Medically reviewed by Dr. Michael Darder OBGYN — Written by Kari Johnson
Updated April 13, 2022
Doctors often recommend compression socks, like the ones we sell at Comrad, as a preventative therapy. For example, a pregnant woman may use compression socks to reduce the risk of varicose and spider veins during pregnancy. Similarly, many surgeons suggest compression garments as a way to protect post-surgical patients from deep vein thrombosis (DVT), the formation of blood clots in the deep vein.
The benefits of compression go beyond preventative care, though. Suppose you already have a venous disorder, such as chronic venous insufficiency (CVI) or deep venous thrombosis. In that case, compression socks act as a first-line treatment for some of the most painful symptoms.
Physicians recommend compression socks because they are easy-to-use, affordable, and backed by scientific research.
What Is Venous Stasis?
Venous stasis, or venous stasis syndrome, describes slow blood flow in the veins of the legs. The cause of venous stasis can vary. Sometimes, it's caused by an injury to the vein. In other cases, venous stasis results from CVI, a disease that causes veins to slowly weaken over time. Whatever the initial cause, venous stasis contributes to a "vicious cycle," where areas of slow-moving blood increase pressure on surrounding vascular structures, causing a cascade of failures.
To understand how venous stasis works, it can be helpful to review what veins do for the human body. The circulatory system relies on arteries to carry freshly oxygenated blood away from the heart and towards the extremities.
On the return trip to the heart, the veins act as the transportation system. Deoxygenated blood travels through the veins to the heart and lungs, removing and processing the carbon dioxide.
Of course, the journey of blood from the feet towards the heart and lungs requires a significant upward push from the circulatory system. Any time a person stands upright for an extended period of time, blood must flow against the force of gravity. This explains why the health of veins is so important to overall cardiovascular health.
Small, one-way valves eliminate reflux (backflow) within each vein and keep blood moving in the right direction. When these valves fail, or when vein walls distend (expand), blood can pool in one place and block healthy circulation.
What Are Venous Ulcers?
Once a person suffers from venous stasis or stagnant blood flow, all the surrounding vascular structures experience additional strain. The veins may bulge and twist, forming varicose veins. Edema (swelling) can occur as fluid leaks from the pressurized vessels into the surrounding tissue. In severe cases, poor circulation can also cause skin ulcerations.
Venous ulcers are particularly dangerous because, without proper wound care, they can easily become infected. It's estimated that 2 million workdays are lost in the United States each year due to venous ulcers. The toll on patients’ quality of life is probably much more significant. In severe cases, infected ulcers can lead to gangrene, amputation, and even death.
Stasis dermatitis, a skin condition, can indicate that a venous stasis ulcer is forming. The symptoms of stasis dermatitis include thickening and itchy skin, scales, and hyperpigmentation. If you see skin changes in the lower extremities, the use of compression socks may enable you to slow the progress of a venous disorder and prevent dangerous sores from forming.
Venous Stasis & Blood Clots
Poor blood flow increases your chance of developing blood clots, including clots in the deep veins (DVT) and superficial veins (superficial phlebitis). Of the two, DVT is the more dangerous condition. DVT causes two significant medical complications for patients.
First, in some DVT patients, a blood clot breaks off and travels through the bloodstream. If the clot blocks a vessel in the lung, the obstruction can be fatal. The second complication, post-thrombotic syndrome, causes long-lasting circulation problems that increase the chance of recurrent blood clots. Aside from venous stasis, other risk factors for DVT include old age, pregnancy, obesity, surgical recovery, bed rest, driving, flying, and certain medications.
For patients with DVT, 20–50 percent go on to develop post-thrombotic syndrome. In the context of DVT patients, the terms "post-thrombotic syndrome" and "venous stasis syndrome" are used interchangeably.
As for CVI, post-thrombotic syndrome can introduce chronic medical problems with compounding symptoms. Severe cases of post-thrombotic syndrome may present with venous stasis dermatitis and open sores.
Compression Therapy For Prevention
Most doctors recommend compression therapy as a way to reduce your risk of venous disorders and swelling. If you successfully prevent CVI and DVT, you will also eliminate the risk of resulting medical complications, such as leg ulcers, pulmonary embolism, and post-thrombotic syndrome. In particular, many doctors advise using compression socks or stockings as a preventative therapy for high-risk groups, including pregnant women, airline travelers, and post-surgical patients.
Additionally, studies have shown that compression therapy can significantly improve outcomes for patients with CVI. The progression of this chronic condition is defined by a classification system that ranks the severity of symptoms by CEAP class.
The most severe CEAP classes show increased leg inflammation, enlarged lymph nodes, and leg ulcers. Compression socks may help with painful symptoms of CVI. They may also help slow the progression of a chronic venous disorder, especially when combined with vasoactive medications.
Healing Ulcers
There is compelling evidence to support the use of compression socks and stockings for healing and preventing venous ulcers. In fact, a meta-analysis of eight studies showed that graduated compression stockings were more effective than bandages at healing ulcers.
The research indicated that 62.7 percent of ulcers healed with stockings versus 46.6 percent with bandages. Plus, those patients treated with graduated compression therapy healed three weeks faster than those exposed to alternative treatments.
Patients suffering from venous ulcers should always use graduated compression therapy as part of a comprehensive medical treatment plan. It’s important to address skin ulcerations quickly and carefully. Doctors may also prescribe oral antibiotics and topical ointments to treat skin ulcerations.
What Compression Level Do I Need?
Graduated compression socks prevent venous stasis in the lower legs by applying upward pressure to support the veins. They do this by exerting a more substantial pressure at the ankles than the calves.
At Comrad, we offer True Graduated Compression in a range of compression strengths, measured in millimeters of mercury (mmHg). Before you use graduated compression therapy to treat medical symptoms, we advise consulting with a physician about the optimal compression strength for your body.
For most people, 15-20 mmHg socks provide enough pressure for preventative care. With 20 mmHg at the ankle, these socks give you a mild squeeze that can support blood circulation, protect vascular structures, and reduce venous reflux. Our best-selling socks deliver slightly more compression at the ankles, with 15-25 mmHg. They offer treatment in addition to preventative health benefits.
If you suffer from active ulcers, talk to your doctor about the best way to promote healing. Some studies indicate that higher compression strengths yield better results, but medium compression socks have also promoted healing. No matter which socks you choose, you should work closely with your doctor to monitor the health of your skin and veins.
Sources:
Blood Clots and Travel: What You Need to Know | CDC
Chronic venous disease during pregnancy | Phlebolymphology
Circulatory Pathways | National Institute of Health
Deep vein thrombosis | Mayo Clinic
Eczema types: Stasis dermatitis self-care | American Academy of Dermatology
How long should I wear compression stockings after surgery? | NHS
Graduated compression stockings | Canadian Medical Association Journal