Can compression stockings be used routinely?
Properly fitted and properly applied compression hose are ideally worn from the earliest convenient time in the morning until bedtime.
If there is a limitation of time, the rule to adhere to is it is OK to wear these hose from early morning and not later in the day, however generally inadvisable to first apply then later in a day.
The reasoning that such is the case is that the hose should have been measured for you with least swelling (first thing in the morning) because they are made to maintain swelling reduction- not made to achieve swelling reduction. Thus, if they were Properly fitted initially, they would be inappropriately too tight and act as a potential tourniquet worsening venous health if applied in an afternoon when the leg is probably swollen.
How long do I have to wear compression stockings?
Compression stockings , when properly fitted and instructed , work by at least two mechanisms. They do apply direct compression to the veins underneath them AND enhance the volume of venous blood and tissue fluid which is pumped by the calf muscles. Both of these properties aid in healing following endovenous laser ablation . The direct pressure encourages the vein which was lasered to heal closed and reduces discomfort but generally supporting the irritated area around the vein. The stockings also optimize vein function in all veins, adding protection from post procedure blood clotting.
It is generally recommended to wear compression for two weeks after laser ablation.
In addition, however, most individuals with lower extremity venous disease should enjoy the beneficial support from routine wearing of compression hose. Indeed, if these stockings are properly fitted, and the patient is provided with an instructional support system to insure the use is professionally monitored, the support hose DOES FEEL GOOD !
Are compression stockings from the drug store okay or do I need prescription?
Compression Stockings play a critical role in the care of leg vein wellness. Unfortunately , they are poorly misunderstood.
First some simple science! The pressure in a varicose vein at the ankle level when standing is in the range of 40-80 mmHg, approaching artery pressure. Proper compression hose have the characteristic of applying GRADIENT compression. This means, highest compression at the ankle and gradually reducing compression as they go up. Thus, the range of compression required from beneficial hose needs to be substantial. I prescribe moderately high compression hose in the 30-40 mmHg at the ankle and occasionally 20-30 pressure for maintenance.
Further, it is a MYTH that a PRESCRIPTION is required for any level of compression hose as these garments are not regulated by the FDA or any other legal entity. The reason that this Myth persists is to protect the suppliers' medical-legal position because adequate pressure hose can be harmful in a patient with artery narrowing or some instances of congestive heart failure. As a matter of fact, OVER-THE-COUNTER hose can cause worsening of venous problems as they tend to be held up by the tightest band at the top and can act as a venous tourniquet.
So there are a host of differences between all types of hosiery and for this reason, only an informed phlebologic professional can be qualified to recommend the proper hose on an individual basis.
As far as the cost, and by understanding the above information, zero cost is overpriced for a potentially harmful hose, whereas the $60 hose that have been proven to provide equal improvement compared to surgery, laser or any interventional procedure and can be worn daily for 6 months, is really pennies a day in value.
How should one go about buying Compression Stockings?
This is an excellent question and deserves much more attention than it receives.
Compress plays a key roll in leg vein heath and function, yet is rarely treated scientifically. There are thousands of pages and professional medical studies and research on this topic. Many individuals prescribing hose are not truly informed .
The needs and applications are so variable and options so wide, that only a trained professional with specific experience should determine the details of each patient's optimal garment. Additionally, professional instruction as well as wear and care instruction is
required for full benefit. As these medical garments are expensive, equal value should be given to the fitting and support needed to obtain a proper result.
As there are indeed so many variables, mI will simply list a few issues involved. Hose can be harmful if improperly fitted, fitted when a leg is swollen ( which generally means fitting should occur very shortly after arising in the morning), size varies with general weigh
changes as well as changes in degree of swelling- so RE-ORDERING A SIZE ON THE INTERNET without re-evaluation is by no means always correct.
The techique of application vary from brand to brand and even the washing material can destry the elastic properies of the hose after ONE CONTACT .
Thus, in order to insure optimal benefit, avoid complications, and create a support level to encourage ease of applying and removing these powerful medical hose, the process should begin in experienced professional hands.
Is it better to get full-length compression stockings or knee-highs?
This is an important question. Many prescribes are not aware of the implications of the type, strength, and length of optimal compression hose.
The most critical issue is encouraging the individual to actually wear the hose, which is referred to as compliance. As your question indicates, knee high hose are easier and generally most comfortable. Furthermore, knee high length is most effective and even our pregnant patients are placed in knee high compression. The hemodynamic (or circulatory) benefit of compression is not as simple as "squeezing out excess fluid and blood." The primary mechanism of how compression works is by enhancing the volume of fluid by the calf muscles. Thus, the shortest hose also allow for the most precision in the fitting of the stocking, as length parameters do not need to be taken into account and hose that cross the knee add potential issues such as loosening down and bunching at the back of the knee. So, I emphasis on strength and precision fitting is also consistent with comfort and increased tendency to be applied.
What can I do about constant pain with varicose veins?
Leg pain caused by varicose veins usually becomes less painful when the person is walking because the calf is pumping out excess high pressured blood from the vein. However, stair climbing is not the reliable type of walking to achieve this pumping relief as is outdoor "heel-to-toe" walking.
It is also not uncommon to have varicose veins in a leg where the pain is not coming from veins, but rather other causes such as muscular. A professional examination may clarify this.
Proceeding with the use of Properly Fitted and Professionally supervised Compression Hose may help make the diagnosis as well as relieve the pain. If the hose are, again, Professionally fitted and supervised, pain from varicosities should be expected to improve, clarifying the cause of the pain and also improve symptoms especially combined with increased walking. To be beneficial, the hose precision cannot be over emphasized. Hose compression strength, length, guides application and care of hose are frequently NOT given the critical importance which is required. Fitting with a leg which is actively swollen, eg. not rapidly following getting out of bed are almost certain to be compromised.
Finally, if the varicosities are inflamed or clotted, hose compression may add some pain relief, however further medical evaluation is indicated.
What Compression Stocking Devices can help me?
Leg Compression is a powerful and extremely misunderstood modality. Every varicose vein treatment plan should include compression as a basic cornerstone for leg wellness. This is so important that large medical studies have demonstrated similar reduction of symptoms and medical complications of venous insufficiency comparing proper leg compression and interventional procedures such as vein elimination.
Our current knowledge that at least 1/3 of venous leg ulcers are caused solely from varicose veins ( and not from having had a deep vein thrombosis, Post Phlebitic Syndrome , as was thought a decade ago) dictates that NO treatment for significant varicose veins is unacceptable at the present time. Compression in some form represents the minimal required treatment.
The most common form of Compression is the use of Medical Quality Gradient support hose which requires professional fitting and a very expert support system in order to insure maximum benefit is actually being received.
Other form of compression devices exist and are generally indicated for patients with specific needs.
The most Critical "device" with which to properly apply hose is A PAIR OF SNUGGLY SIZED RUBBER GLOVES WITH GOOD GRIPPING TEXTURE ON THE PALMS. Again professional instruction is also key in order to achieve proper results and ease of application and care.
In the United States, there is no official regulatory agency for compression hose supervision and the FDA does not evaluate the garments. Improperly fitted, incorrect amount of compression (essentially like a DOSE ) , and failure to supervise compression hose can not only be of no value, but can worsen a vein condition.
Finally, our Pregnant patients are usually fitted for KNEE HIGH length hose, as there is little benefit in "Maternity Pantyhose" which is awkward and reduces usage (compliance).
Even the mechanism of hose is poorly appreciated. Calf compression does not work by squeezing fluid out of the leg.
