What are some situations where you should wear stockings? What are the known effects, are there contraindications and how long should they be worn?
As a diagnostic radiographer who works in theatres and interventional radiology, I always see surgeons recommend compression socks for some procedures before and after surgery.
And patients usually ask me why and when they should wear compression stockings.
For this article I have relied on scientific medical studies and my professional knowledge to determine whether it is appropriate or not to wear compression stockings in specific situations.
All references I have relied on are at the end of this article and any questions or comments are welcome.
Enjoy reading and feel free to share your own experience.🙏
Last updated: May, 2025. Written by Juliet Semakula, a diagnostic radiographer.
Disclaimer: Amazon affiliate links, complete disclosure in the legal section.
▶️What are different types of compression stockings available?
There are two main types of compression socks for lower limbs which come in two main types: Graduated and Uniform.
1️⃣Graduated compression socks: these are tighter at the ankle and gradually loosen towards the thigh.
2️⃣Uniform compression stockings: these apply the same pressure throughout the leg.
Below-knee compression socks image left and thigh-length compression stockings image on the right,
Image from Lim,2014
In addition to these two main types there are maternity compression socks, flight socks, knee high, and clinical compression socks.
In the UK, stockings are classified according to the amount of force required to stretch them and hence the level of compression they can apply to a limb.
In addition, different classification systems are used in other countries.
The table shows classification of compression stockings in the UK (Nelson,2014)
The best type of compression sock for you will depend on your specific needs and the advice of your doctor.
▶️What does a compression sock do?
Working in the health sector, particularly radiology theatres, I have seen patients being advised to wear compression stockings after they have had surgery.
This made me want to find out the benefits of compression socks with or without surgery for both health and sick people.
▶️Some of the benefits of compression stockings.
Compression stockings are often used by people with varicose veins, those on long flights, or anyone who spends extended periods sitting or standing.
Up to %1 of adults will have a leg ulcer at some time. Leg ulcers are venous in origin and are caused by high pressure in the veins due to blockage or weakness of the valves in the veins of the leg (Nelson 2014)
🟢Compression socks provide gentle and graduated pressure to the legs, primarily to improve blood flow and prevent blood pooling in the veins.
🟢This helps reduce swelling or edema caused by prolonged pressure on the veins in the legs that can impede the return of blood to the heart, leading to fluid accumulation in the lower extremities.
🟢Prevent blood clots especially after surgery.
🟢Alleviate leg pain and fatigue.
There is limited evidence about the effectiveness of some situations as listed in the table in this article.
▶️Where does the fluid go when wearing compression stockings?
The amount of fluid in our body remains the same when you wear compression stockings
Wearing compression stockings helps to prevent blood and other fluids from pooling in the legs only, which can lead to swelling and discomfort.
Our body’s circulatory system is a complex network of vessels through which blood and other fluids travel to every part of our body.
Fluid in the legs is moved upwards throughout the body by the pressure, wearing compression socks helps to improve overall circulation.
As a result, fluid is more evenly distributed throughout the body and there is less accumulation in the legs.
▶️How long does it take for compression socks to reduce swelling?
Some people I have seen with swollen legs who have used compression socks claim to feel immediate relief and reduction in leg swelling and improved blood circulation.
Some people notice a reduction in swelling within a few hours of wearing compression socks especially after activities like long periods of standing or travel.
However, for more persistent or underlying conditions, it may take several days or even weeks/months of consistent wear to see significant improvements.
Remember this could only apply to some people; we all heal different and have different situations.
▶️When should compression stockings be worn?
You Can wear compression stockings throughout the day, they do not cause harm unless your doctor advised you not to wear them.
However, compression stockings are more effective while standing or sitting and less likely to cause discomfort or excessive swelling.
I have seen patients advised to wear compression socks first thing in the morning as soon as they get out of bed, some people sleep with them without discomfort.
However, not wearing compression socks while sleeping at night is no harm.
Sometimes it is recommended to remove them before bedtime to allow your ankle and leg to relax and prevent skin irritation from prolonged pressure.
Remember compression socks are designed to help with circulation when standing or sitting.
The best time to wear compression stockings can vary depending on individual circumstances and medical conditions.
Always follow your doctor’s specific instructions if you have any questions or concerns
▶️Benefits of wearing compression stockings
There was a bias present in the scientific publication, of how effectiveness compression socks are in preventing many things but with limited evidence to support. This was noted in some international scientific publications I used.
So, I relied on the most reliable sources to my knowledge produced by the international publications by the Cochrane collaboration.
Here is what medical scientific studies say about the benefits of wearing compression stockings.
A list: when to wear compression socks: pathologies and situations evaluating the effectiveness of compression stockings
| Pathologies | Probable effects of compression stockings (references) |
| Treatment for leg venous ulcers cause by high pressure in the vein (Stansal,2024) Severe venous leg wound ulcers | 🟢Helps reduce the pressure in the vein. 🟢Recurrence of venous ulcers is lower(Nelson, 2014)Not very beneficial for the elderly people who have severe wounds, it will need them to wear them for which can be very restrictive as the perception of improvement is far from immediate especially (stansal,2024) 🟢 Insufficient evidence to facilitate choice among different types of compression stocking. |
| Muscle fatigue, edema or swelling of the leg triggered by prolonged standing has been associated with blood pooling in the lower limbs | · Lower-leg muscle fatigue and edema appear to be prevented to a larger extent by wearing compression socks.(Chiu,2006) |
| Preventing thrombophlebitis which is an inflammation that causes blood clot to form in a vein | Compression stockings can also be helpful in preventing blood clots after surgery or during long periods of inactivity, as well as reducing swelling and improving circulation (Calnan,1975) |
| Preventing the risk of phlebitis during pregnancy and post-natal in pregnant women at risk. | While compression socks are recommended for symptoms relief of leg swelling associated with varicose veins during pregnancy in United Kingdom, United States, or Germany (Joassard,2024)There is little evidence of their effectiveness, very limited data on the subject. |
| Lymphedema where lymphatic fluid buildup occurs in body tissues(Bowman,2024) | Compression stockings can help reduce swelling and prevent infections associated with lymphedema |
| Prevent phlebitis and edema during flight travel | It has been suggested that wearing compression stockings might reduce this risk (weak evidence thou) (Clarke,2001) |
| Preventing the risk of phlebitis after surgery | compression stockings for prevention of deep vein thrombosis in postoperative surgical patients (But unclear whether knee length graduated compression stockings or thigh length stockings are more effective (sajid, 2012) |
| Preventing phlebitis after a stroke | No compression stockings do not reduce the risk of phlebitis after a stroke (Naccarote,2010) |
▶️How many hours a day should you wear compression socks?
Generally, you can wear compression socks most of the day, from morning until bedtime regardless of the indication.
The reason being the action of the stockings ceases as soon as they are removed especially when you are standing or sitting for long.
▶️Can compression stockings be removed at night?
Yes, there is no contraindication to wearing them while sleeping. Some people even find it comfortable to wear them at night.
However, you can remove them before sleeping, as they are not typically needed at night.
The ideal practice is to put them back on as soon as you wake up reason being:
🟢When sleeping there is less venous stasis, and your blood circulates better as the foot is not in a dependent position.
🟢But as soon as you get up or sit, venous stasis can resume.
The amount of time you wear them depends on your specific needs and any medical conditions you may have.
▶️Can I skip a day of wearing compression stockings?
Skipping a day of not wearing compression stockings is not a life sentence. However, there are potential consequences of skipping and this will depend on the reason why you are wearing them.
This can reduce their effectiveness and potentially worsen your symptoms like swelling.
It is always recommended to wear compression stockings daily for optimal benefits.
But as I have said, always follow your doctors’ instructions and advice in your case. You may not need them daily or otherwise.
or if you’re unable to wear them daily, it’s crucial to discuss it with your doctor or health professional to ensure you’re following the most appropriate course of action.
▶️ When to remove compression stockings when you have had surgery or not?
Usually, the person who prescribed the compression stockings will inform you how long to wear them
The duration for wearing compression stockings after surgery will vary depending on the type of surgery and your individual circumstances.
However, I have seen even less invasive procedures such as knee arthroscopy, knee replacement where compression stockings have been prescribed.
They are normally worn for at least 2-4 weeks or until you can resume a more lifestyle outdoor activity like walking.
Certain operations I have seen, most of the time you are not able to move your legs much during the recovery period.
You may need to stay in bed and even in that position you might have limited mobility.
In such situations there is an increased risk of blood clots in your legs due to reduced blood circulation.
Because of the operation the surgeon may have had to manipulate some blood vessels and capillaries during the operation which may alter blood flow.
You are usually given medications or injections to stop all that, but compression stockings are one of the methods used to help reduce the risk of clot formation.
It’s crucial to follow your surgeon’s specific instructions because this is on an individual basis.
▶️Here are some examples when you may remove compression stockings.
🟠If you wore compression stockings on a flight to prevent the risk of thrombophlebitis during a flight, you could remove them within hours of landing.
🟠After surgery sometimes they may give an injection or medications to help with thrombophlebitis, however if you did not have any treatment for phlebitis, you can remove them after a few weeks.
🟠Some people with leg venous ulcers who want to reduce the risk of new ulcers may need to wear them for life.
▶️When can you stop wearing compression stockings after a hip or knee replacement?
Always when you have had surgery, your doctor will give you instructions on how long you can wear compression stockings. This is on individual advice based on your condition.
However, usually after a hip replacement, I have seen patients being told to wear compression stockings:
🟠In the first initial 48 hours continuously, which is very important after hip surgery.
🟠Then the first 2 weeks you can wear compression stockings during day and night.
🟠After 3 to 4 weeks, you can wear socks during the day when active and remove them during night time.
🟠After 4 weeks compression stockings are no longer needed unless your surgeon advises otherwise.
It can be challenging in the weeks following a hip replacement surgery, it will be up to your own opinion on the potential benefits of wearing compression stockings.
▶️How to tell if compression socks are working?
You may be able to tell if compression stockings are working if you start seeing your symptoms which in the first case prompted you to wear them.
For example, if you had swelling and discomfort you may:
🟠See a reduction in swelling leading to lighter legs.
🟠You may notice decreased muscle soreness after exercises.
🟠Pain may reduce and any discomfort may disappear.
🟠Some people claim to have no numbness and tingling in the toe’s feet and ankle.
However not all people report improvement in their symptoms even after wearing compression stockings.
▶️Is there a disadvantage to wearing compression socks?
There are certain situations when it is better not to wear compression stockings due to the risk of side effects they might cause.
Who should avoid compression socks?
1️⃣A compression stocking should not be worn in the case of circulation disorders in leg arteries such as peripheral arterial disease or bypass, as the pressure exerted by compression socks can worsen cutaneous arterial insufficiency.
2️⃣Having a serious heart condition leading to massive leg swelling or pulmonary edema.
3️⃣You may also take caution if you have sensory impairments due to diabetes and neuropathy (nerve damage).
4️⃣Some people are allergic to the sock’s material.
5️⃣Having severe cellulitis, soft tissue conditions can be discomforting wearing compression socks.
Lim,2014
▶️Should you elevate your legs when wearing compression socks?
Yes, it is always advisable for you to elevate your legs when wearing compression socks, especially if you have just had surgery or have conditions like varicose veins.
This will help:
🟠Maximize their effectiveness and benefit.
🟠Elevating the legs helps improve blood flow and reduce swelling.
🟠Some people feel increased comfort and less fatigue in the feet when they elevate their legs especially after sitting for a long time.
You will always do what is comfortable for you and always seek help if you need to.
▶️ Is it OK to put compression socks on swollen feet/ legs?
It will depend on what caused your swelling, there are different types of swelling for feet.
🟣Venous swelling common when you have had a sprain or fracture
🟣Edema or swelling of cardiac origin in case of heart failure
🟣Lymphedema is mostly associated with cancer.
🟣Edema is common when pregnant.
🟣Liver disease may affect protein production leading to fluid build-up causing swollen feet.
As we have seen there is not much evidence to conclusively state that compression stockings significantly reduce edema of the venous origin.
Though they are sometimes prescribed for edema of the lymphatic or venous origin and for pregnant women.
However, compression stockings are contraindicated for edema of cardiac origin as they worsen heart failure.
Compression stockings will not make venous edema disappear faster, but they can potentially provide better comfort and help reduce the edema when worn.
▶️Why do my legs ache after wearing compression socks?
Compression socks are effective in some situations in supporting leg comfort however there are common reasons why you may feel leg aches when you first wear them.
🟣Initial adjustment period: I remember when I wore compression stockings for the very first time, the pressure that was exerted by the socks felt unfamiliar but after some times the aches disappeared.
So, you may give yourself time for your body to adjust as the aches may diminish overtime unless your skin is allergic to the stocking material.
🟣Compression level suitability: most of these socks come in different levels ranging from mild, moderate to extra firm. It is always important to choose the right size for your case.
If the pressure exerted by the socks feels too intense it may result in aches, dry skin irritation or pain.
🟣Incorrect size or fit: you must always wear the correct size for you. Uneven or excessive pressure may lead to aches.
🟣Certain underlying medical conditions such as peripheral artery disease may require specific consideration. Always consult your doctor for advice.
🟣Dehydration: you not drinking enough water during the day may hinder health blood circulation .so ensure you drink enough to avoid muscle cramps and aches.
Always if you feel pain, numbness, tingling when wearing socks, take them off and consult your doctor to discuss the causes and determine a solution for your case.
▶️Compression socks when flying?
I usually wear compression socks on longer flights of over 8 hours and more to help improve my blood circulation and reduce the risk of deep vein thrombosis (DVT).
Usually when you sit for a long time without moving, you may start to feel discomfort particularly in your lower limb.
That’s why sometimes on longer flights you see some people stand up and walk down the airplane corridor to stretch their legs to allow blood circulation.
Wearing socks on long flights can reduce leg pain and stiffness.
And if you have been told by your doctor that you have an increased risk of deep vein thrombosis or you have a history of blood clots, consider wearing compression socks.
Anyone experiencing leg swelling or discomfort may find compression socks useful
Always remember to choose the right level, moderate compression is normally recommended for flying and if you have concerns about DVT or other circulatory issues, it is always good to consult your doctor before any flight travel.
▶️Types of compression socks
As we have discussed there are so many different types and sizes of compression stockings.
Here in the United Kingdom, compression stockings are normally supplied in NHS hospitals when you need them and your doctor will always prescribe the right size for your case.
You can always buy them:
♦️At some pharmacies or drug shops
♦️Some medical or general stores
️ ️Online, you can see on Amazon for different types and sizes. Make sure you purchase graduated compression stockings of the desired class, often class II.
Here are two examples:
We have come to the end of this article, any comments are welcome, wishing you a quick recovery.🙋
📚Sources:
Nelson EA, Bell-Syer SE. Compression for preventing recurrence of venous ulcers. Cochrane Database Syst Rev. 2014 Sep 9;2014(9):CD002303. doi: 10.1002/14651858.CD002303.pub3. Update in: Cochrane Database Syst Rev. 2024 Mar 7;3:CD002303. doi: 10.1002/14651858.CD002303.pub4. PMID: 25203307; PMCID: PMC7138196.
Garcia MG, Roman MG, Davila A, Martin BJ. Comparison of Physiological Effects Induced by Two Compression Stockings and Regular Socks During Prolonged Standing Work. Hum Factors. 2023 Jun;65(4):562-574. doi: 10.1177/00187208211022126. Epub 2021 Jun 2. Erratum in: Hum Factors. 2023 Jun;65(4):695. doi: 10.1177/00187208211043821. PMID: 34078143; PMCID: PMC10210207.
Chiu MC, Wang MJ. Professional footwear evaluation for clinical nurses. Appl Ergon. 2007 Mar;38(2):133-41. doi: 10.1016/j.apergo.2006.03.012. PMID: 16765904.
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Joassard O, Kerveillant AL, Sellal C, Coatantiec E, Jabbour V, Desjeux G, Braithwaite B, Elias A, Fauconnier A. Evaluation of Elastic Venous Compression Device dispensation in pregnant and post-partum women using the French National Health Insurance Claims Database: The ProFIL retrospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2024 May;296:342-348. doi: 10.1016/j.ejogrb.2024.03.014. Epub 2024 Mar 15. PMID: 38531180.
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Bowman C, Rockson SG. The Role of Inflammation in Lymphedema: A Narrative Review of Pathogenesis and Opportunities for Therapeutic Intervention. Int J Mol Sci. 2024 Mar 31;25(7):3907. doi: 10.3390/ijms25073907. PMID: 38612716; PMCID: PMC11011271.
Calnan JS, Allenby F. The prevention of deep vein thrombosis after surgery. Br J Anaesth. 1975 Feb;47(2):151-60. doi: 10.1093/bja/47.2.151. PMID: 50076.
Clarke MJ, Broderick C, Hopewell S, Juszczak E, Eisinga A. Compression stockings for preventing deep vein thrombosis in airline passengers. Cochrane Database of Systematic Reviews 2021, Issue 4. Art. No.: CD004002. DOI: 10.1002/14651858.CD004002.pub4. Accessed 04 May 2025.
Sajid MS, Desai M, Morris RW, Hamilton G. Knee length versus thigh length graduated compression stockings for prevention of deep vein thrombosis in postoperative surgical patients. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD007162. DOI: 10.1002/14651858.CD007162.pub2. Accessed 04 May 2025.
Naccarato M, Chiodo Grandi F, Dennis M, Sandercock PAG. Physical methods for preventing deep vein thrombosis in stroke. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD001922. DOI: 10.1002/14651858.CD001922.pub3. Accessed 04 May 2025.