Do you have heavy, aching legs and swelling that worsens by the end of the day? Compression therapy is often recommended to relieve these frustrating symptoms using controlled, gentle pressure to improve blood flow back to the heart, which can lead to greater comfort for patients.
At Inovia Vein Specialty Centers, compression therapy is part of a comprehensive, patient-first approach to diagnosing and treating vein disease at its source. As the Pacific Northwest’s largest vein-centric healthcare practice, Inovia Vein Specialty Centers is trusted for delivering advanced, minimally invasive vein care backed by experience, innovation, and proven results.
Compression therapy, such as the use of graded compression stockings, is often prescribed to:
- Manage varicose veins
- Manage lymphedema and swelling in the legs
- Assist with venous leg ulcer & wound healing
- Prevent blood clots after surgery
- Address pregnancy-related leg & vein symptoms
When used preventatively, compression therapy can help prevent:
- Worsening of venous insufficiency symptoms
- Leg swelling in those who stand or sit for long periods of time
- Development of venous thromboembolism due to immobility
- Recurrence of venous leg ulcers
Types of Compression
Compression stockings are the most common method of compression therapy.
Most compression stockings are graduated, meaning they are tighter around the foot and ankle than at the knee or thigh. This is critical in most cases, since most leg swelling occurs by the ankle.
Compression stockings can be knee high, thigh high, or cover the pelvis depending on need. Open toe options are available as well.
- Compression wraps or bandages, like Unna Boots, are also used when indicated.
- Mechanical compression devices, like wearable compression boots or compressed air devices, are available for home or clinic use as well.
Levels of Compression
Some lighter use compression socks are available over the counter at drugstores or online. These are not considered to be medical grade can be purchased without a prescription. Higher degrees of compression often require a prescription.
Light Support Compression
(15–20 mm Hg)
- Mild foot and lower leg swelling
- Mild varicosities with minimal swelling
- Preventative support for work or travel
- Standing, sitting or traveling for extended periods of time
- Post surgical “anti-embolic” or TED hose provided by hospitals at the time of surgery
- Non ambulatory patients who are bed ridden
Moderate Compression
(20–30 mm Hg, Class I)
- Chronic leg fatigue and heaviness
- Ankle, foot and leg swelling
- Mild varicosities
- Preventative and treatment of swelling during pregnancy
- Superficial thrombophlebitis
- Post-vein treatment including sclerotherapy
Heavy
Compression
(30–40 mm Hg, Class II)
- Moderate varicosities with advanced swelling
- Chronic Lymphatic edema
- Prevention and treatment of venous ulcers
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How Does Compression Therapy Work?
Compression therapy helps to improve blood circulation in the lower legs, ankles and feet by applying the correct amount of pressure on a consistent basis. The goal is to reduce the amount of venous fluid filtered out from venous insufficiency, to help return the filtered lymphatic fluid back to the heart. Here’s how compression works for the different conditions it’s used for:
For chronic venous insufficiency, including varicose veins:
Compression can help reduce the amount of venous blood pooling in the lower legs, thus reducing the amount of fluid that filters into the tissue as edema. This helps push blood to the deeper veins, where the leg muscles can pump the blood back toward the heart.
For swelling (edema):
Compression therapy applies pressure circumferentially to the lower leg to help move fluid back to lymphatics, where it can be returned to the circulation.
For deep vein thrombosis (DVT):
With a DVT, blood flow to the heart can be obstructed by blood clotting in the veins. Compression therapy can help prevent blood from pooling and clotting, especially when coupled with an anticoagulant. However, it’s important to speak with your healthcare provider before starting compression therapy for DVT.
For leg ulcers:
Wounds do not heal well in the presence of high vein pressures from venous insufficiency and in the setting of swelling. Compression therapy can aid recovery from leg ulcers and wounds by encouraging blood flow.
Frequently Asked Questions
Compression Therapy
The popularity of compression socks has increased substantially among athletes in endurance events such as running and hiking. Whether athletic stockings will work for you all comes down to the reasons you are wearing compression. For more mild and preventive scenarios, athletic recovery stockings may be fine. For more advanced venous and lymphatic disease, they are not likely to be as effective. A consultation with a vein specialist can help guide you as to your needs and best options.
Because swelling goes down with time with frequent use, you should have your legs measured again and your stockings replaced every 3 to 6 months.
You should generally obtain at least 2 stockings, or 2 pairs if you're wearing them on both legs. This means you can wear 1 stocking (or pair) while the other is being washed and dried. Follow any washing instructions provided with the socks at purchase. Many require hand washing, in which case it’s ideal to use warm water (comfortable hand temperature) and dry them away from direct heat.
Uniform, or regular, compression socks maintain the same degree of compression throughout the length of the stocking. In contrast, graduated compression garments offer gradient pressure by providing a range of pressure, with more pressure closer to the feet and less pressure closer to the knees. Graduated compression socks are more effective at preventing blood and fluids from pooling in the lower legs and are better at reducing chronic swelling.
It depends on the reason you are wearing them. If you are wearing compression socks to prevent swelling on a long flight, or for work where you stand a lot, the lower degree of compression hose are usually all that you need (15 to 20 mmHg). If you have had a new DVT or a varicose vein treatment session, generally patients are prescribed to use compression in the mid-range (20 to 30 mmHg). For patients with more advanced chronic vein and lymphatic disorders with sevre skin changes, higher degrees of compression are often utilized to minimize the swelling as best they can (30 to 40 mmHg). A consultation with a vein care specialist can help determine the optimal degree of compression for your needs.
Most communities have a variety of places where people can obtain compression hose. For patients who have been wearing compression for a while and know the brand, size and degree of compression they are looking for, online stores are a great option. For those new to compression, it often makes sense to see a professional to help measure you and advise on the size, degree of compression and a variety of different brands that might be best for your particular needs.
Generally not. Most experts agree that you should take off compression socks while you sleep since they provide the most benefit when you are up and walking. At night, swelling generally goes down on its own. However, if you do wear compression stockings at night, there should not be a problem. Adverse side effects from wearing compression socks are rare under most circumstances.
Severe complications of wearing compression socks are rare under most circumstances. However, some people should be cautious with compression, such as those with delicate or easily irritated skin. Patients with severe arterial disease should also seek medical advice before using compression, as in some extreme cases they are contra indicated. It’s also important that compression socks are properly fitted so they are not too tight. A consultation with a vascular or vein specialist can help guide you to what considerations are important in your particular case.
Compression stockings help alleviate the swelling and pain caused by varicose veins. Graded compression stockings can also help heal any skin inflammation or ulcerations due to venous insufficiency. They must fit properly to achieve these benefits.
Yes. Compression therapy can improve circulation and reduce blood pooling in the legs, which may help decrease nighttime leg cramps, aching, and restlessness, especially in people with vein disease or chronic venous insufficiency.
Compression stockings should feel snug and supportive, but not painful. They should apply firm, even pressure without causing numbness, tingling, or pinching.
Yes. A feeling of pressure is normal when you first begin wearing compression stockings, particularly during the adjustment period. This sensation usually improves as your legs adapt over several days.
If stockings are the wrong size or compression level, they can restrict circulation, causing discomfort or skin changes. That’s why proper measurement and medical guidance are important, especially for higher-strength compression.
Most wear compression stockings during the day while upright and active, and remove them at night. Your vein specialist may adjust this based on your condition and treatment plan.
Some people notice relief from swelling, heaviness, or aching within days, while others may take a few weeks. Results vary depending on the severity of vein disease and how consistently the stockings are worn.
Compression stockings typically last about three to six months with regular use. Over time, the elastic fibers weaken and stop providing effective compression.
Compression therapy may not be appropriate for individuals with significant peripheral artery disease, severe circulation disorders, certain skin infections, or uncontrolled heart failure. A medical evaluation is important before starting therapy.
Compression therapy works best when combined with regular walking, leg elevation, maintaining a healthy weight, staying hydrated, and avoiding prolonged sitting or standing. These habits help support circulation and reduce vein-related symptoms.
Why Choose Inovia Vein Specialty Centers
Inovia Vein Specialty Centers was founded with a clear mission: to address widespread vein concerns using the most minimally invasive, outpatient treatment options available. Unlike many vein specialists who perform procedures in hospital settings, often leading to higher costs and greater barriers to care, Inovia is entirely office-based. This approach allows us to provide high-quality, affordable, and accessible vein care in comfortable, convenient locations. Originally founded in Bend, OR, Inovia has expanded throughout Oregon and into Southwest Washington, becoming the Pacific Northwest’s largest vein-centric healthcare practice.
At Inovia Vein Specialty Centers, we offer far more than treatment for surface-level vein issues. Our team provides comprehensive vein care, from advanced diagnostics to the latest evidence-based therapies, all designed to treat current vein problems and help prevent future recurrence. We are proud to be home to some of the Pacific Northwest’s leading board-certified vein surgeons, who work closely with patients from initial consultation through treatment and follow-up. We focus on patient-centered care, treating people, not just symptoms.
Get Started with Compression
The optimal degree of compression needed can vary depending on the patient & medical condition being treated, the type of compression being applied, and the material used in the compression garment.
Because of this, it’s important to make sure that you’re using the right stockings or other medical compression device for your particular condition. Your vein care provider can help you assess what kind of compression you need and discuss fitting options.
Book a consultation at any Inovia clinic to find out which compression therapy options may be right for you.