early in the morning, before getting out of bed. 

Dr. Hugo Parsch explains the "common experience" of legs that swell at the end of a working day, writing, "It is caused by extravasation of fluid from the venules because of a steadily increased venous pressure...owing to gravity." (737) Graduated compression socks work against gravity by exerting more pressure on the ankle and less pressure at the calf. Through this gentle upward pressure, compression socks assist the veins in pumping waste fluid and blood out of the lower extremities, thereby reducing discomfort, heaviness, and swelling. 

How Many People Suffer From Edema? 

LIMPRINT (Lymphoedema IMpact and PRevalence – INTernational Lympoedema Framework), an international study, is underway,attempting to determine the number of patients around the world who suffer from chronic edema. On the study's website, researchers explain, "From 2014 to 2017, 9 countries with 40 sites have contributed to an international data set of over 13,000 patients." ("LIMPRINT") So far, data suggests that nearly one third of hospital inpatients have chronic edema, but more results are forthcoming. 

By all accounts, peripheral edema is an incredibly common symptom with a large number of root causes. According to doctors Shaun Cho and J. Edwin Atwood, peripheral edema occurs in 80% of normal pregnancies and, "Peripheral edema is a common manifestation of many disease states." (583) It is likely that most people will suffer from some form of swelling in their legs, ankles, or feet at some point in their lives, whether from a broken ankle, a bee sting, or a varicose vein. 

What Causes Swelling in the Lower Legs? 

Leg swelling has many potential causes. We've listed a few below, but it's important to see a doctor if you're experiencing leg swelling. Edema may be a symptom of a serious medical condition.

Medications 

Some medications may cause swelling as a side effect. 

These include:

• Hormones 
• Some antidepressants
• Diabetes medications
• Calcium channel blockers
• Steroids and corticosteroids
• Non-steroidal anti-inflammatory drugs
• Direct vasodilators 
• Nonselective cyclooxygenase inhibitors
• Selective cyclooxygenase-2 inhibitors
• Antisympathetics
• Beta-blockers

Many other types of medications include swelling as a potential side effect, so be sure to read the labels on your medications and consult with your prescribing physician. 

Vascular Disease 

Chronic venous insufficiency (CVI) results from the failure of one-way valves within your veins. When these valves function improperly, blood and waste fluids back up in your vascular system, causing the pooling of fluid in the lower extremities. In addition to swelling, CVI causes discomfort, skin changes, and unsightly spider and varicose veins. Cho and Atwood explain, "Symptoms may be exacerbated by heat or prolonged sitting or standing." (583) Compression socks restrict the circumference of veins, creating what we call, "the garden hose effect." 

Imagine covering the nozzle of a garden hose with part of your thumb. The resulting water spray becomes stronger. The same thing happens inside a vein when you apply pressure with compression socks. The blood inside your veins travels towards your heart with increased velocity. The blood in your lower legs moves more quickly and efficiently, reducing the buildup of stagnant fluid in your legs, ankles, and feet. 

Blood Clots 

If you develop blood clots deep in your veins, doctors refer to the condition as deep vein thrombosis (DVT). Sometimes, those blood clots break off and travel to the lungs. When that happens, DVT may result in a fatal pulmonary embolism. Swelling is a symptom of DVT, and it may be the first warning sign that a dangerous blood clot has formed in your deep veins. 

Luckily, compression therapy helps to prevent DVT and also manage and treat existing clots. ("Deep") While compression socks may not eliminate the swelling caused by DVT, they are an important way to prevent DVT from worsening. Because pulmonary embolism can be fatal, it is important to take peripheral edema seriously. Consult a doctor if you experience unexplained swelling, especially if the swelling occurs in only one leg. 

Lymphatic Problems 

Lymphedema is another common cause of swelling. Unlike CVI and other vascular diseases, lymphedema does not necessarily improve when you elevate your legs overnight. "Lymphedema results from impaired lymphatic transport leading to the pathologic accumulation of protein-rich lymphatic fluid..." (Cho et al. 583) Depending on the severity of the impairment, you may experience significant swelling in one or both legs, along with other body parts.

Sometimes, lymphedema can be caused by the removal of lymph nodes, as is the case for many cancer patients. No matter the cause, treatment for lymphedema usually involves manual drainage and includes different forms of compression therapies. A 1992 study in The Journal of Vascular Surgery explained that graduated compression garments, along with pneumatic compression, resulted in the long-term reduction in limb girth for 90% of lymphedema patients. (Pappas) 

Pregnancy 

Hormonal changes, including the hormonal changes that take place during pregnancy, may cause peripheral swelling. As stated above, peripheral swelling occurs in 80% of normal pregnancies. Most doctors recommend compression socks from the first month of pregnancy to six weeks after giving birth. Compression therapy helps to reduce swelling and prevent blood clots, varicose veins, and spider veins from forming. 

Poor Circulation 

Standing and sitting for long periods can have a significant toll on the circulatory system. When standing for long periods, the heart must work against the force of gravity to pump blood and waste fluid from the feet to the heart. For someone who spends many hours seated, blood can pool in the lower legs and feet, eventually causing numbness, pain, and swelling. 

A 2004 study in Dermatologic Surgery concludes, "Calf‐length compression stockings with a pressure range between 11 and 21 mmHg are able to reduce or totally prevent evening edema and may therefore be recommended for people with a profession connected with long periods of sitting or standing." (Partsch et al. 737) 

Other Medical Conditions 

Edema can be caused by a number of other underlying medical conditions. Since wearing compression garments will not treat these conditions, it's important to consult with a doctor in order to determine the cause of your swelling.

Other causes of edema include:

• Heart failure
• Kidney disease
• Liver disease
• Allergies
• Tumor
• Infection
• Sprain or fracture

Health Tips 

The material that a sock or stocking is made of isn't as important as the compression level and type of compression. 

Graduated Compression 

Graduated compression socks exert more pressure on the ankle than the calf, which forces blood and lymphatic fluid out of the extremities. Because graduated compression works against the force of gravity, it is a more effective form of therapy to reduce swelling from CVI, poor circulation, pregnancy, along with any other condition that is worsened by standing.

Uniform Compression 

Uniform compression socks maintain the same level of pressure throughout the length of the sock. Uniform compression socks do not move blood and lymph fluids up the leg with graduated pressure; therefore, they are not as effective in treating swelling from CVI, poor circulation, pregnancy, etc.

Millimeters of Mercury Rating 

The pressure of compression garments is measured in millimeters of mercury (mmHg). The higher the mmHg measurement, the tighter the sock and the greater the reduction in swelling. At Comrad, we manufacture socks that fall into "the compression sweet spot," since they're tight enough to provide significant medical benefits without feeling uncomfortably tight. 

Try Companions, measuring 15-25 mmHg, or Guides, measuring 15-20 mmHg. 

To get the most out of compression socks, it's important to wear them flat against the skin without any bunching. Socks also have to be sized correctly in order to deliver the compression level described on the label. 

If you're experiencing swelling of the feet, ankles, legs, or lymph nodes, it's important to consult your doctor so that you can treat the underlying cause of the inflammation. For many forms of swelling, compression socks offer the first line of defense. They can help to prevent some health conditions—such as varicose veins and deep vein thrombosis—from worsening. At the same time, for many patients, graduated compression therapy offers a way to reduce pain, numbness, and swelling.

Consult with your doctor to find out if graduated compression socks will work to reduce your edema. When you're ready to get started with compression therapy, our team has designed socks to help you look and feel your best. 

Less swelling? Yes, please! 

Don’t settle for regular socks when you could be wearing socks with benefits. 

Sources:

Agu, O., Hamilton, G., and Baker, D. "Graduated compression stockings in the prevention of venous thromboembolism." British Journal of Surgery, Vol. 86, Iss. 8, Aug. 1, 1999, pp. 992-1004. British Journal of Surgery Society Ltd., https://bjssjournals.onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2168.1999.01195.x.

Cayley, William E. “Preventing deep vein thrombosis in hospital inpatients.” Clinical Review, Midlands Business Journal, Jul 19, 2007, https://www.bmj.com/content/335/7611/147.

Cho, Shaun, and J Edwin Atwood. “Peripheral Edema.” American Journal of Medicine, vol. 113, 2002, pp. 580–586.

“Edema: Types, Causes, Symptoms, and Treatment.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/159111.

Health Quality Ontario. “Compression Stockings for the Prevention of Venous Leg Ulcer Recurrence: A Health Technology Assessment.” Ontario Health Technology Assessment Series Vol. 19, Iss. 2, pp. 1-86. 19 Feb. 2019, https://www.ncbi.nlm.nih.gov/pubmed/30828407.

“LIMPRINT.” International Lymphoedema Framework, 12 Nov. 2019, www.lympho.org/limprint/.

“Deep Vein Thrombosis (DVT).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Mar. 2018, www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/diagnosis-treatment/drc-20352563.

Pappas, Chrisos J, and Thomas F O'Donnell. “Long-Term Results of Compression Treatment for Lymphedema.” Journal of Vascular Surgery, vol. 16, no. 4, Oct. 1992, pp. 555–564. ScienceDirect, https://www.sciencedirect.com/science/article/abs/pii/0741521492901633.

Parsch, Hugo, et al. “Compression Stockings Reduce Occupational Leg Swelling.” Dermatologic Surgery, vol. 30, no. 5, 22 Apr. 2004, pp. 737–743., http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.621.2243&rep=rep1&type=pdf.