Frequently Asked Questions
Q. Who benefits from wearing compression?
A. Anyone's legs can feel better while wearing gradient compression stockings, especially those of us who spend too much time in sedentary sitting or standing positions. Gradient compression stockings are of most benefit to individuals with the following leg complaints:
- Tired, aching, heavy feeling legs
- Leg swelling
- Varicose veins
- Venous insufficiency
- Post-thrombotic syndrome
- Healed venous ulcer
- Active venous ulcer
It is recommended that you consult with your physician before wearing compression 20 mmHg and above. If you also have arterial circulation problems in your legs please consult with your physician before wearing any level of compression.
Q. What is gradient compression?
A. Gradient compression delivers a squeezing to the leg that is tightest at the ankle. The amount of squeezing or compression gradually decreases up the leg. Compression is expressed in mmHg (millimeters of mercury).
Q. What is Compression Therapy?
A. Compression therapy refers to the benefits gained from the use of specialized stockings or bandages in the management of chronic venous disease and lymphedema. Individuals suffering from chronic venous disease (often called insufficiency) present with leg complaints of fatigue, heaviness, and aching. Gradient elastic stockings pioneered by engineer and patient, Conrad Jobst®, in the early 1950s remain the standard in the management of chronic venous disease. Gradient compression delivers a squeezing to the leg that is tightest at the ankle. The amount of squeezing or compression gradually decreases up the leg. While the exact mechanism of action of compression remains elusive, compression is believed to provide two primary benefits to individuals suffering from chronic venous insufficiency.
Perhaps the most important effect is that compression increases the pressure in the tissue under the skin (subcutaneous) thereby helping to reduce and prevent swelling. The compression of this subcutaneous tissue helps move excess fluid (swelling) back into the capillaries (tiniest of the blood vessels) and helps prevent too much fluid from leaking out of these little vessels.
Secondly, compression reduces the ability of the superficial veins in the leg to expand and overfill with blood. This in turn helps prevent blood in these veins from flowing backward causing congestion. Congestion in the leg accounts for the leg complaints, swelling, and skin changes common in persons with venous problems.
Q. Are there reasons an individual should not wear compression?
A. Contraindications (medical conditions in which compression is not recommended):
- Ischemia (e.g. advanced arterial disease) of the legs
- Uncontrolled congestive heart failure
- Untreated septic phlebitis of the leg
- Phlegmasia coerulea dolens
The wearing of compression should also be used with caution in the presence of:
- Skin infections
- Weeping dermatoses
- Incompatibility to fabric of garment
- Impaired sensitivity of the limb
- Immobility (confinement to bed)
Please consult with your physician before wearing compression 20 mmHg and above.
Q. Why are elastic stockings so hard to put on?
A. Your physician may tell you that, "if they are not hard to put on, then they cannot be providing the compression needed." That is probably not the answer you wanted. Because gradient compression stockings provide the greatest compression at the ankle this requires the largest part of the foot - the circumference from the top of the foot around the heel - to pass through the smallest and tightest part of the stocking - the ankle. Newer knitting technologies, yarns, and finishes produce stockings that are easier to put on than the stockings of old. However, for those who have diminished arm or hand strength, or impaired mobility there are items that can make the task easier. These items include:
- Rubber gloves
- Rubber mat (or back side of a computer mouse pad)
- Jobst® stocking donner
- Easy Slide and Easy Slide Too
Q. What is latex?
A. Latex is a natural substance that comes from the rubber tree. Latex can be used in textiles in two forms: Dry natural rubber and natural rubber latex.
Q. Do Jobst® stockings contain latex?
A. Most Jobst® garments are latex-free. The elastic used is a synthetic spandex. The Jobst® stockings that contain latex are:
- Elvarex Jobst® for Men (8-15 mmHg)
- Men's Dress (8-15 mmHg)
- Men's Athletic (8-15 mmHg)
- Men's Casual Vairox (excluding zippered Vairox)
- Women's Casual Socks (8-15 mmHg)
Other Jobst® garments that contain latex include:
- Jobst® Facioplasty Elastic Support
- Fredricks Mammary Support
Q. When can a knee-length be recommended?
A. A knee-length gradient compression stocking is generally recommended to prevent or manage signs and symptoms of chronic venous insufficiency or other causes of lower leg swelling and skin changes. When swelling or varicosities are present above the knee then a thigh, chaps, or pantyhose style may be a more effective choice. Please consult with your physician and Jobst® fitter for assistance.
Q. Is there a layering or additive effect of compression? Can I wear one compression stocking on top of the other instead of wearing a higher compression stocking?
A. Yes, there is an additive effect with compression stockings. For example, some doctors instruct their patients to wear one level of compression in a pantyhose style and then wear a knee-length compression stocking over the compression pantyhose. Please consult with your physician and Jobst® fitter for assistance.
Q. Why are compression stockings prescribed after a blood clot (DVT) in the leg?
A. Knee length gradient compression stockings are often prescribed for a patient who has sustained a deep vein thrombosis (DVT) or blood clot in the leg. The stockings are helpful in:
- Controlling the swelling in the leg that occurs with DVT, and
- To help prevent the development of post-thrombotic syndrome that may occur several months after the DVT.
Q. What is post-thrombotic syndrome or PTS?
A. Post Thrombotic Syndrome (PTS) is a collection of subjective complaints and clinical signs following a thrombotic episode. PTS manifests itself with clinical signs of swelling, dilation of the veins around the ankle bones, pigment changes in the skin of the lower leg along with subjective complaints of spontaneous calf pain and/or pain with standing/walking. The syndrome can present with symptoms ranging from mild severity to excruciating or incapacitating pain and swelling.
Q. What is the difference between an antiembolism stocking and a medical compression stocking?
A. Anti-embolism stockings are designed specifically for bed bound (non-ambulatory) patients to help prevent blood from pooling in the veins of the leg. Pooling of blood in the veins of the leg may contribute to blood clots forming in the veins. Anti-embolism stockings are generally made for short duration of wear during a hospitalization. Anti-embolism stockings deliver gradient compression and, depending on the manufacturer, the compression delivered to the ankle is in the range of 13 - 18 mmHg. These stockings are normally only available in white. After discharge from the hospital or extended care facility, if you need to continue wearing gradient compression stockings (such as Jobst® Medical LegWear) your physician can advise you on an appropriate level of compression. Jobst® manufactures stockings in the 15-20 mmHg, 20-30 mmHg, and 30-40 mmHg ranges that are ideal for long term wear and comfort. Jobst® Medical LegWear look fashionable and are available in a variety of colors and styles.
Q. Why doesn't my compression glove completely control the swelling on the back of my hand?
A. The back of your hand may swell because unlike the fingers or leg, the hand is more flat in shape than round. Inserting a foam pad under the glove over the back of your hand can increase the pressure to the back of your hand where it is swelling.
Q. Do Jobst® compression stockings and armsleeves require a prescription?
A. When the FDA cleared our products for sale, they required our Jobst® Custom product lines to be dispensed by prescription. The ready-to-wear products available on the shelf do not require a prescription. However, a dealer/retailer of Jobst® compression stockings may choose to require a prescription or physician order for the safety of the patient.
Q. Is uniform compression effective?
A. Yes, uniform compression is effective clinically in managing edema. However, research has indicated that gradient compression in the legs is more effective than uniform compression in improving venous return.
Q. Why should compression stockings for the legs be gradient?
A. Gradient compression (see What is Gradient Compression) is specifically important to the legs. When we stand still the forces of gravity increase the pressure within the veins of the legs - greatest at the ankle and decreasing gradually up the leg and body. This pressure depends on the vertical distance of the column of blood from the heart to the foot. Approximately 86 mmHg of pressure is inside the veins of the ankle of a 5'7" adult in the quiet standing position. In the vena cava vein just before it enters the heart, the venous pressure is about 2 mmHg. Gradient compression stockings are designed with the pressure greatest at the ankle and decreasing up the leg in order to counter the effects of the higher venous pressures.
Q. Does the unaffected leg need to wear compression?
A. Only the leg with the symptoms or disease needs to wear the compression. Some people prefer to wear compression on only the affected leg. Others may opt to wear the same brand of stocking but in a lower compression level on the unaffected or healthy leg. For example, your physician may have told you to wear a Jobst® forMen 30-40 mmHg stocking for the chronic venous insufficiency present in one leg. You may choose to wear a Jobst® forMen 15-20 on the other leg. Always verify with your physician that the problem is present in only one leg.
Q. What is "economy class syndrome"?
A. Economy class syndrome is a term used to describe the medical condition deep vein thrombosis when it follows extended airplane travel.
Q. What is the best time of day to measure for compression stockings?
A. It is best to measure earlier in the day before swelling builds in the legs. Measurements taken later in the day after swelling is present may result in choosing a stocking size that is too large. Many clinics that are unable to see patients earlier in the day will elevate, bandage, or pump the legs for a period of time before measuring in order to reduce any swelling that is present.
Q. What does the abbreviation mmHg stand for?
A. mmHg stands for millimeters of mercury. It is the measurement of how much compression or squeeze that is placed on your leg. The higher the number the more compression.