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, 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. 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: 1. Controlling the swelling in the leg that occurs with DVT, and 2. To help prevent the development of post-thrombotic syndrome that may occur several months after the DVT.

Q. What is the difference between an anti-embolism 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. Do  compression stockings and arm sleeves 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. 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 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.