Compression socks and stockings are one of the easiest ways to provide daily relief to swollen or aching legs, a common symptom of varicose veins and venous insufficiency. But once you start shopping around, the numbers, sizes, and choices can be overwhelming.
When Dr. Bunker diagnosed me with chronic venous insufficiency (CVI), one of the first orders of business was buying myself some medical-grade compression stockings—I’d been wearing the same two pairs of pink compression sports socks for nearly a year, and trying to match my clothes to them was a nightmare.
After hours and hours of price checking, researching, scrolling, and comparing, we’ve put together this buying guide so that you know exactly what to look for.
Just like a wedding dress or tuxedo, compression stockings have to be properly fitted in order to be the most effective. The tightness of the stocking is graduated, meaning that it starts out the tightest at your ankle and gradually loosens moving up the leg. Since all of our bodies are unique, sizing for compression is based on your specific measurements.
Locally, The Comfort Store on Burnet Road is a great resource for being professionally fitted, and the staff there is extremely helpful about selecting the right size and style for you. Because they offer personalized assistance and a range of the highest quality compression garments, you should be prepared to spend $100 or more for one pair. You will be able to put them on or take them home immediately, and feel confident that you’ve made the right choice.
If that isn’t in your budget, there are tons of more affordable options online. Most online vendors offer sizing charts and sizing guides, which are all based on the same set of measurements. If you will be sizing yourself, here’s what you’ll need:
- A soft measuring tape
- A pen and paper to write down the following measurements, in inches:
- The circumference (distance around) of the smallest part of your ankle
- The circumference of the widest part of your calf muscle
- The circumference of the widest part of your thigh, about 2 inches below your bum
- The distance from the floor to your knee
- The distance from the floor to your thigh, about 2 inches below your bum
- If you would like a pair of stockings or hose (instead of single knee- or thigh-highs), you will also need the circumference of the widest part of your hips.
If you are taking your own measurements, be as exact as possible. Take each measurement at least twice, to be sure you’re hitting the right number. My feet and legs are different sizes, so I took each set of measurements for each leg.
Make Sure It’s Medical Grade
If you’re shopping online, you’ll need to take extra care to carefully read each product listing, specifically looking for the words “medical grade.” Many brands and styles claim to have the right levels of compression (more on that below), but if they don’t clearly say “medical grade,” you’re not going to get the quality or tightness that you need for relief.
Know Your Levels
Compression stockings are rated on a scale of millimeters of mercury (mmHg), which denotes how tight they will be. The levels range from 8-15mmHg at the lowest, to 30-40mmHg at the highest.
If you are wearing compression to prevent, relieve, or treat symptoms of vein disease, you will need 20-30mmHg minimum. If you have already developed severe varicose veins or venous ulcers, or if you are at risk for deep vein thrombosis (DVT), you should look for 30-40mmHg. If you just want support for your legs during the day, but don’t have any symptoms of vein disease, you should be fine with 8-15 or 15-20mmHg.
As I learned when I got my new collection of compression garments, every brand is slightly different, and although two pairs of socks or stockings might both be rated at the same level, one might feel slightly tighter or looser than another.
Find the Style That Suits You
So you have your size and level down…but there are still so many choices. Here’s a quick breakdown of each of the major styles of compression garments:
Thigh-Highs are the style Dr. Bunker recommends. They are single stockings that come to just a couple of inches below your bum, offering compression for the entire leg. Pro: You don’t have to take them off to use the bathroom. Con: They tend to roll or slide down your leg during the day, so look for silicone tops that stick and prevent this. They are also harder to wear with shorts.
Knee-Highs come to just under your knee. They only offer compression for the feet and lower legs, but are easier for daily wear in the Texas summer. Pro: I love knee highs because they’re so much easier to coordinate with your clothing and tend to come in a wider range of patterns and colors. Con: You have to rotate these with thigh-highs to make sure you’re getting relief for your whole leg. Also, some brands are uncomfortable at the top, leaving a mark or causing itching at the back of the knee at the end of the day.
Stockings or Hose are one piece that you put on like pants and that covers both legs. Pro: Full stockings provide the most comprehensive coverage for the entire leg and groin. Con: They are very difficult to manage for daily wear. Harder to put on and take off, must be taken down to use the bathroom, and very hot on sunny days.
Footless compression garments are my absolute favorite. You can find footless options in any of the styles above. Rather than covering your whole foot like a sock, they stop at the ankle. This means that you can easily wear flats, sandals, or flip flops with your compression (not the case with footed styles). They’re also much cooler on hot days.
Sleeves are short compression garments often worn by athletes, usually covering just from the ankle to below the knee. These are much easier to wear and find in fun colors, but are typically lower-grade and not sufficient for managing or preventing vein symptoms. I have a pair that I cycle into my rotation, but I wouldn’t trust them for a concert or travel or anything else that puts a lot of strain on the legs.
Leggings are often sold as compression garments in sports stores. I would put these in the 8-15mmHg category, even though they are not typically rated. They look nice, and they’re a good choice for extra support, but they can’t take the place of a pair of medical grade socks or stockings.
Check with Your Insurance
Some insurance companies will cover the cost of your compression garments if you are using them as conservative therapy in the treatment of vein symptoms. In order to make sure you’re covered, check with your carrier for details. Most companies will only cover certain styles, such as those that extend down to the foot or cover the entire leg.
Even after narrowing down all of these choices, there are still dozens of brands and products you’ll have to consider. The best way I’ve found to judge the quality of any one brand or style is to search for it on Amazon.
Look for a listing that has the most customer reviews and scroll down to read them. Keep in mind that the happiest and unhappiest customers are usually the ones who leave reviews, so reading as many as you can will help get a fair view.
Usually, customer reviews include all kinds of helpful information—I almost bought a few pairs of some cute patterned socks I found, until I read many people say that they lost their compression after very little use. Other reviews helped me pick knee-highs that don’t pinch at the top and thigh-highs that don’t roll down.
Buy More Than One Pair
If you’re wearing compression daily, you’ve got to have more than one pair of good socks or stockings that you actually like wearing. Why? First and foremost, you can only wear them once or twice before they’ll need to be washed, and no one wants to do laundry every day.
Aside from that, I have found it really helpful to have more than one style and color to choose from when I’m getting dressed. I got my favorite pair of footless knee-highs in both beige and black, which gives me much more flexibility with my outfits. I also found some blue herringbone socks and pink sleeves, which aren’t as effective as thigh-highs, but work well for short outings or parties when I want something a little more fun.
It took me lots of research, but in the end, I started my collection with 2 pairs of footless knee-highs, 1 pair of footed thigh-highs, 1 set of sleeves, and 2 pairs of socks for $230 at CompressionSale.com.
Beware Cute Compression
It is very, very difficult to find high quality compression garments in anything other than solid colors, mostly beige and black, and a few simple patterns. If you find a company that offers really snazzy designs and colors, watch out! In my experience, they only come in the lowest level (8-15mHgg), if they are rated at all.
Of all of the garments listed above, the only ones I had to send back were the cute ones. I got a pair of pink striped socks from Sigvaris, otherwise a great brand, but they were nowhere near as tight as the rest, despite being sold as 20-30mmHg.
Don’t Put Them in the Dryer
One last bit of advice to get the most out of your new compression collection—don’t put them in the dryer! They are fine to go through the washing machine on the gentle or hand washable cycle, but should be hung or laid out to dry. Otherwise, the heat will degrade the elastic and your stockings will become loose and baggy.
Now you know all of the basics for making the best compression choices. If you’re drowning in all of this information and need someone to help you, go visit our friends at The Comfort Store. If you have any questions about using compression to treat vein symptoms, or if you think you may be experiencing them, call Bunker Vein & Imaging for a free screening at (512) 726-0599.