We have already explained how compression stockings work, now we will see what uses we can give them according to their degree of compression.
– Even people who claim that we cannot do anything to change our destiny look before crossing the street.
Graduated compression stockings provide decreasing pressure on the limb from bottom to top, tighter on the ankle and gradually decreasing as the garment goes up the leg, creating a gradient that helps promote circulation.
The need for pressure for each patient will depend on the problem they present and can change over time, there are no fixed recipes. Sometimes a person can stabilize with a particular pressure, while in some cases we may have to increase or decrease the pressure.
It should be noted that there is no single worldwide standard to classify compression stockings according to the compression provided, this sometimes makes scientific communications difficult when speaking in non-standardized terms. The problem becomes important when we remember that it is a treatment considered fundamental in venous insufficiency.
LOW compression: up to 20 mmHg:
The lower compression stockings range from 8 mmHg to 20 mmHg and are used to help those with minor venous problems, patients with leg pain from pregnancy, or people who for work reasons spend many hours a day on their feet (cooks, surgeons, etc). They serve as a means to prevent thromboembolic disease in hospitalized patients, but are useful in preventing or treating post-thrombotic syndrome.
Generally, lighter compression stockings are less expensive than stockings with higher compression grades, the latter requiring more yarn to achieve greater compression and a more expensive manufacturing process. They are available over the counter in most pharmacies.
This group that compresses up to 20 mmHg can be divided into soft compression stockings (8-15 mmHg) and those with medium compression (15-20 mmHg).
Soft compression (8-15 mmHg)
Provides very light compression. They can relieve tired and painful legs, possibly help control mild inflammation. Grades C1 to C2 of the CEAP classification of chronic venous conditions are recommended in venous insufficiency, which includes small spidery veins (telangiectasia) and trunk varicose veins (Greater than 3 millimeters in diameter).
In bedridden patients who require stockings to prevent venous thrombosis, stockings of less than 15 mmHg are usually recommended. This is because when lying down, completely horizontal for a long period of time, your circulatory system does not have to fight gravity, and pressure greater than 20 mmHg applied to your ankle and calf during this time can restrict your circulation. Although antithrombotic stockings offered for bedridden patients are actually recommended up to 15 mmHg, they range from 18 mmHg. People in active movement and who do not lie down with the stockings will require a higher degree of compression to prevent venous disease.
15-20 mmHg compression
It is used to help the patient tolerate long periods of standing and sitting. They are ideal for traveling, standing or sitting for a long time. They offer relief from mild inflammation and varicose veins. These are often recommended during pregnancy.
They may also be good for initiating elastocompression therapy in order to seek adherence to the treatment, so as to adapt the patient to its use before progressing to higher compressions that may be more uncomfortable (depending on the patient).
Stocking models with compression between 15-20 mmHg:
MEDIUM compression: 20-30 mmHg
This is the most frequently prescribed level of compression, they are often used for venous problems accompanied by edema or swelling.
These stockings are beneficial for the prevention of venous thrombosis during a long trip, relief of varicose veins and swelling, they can be useful in lymphedema and superficial thrombophlebitis. They are often prescribed after sclerotherapy and to prevent venous stasis ulcers.
You have to be careful not to be tempted by pricing. The compression indicated by the doctor derives from the patient’s health situation and will most likely be the one he considers will offer him a real benefit, so wearing less compression stockings to save money may be an insufficient option that puts the treatment at risk. Unfortunately, good stockings can hardly be replaced with cheaper ones.
Stocking models with compression between 20-30 mmHg:
In patients who must use compression levels higher than 30 mmHg, which are difficult from the start, the use of 20-30 mmHg stockings may be a good strategy to start adapting and then move on to the next degree in a few weeks.
Going to a higher compression stocking should be indicated by the doctor in close evaluation of the patient.
HIGH compression: greater than 30 mmHg
Extra firm compression (30-40 mmHg)
They are used to help relieve pronounced edema, severe varicose veins, and lymphedema. They are also used after an episode of deep vein thrombosis, in severe chronic venous insufficiency or post-thrombotic syndrome.
They should only be used under the supervision of a doctor. In a patient who has never worn compression stockings, it is not recommended to go directly to starting with the compression of 30-40 mmHg, as we have just explained in the previous sections.
The higher the compression, the more difficult it will be to put on the stocking. People with severe arthritis, limited hand strength, or limited flexibility may have difficulty doing so, in which case I invite you to view the article where we explain some devices that facilitate donning.
Stocking models with compression between 30-40 mmHg:
More than 40 mmHg
These types of compressor elements are used under strict medical indication in severe chronic venous insufficiency or post-thrombotic syndrome (SPT) that are accompanied by high venous pressure.
Compressor models greater than 40 mmHg: