Compression Therapy

 

Graduated compression hose are a valuable tool in the treatment of venous disease. The first thing to understand is what the numbers on the hose mean. Hose come with a pressure listing such as “30-40 mmHg.” The larger number refers to the pressure applied by the garment at the ankle and the lower number refers to the pressure applied at the top of the garment, either at the knee or thigh, depending on the length of the hose. This gradient of pressure is designed to aid in the movement of blood up the leg.

 

Generally, pressures up to 15-20 mmHg may be purchased over the counter. 20-30 mmHg and 30-40 mmHg should only be worn with a doctor’s prescription. It is important that prescription hose be sized to the patient by measuring the diameter of the legs at certain specific points.

 

Some patients may find it difficult to get prescription compression hose on without another person helping them. For these patients, we have a “Hose Buddy” (pictured below) that can make donning the hose much easier. Another option that makes it easier to don the hose is to wear two sets of 15-20 mmHg hose over each other to create the equivalent of 30-40 mmHg pressure. For patients that have trouble with the hose slipping down we have a special hose adhesive to prevent slippage (see below).

 

Also, keep in mind that the T.E.D. hose (anti-embolic hose) patients wear after surgery are only meant for use when a patient is in bed. They are not designed for upright use and provide inadequate pressure to be of any use for vein disease in the ambulatory patient. To learn more about T.E.D. hose click here.

 

Common uses for graduated compression hose include the following:

 

Symptom relief. Patients with mild vein disease, including swelling, may get significant relief of some of their symptoms when they wear properly fitted graduated compression hose. Some experts believe that wearing compression hose may also slow the progression of vein disease.

 

Conservative management of venous disease. Most insurance companies require patients to wear prescription graduated compression hose for a period of time (usually 6 weeks or 3 months) before they will consider approval of any treatment for vein disease. This is one part of what insurance companies refer to as “supervised conservative management.” This trial must be under the direct supervision of a physician and also includes elevating the legs when possible, walking daily, using over-the-counter analgesics as needed, and trying to lose weight, if indicated.

 

In association with treatment. After any of the four major types of treatment for venous disease (EVLT, microphlebectomy, USG sclerotherapy, or visual sclerotherapy) patients are required to wear prescription hose for 1-2 weeks, depending on the procedure.

 

Chronic use. Some patients have such advanced vein disease that even after treatment they need to wear compression hose. These patients have usually reached the point where their vein disease has irreversibly damaged their skin and the extra pressure of the hose protects the skin from further damage.

 

Our goal with all but the most advanced vein disease patients is to get their legs both feeling great and looking great—without the need to wear compression hose. The sooner a patient gets treatment the better the chances of avoiding long term complications.

 

We have most sizes and types of Jobst stockings in stock. We can also order any style or brand of hose and have them in the office within a few days. 

 

Clovis E. Manley, MD

Evansville Regional Vein Center