How Compression Hosiery can help you?

Compression hosiery are elasticated stockings that give support to your legs. In graduated compression hosiery, the pressure given by the stockings is greater at the ankle and reduces towards your knee. The stockings can be knee-length or thigh-length depending on your condition.

Why do I need compression hosiery?

The veins in your legs carry blood back to the heart. The calf muscles are responsible for pumping the blood through the veins back to the heart. The veins have one-way valves to ensure the blood flows in the correct direction. Damage to the veins and the valves can lead to the blood being unable to get out of the legs and collecting there, instead of being pumped back towards the heart. As a result, the pressure in the veins increases which can lead to the symptoms such as:

• Swelling of the ankles
• Pain in the calf and legs
• Aching in the leg
• An itching or burning sensation in the leg
• Darkening of the skin
• Leg ulcer

Possible causes of poor function of the veins include:

• Varicose veins
• A blood clot in the leg (this is also called deep vein thrombosis (DVT))
• Faulty valves in the veins deep inside the leg causing high pressure in the veins.

What are the benefits of compression hosiery?

By wearing compression stockings, symptoms due to the following conditions can improve:

• Varicose veins
• An open or healed leg ulcer
• Swollen legs due to likes of pregnancy, immobility after you have had venous surgery
• Deep vein thrombosis (blood clot in legs)

Compression stockings apply pressure to your legs, which increases the blood flow in the veins upwards towards the heart. They work by squashing the veins and squeezing the blood back up your leg. This then helps to prevent venous leg ulcers and reduce swelling, pain, itching and the burning sensation in your legs. If you have had a leg ulcer, wearing compression stockings may prevent the leg ulcer from forming again.

Risks of compression hosiery

• Compression hosiery can cause skin damage if applied to a leg with a reduced blood supply; in this case compression hosiery is not recommended. If your leg increases in size and the stockings become too tight, they may cause skin damage. If you lose weight and your legs become thin, the compression stockings may become too loose and may not work. Some people can be allergic to the stockings, but this is very rare. If you have an allergic reaction to the stockings, remove them and seek advice from your health professional. If you get an infection in your leg (cellulitis), your leg may swell up and become hot and painful. In this case, you may find it too uncomfortable to wear the stocking. If this happens, you should seek advice from your GP, leave the stocking off and rest with your leg elevated. Your ankles should be elevated higher than your heart to reduce the swelling in your leg.

If you experience any pins or needles in the feet, numbness, discolouration, reaction to the stockings, shortness of breath or increased pain in the legs, remove the stockings and inform your health professional.

What are the alternatives?

Compression stockings are not a cure and need to be worn long-term to be effective. The alternative treatments available depend on the condition you are being treated for. For example, if varicose veins are the reason for you wearing the compression hosiery then varicose vein surgery, ultrasound-guided foam sclerotherapy and radio frequency ablation may be alternative treatments. See Eamonn from Whelehans Pharmacy’s article on varicose veins at www.whelehans.ie for more details on varicose veins.

How to apply your compression stockings

It is best to apply compression stockings first thing in the morning, before getting out of bed (before legs begin to swell).

1. Turn the stocking inside out up to the heel. If you are putting on open-toe stockings, place the slipper aid over the foot (slipper aids are provided in stocking box).
2. Pull the foot of the stocking over your foot.
3. Gradually ease the stocking up over the heel and ankle.
4. Ease the rest of the stocking up the leg. Avoid pulling too hard at the top of the stocking.
5. Check toe and ankle pieces are in the correct place: - The top of the knee-length stocking should be 2 finger spaces below the crease of the back of the knee. The top of the thigh-length stocking should sit 2 finger spaces below the crease under your buttock.
6. Remove slipper aid from foot.

You must wear your stockings all day but remove them at night. There are various aids available to assist in applying your stockings and your pharmacist can give you more information about these if you need it.

How to remove your compression stockings

Remove your stockings prior to going to bed. Remove carefully trying not to damage the skin

Washing and drying your stockings

Washing

Wash in warm water with a non-biological washing detergent. Do not use fabric conditioner. Stockings can be washed in the washing machine on a delicate cycle at 40°C.

Drying

Do not use direct heat (fire or radiator) or a tumble dryer to dry your stockings. This will damage the elastic and the stockings will become ineffective. Roll them in a towel to remove excess moisture. Hang stockings on the washing line to dry.

What class stockings should I wear?

Compression stockings are classed 1-3 with class 1 being the lowest strength. Your doctor, nurse or pharmacist will advise the class of stocking you require.

How often should the stockings be replaced?

You will be advised by your nurse/GP/pharmacist how often you will require new stockings as with time they will lose their elasticity and will not work as well. Generallly, you should have your legs measured again and your stockings replaced every 3-6 months. Once compression stockings are prescribed for your legs you will need to wear them permanently, as long as there is enough blood getting into your legs (arterial circulation is good).

Are they allowed on the medical card?

For anyone with a medical card; the HSE allow you reveive two free pairs of compression per annum (one every six months) on the hardship scheme once you have a valid prescription from your GP. You only need to pay the standard HSE Medical Card fee of €2.50 towards the cost of your stocking. Your pharmacy team can help and advice you on applying for your stocking via the hardship scheme.

How to improve the way your veins work

Diet and weight control

Extra body weight puts extra pressure on the veins in the legs, managing your weight can help to heal your leg ulcer. It is also important to eat a healthy, well balanced diet including fruit and vegetables; this will also aid wound healing.

Skin care on your legs

You should note any skin changes and report them to your health professional. Ensure your skin is moisturised with an unfragranced ointment or cream e.g. emulsifying ointment. Apply ointment in a downward motion in the evening after removing your stockings.

Avoid injury

Be careful not to bang your legs on furniture or sharp objects as any injury may cause a wound which may take a long time to heal.

Walk or exercise regularly

This will help to keep the calf muscle pump working properly. If you are immobile, perform foot and ankle exercises. Do this by rotating feet round and round and moving feet up and down

Avoid standing for long periods

If this cannot be avoided, activate the calf muscle pump by taking the weight off your heels and standing on your toes and rolling back onto your heels with toes off the ground. This will encourage the venous blood supply to return to the heart.

Elevation

Rest every day with your legs elevated, so that your feet are above your waist height.

Part 2 

In Part 1 I discussed how compression hosiery can prevent or improve swelling in the lower leg and ankles, pain, aching or itching, leg ulcers, varicose or spider veins, blood clots in the legs also known as DVT (deep vein thrombosis).  They may be used to prevent leg swelling caused by pregnancy or a lack of mobility following surgery. Graduated compression hosiery (also called elasticated stockings) are available in either knee or thigh length. They apply pressure to the legs (greater at the ankle, reducing towards the knee) which squeezes the blood back up your leg.

How to apply your compression stockings

Apply compression stockings first thing in the morning, before getting out of bed (before legs begin to swell).

1. Turn the stocking inside out up to the heel. If you are putting on open-toe stockings, place the slipper aid over the foot (slipper aids are provided in stocking box).
2. Pull the foot of the stocking over your foot.
3. Gradually ease the stocking up over the heel and ankle.
4. Ease the rest of the stocking up the leg. Avoid pulling too hard at the top of the stocking.
5. Check toe and ankle pieces are in the correct place:
6. Remove slipper aid from foot.

You must wear your stockings all day but remove them at night.

Washing and drying your stockings

Washing

Wash in warm water with a non-biological washing detergent. Do not use fabric conditioner. Stockings can be washed in the washing machine on a delicate cycle at 40°C.

Drying

Do not use direct heat (fire or radiator) or a tumble dryer to dry your stockings. This will damage the elastic and the stockings will become ineffective. Roll them in a towel to remove excess moisture. Hang stockings on the washing line to dry.

What class stockings should I wear?

Compression stockings are classed 1-3 with class 1 being the lowest strength.

How often should the stockings be replaced?

With time they will lose their elasticity and will not work as well. Generallly, you should have your legs measured again and your stockings replaced every 3-6 months.

Are they allowed on the medical card?

For anyone with a medical card; the HSE allow you reveive two free pairs of compression per annum (one every six months) on the hardship scheme once you have a valid prescription from your GP. You only need to pay the standard HSE Medical Card fee of €2.50 towards the cost of your stocking.

Free measurement and fitting

With appointments available free of charge every Monday, Whelehans Compression Hosiery Consultation service provides a dedicated fitting service in our private consultation room. Our fully trained staff will guide you through a step by step process to ensure that you have the correct stocking.  They are also qualified to advise on how to manage and maintain your hosiery, such as washing, removal, replacement etc. Once the consultation is complete, they will then order your hosiery which you can collect the following day.

To take advantage of this service, simply call Whelehans Pharmacy on 044 9334591 to book your personal appointment.

Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591.