Use of elastic stockings
The best help that can be given to our legs, which every day have to bear our weight while remaining standing maybe for many hours, are the elastic graduated compression stockings, which help the emptying of the vein by acting as an “additional external pump”and reduce our vascular problems.
Graduated compression elastic stockings are the most effective and complete device for the treatment of venous insufficiency. Compression is a conservative method that, although it does not produce healing from varicose veins, is certainly able to slow down the worsening and especially reduce symptoms such as a sense of heaviness, swelling, pain.
Elastic compression can therefore be considered the most suitable solution in the early stages of the disease, it is ideal for pregnant women or people with vascular problems and patients for whom surgical therapy or sclerotherapy are contraindicated.
There are socks for those who have to do a prevention and socks designed to treat the various degrees of venous insufficiency. It is therefore possible to have a stocking for each leg, whether sick or not, as long as it meets the necessary requirements of quality, the guarantee of compression (which must be declared by the manufacturer in mmHg = millimeters of mercury) and progressive reduction of compression from the ankle to the thigh.
Resting or therapeutic socks
Elastic stockings can be classified as resting, or preventive and therapeutic. In common they have the degressivity of compression or differentiated compression; the former have aesthetic characteristics (e.g. lightness, transparency, range of colours) superior to the latter.
Resting or preventive stockings exert a compressive force on the ankle which, due to their construction and use, should be less than 20 mmHg at the ankle and a value at thigh level equal to about 40% of that found at the ankle. These stockings are indicated, in the absence of an established disease, to prevent the development of circulatory problems in individuals with one or more risk factors (such as familiarity, work involving standing or sitting for many hours, use of oral contraceptives, constipation).
The therapeutic socks, real medical devices, must be prescribed by the specialist and sold at authorized points of sale. In many European countries (Germany, France, Switzerland, etc.) this therapeutic instrument is reimbursed by the National Health Service and must follow and comply with precise rules and legal requirements; they are also tested by special independent institutes that verify the quality and correct degressivity of the compression. In Italy these regulations are not present; however, buying a therapeutic sock with a quality certification that is not the only CE mark, is an additional guarantee.
The correct therapy
For preventive stockings, but in particular, for the therapeutic ones (which are almost custom-made stockings), finding the right size for the patient is essential. In order to determine the size, a correct measurement of certain circumferences (ankle, calf, thigh) is necessary.
In addition, it is essential to choose the compression class (I – II – III – IV) best suited to the severity of the disease.
In the end, the choice must fall on the type or model of a sock (knee-high, sock with thigh support, left or right monocollant and full tights) and on its length (generally or long or short) in relation to the stature of the patient.
Instructions for use
Elastic stockings should preferably be worn before getting out of bed, but if this is not possible it is recommended to apply them before starting your personal day (preparing a coffee when you wake up or going to the bathroom before putting them on are not a real problem).
The rationale for early use in the morning is that it is preferable to wear stockings before the legs start to swell because the therapeutic action of elastic tissue is to promote venous return, eliminate symptoms such as heaviness and keep the lower limbs free of edema.
The elastic brace, especially if therapeutic, should never be chosen and used without the prescription and advice of the specialist doctor and without excluding a concomitant arterial pathology with an eco-doppler examination. In this sense, an arteriopathic or diabetic patient who also has a varicose disease, before even thinking of using an elastic sock must necessarily contact the specialist to avoid choosing a product that is not suitable and sometimes even harmful to the same circulation.
Compression of the lower limbs with the sock must be associated with mobilization to obtain the best results.
It is advisable to wear gloves before putting on the socks, as this does not risk damaging the fabric and makes it less difficult to wear them. In this sense, there are some applicators on the market that are easy to use and make the application much easier, making it much easier, especially for elderly people.
If the sock is open-tipped, you must first put the silk sock or foot pedal (generally supplied in the package) on the foot to overcome the heel and facilitate the sliding upwards; the sock that is supplied with the sock itself must be removed and slipped off once you wear the brace. The legs must be dry; the use of a little talcum powder is allowed to make the skin surface smoother and facilitate the sliding of the sock. In the most difficult cases, it can also be applied on top of a thin nylon knee-high that can also be easily found in haberdashery.
Two systems can be used to wear elastic braces:
The photo below suggests the easiest way to wear a sock, that is, with the help of a silk pedal that is normally supplied with the sock. This should be applied to the barefoot like a small and comfortable slipper: on it should be slipped the sock that, slipping on the thin fabric, progresses more easily upwards allowing you to more easily overcome the heel that is almost always the most difficult obstacle in the first part of the application. Of course, the foot pedal must be removed once the sock has been applied completely. In the absence of this, you can use a common nylon knee-high that performs the same function as the pedal but that is generally left in place since you can no longer remove it easily.
There are also particular and more specific applicators whose use should be recommended only to those patients who have real difficulties in exercising the common maneuvers of applications.
A simple technique for wearing socks is as follows:
A) you insert a hand into the sock to go and grab the heel, so you can turn the sock up to the heel itself; you insert the foot and then you unroll the sock upwards;
B) slowly slide the sock upwards a little at a time, accompanying the fabric without pulling too much.
Care will be taken to distribute it evenly, avoiding areas where more fibers overlap (creating hyper pressure) or areas where the knits are too stretched.
The knee-high model should not be stretched too high to cover a part of the knee or even be turned down because this can create painful constrictions and harmful to the venous return. The limit is exactly up to below the knee, not above or below it.
The sock will be removed in the evening or before resting, as it is usually not well tolerated in bed, grabbing it up and pushing it down, then turning it over gently.
The first times, after having put on the sock, you will be able to feel the sensation of very forced legs, but it will be enough to have a little patience and soon you will feel at ease; on the contrary, usually those who suffer from venous insufficiency in the lower limbs will not be able to do without the sock once used to wear it.
It is always advisable to consult your doctor when you realize that the elastic brace can no longer control the symptoms of venous insufficiency (e.g. swelling), or when it starts to roll up and down along the limb or when, on the contrary, it causes annoying constrictions.
You can review the video to see how to put compression socks
How to make them last longer
Proper maintenance enhances the therapeutic qualities of the stockings and prolongs their life so that a stocking worn daily can last 4-6 months.
Advice to follow is:
- Often wash the sock (frequent washing does not damage the fabric) using lukewarm water and neutral soap.
- Do not use the washing machine.
- Do not use solvents or bleachers.
- After washing, rinse thoroughly with warm water.
- Do not wring or dry by direct sunlight, on radiators or near heat sources.
- The sock should dry lying on a flat surface, possibly between two dry cloths, and never under tension, keeping it hung by one end.
In the event of damage to the elastic brace fabric, such as stretch marks or cuts in the knit, it must be replaced.
Of course, the alternating use of two pairs of socks will allow you to have your ideal therapeutic elastic compression available every day.