To Your Good Health: How to best utilize compression stockings

Would you please address how to use compression socks? I sit most of the day, so wearing the socks helps my legs to feel less heavy and tired by the end of the day. Are there people who should not wear them? And what about wearing them during exercise?

Compression stockings are most commonly used in people with chronic venous insufficiency, a common condition in middle-aged to older people.

The major symptom is swelling in the feet and lower legs. The swelling is usually minimal or gone in the morning and gets worse during the day, especially with prolonged standing and even sitting.

The underlying problem is that the veins, which carry blood from the legs back to the heart, get leaky over decades, and the fluid accumulates in the legs under the force of gravity.

Your doctor can prescribe the right size, length and strength of stocking based on your personal condition. The fact that you feel better with compression stockings suggests that you might have venous insufficiency, but it’s still a good idea to ask your doctor about them.

Compression stockings are pretty safe, but should not be worn by people with serious reduction in arterial blood flow to the legs.

Arterial disease is completely different from venous insufficiency. It’s caused by blockages in the arteries that carry blood from the heart to the legs.

An expert, such as a vascular surgeon, is an appropriate consultant for a person with arterial insufficiency before they consider using compression stockings.

Unless you have moderate to severe arterial disease — in which case you should check with your doctor if you aren’t sure — there is no harm from wearing compression stockings during exercise. There may even be some benefit.

Compression stockings should not be worn by those with an acute clot in a major leg vein, a deep venous thrombosis. Once the clot is stabilized for a few days with medication, compression stockings can help treat and even prevent swelling in the affected leg.

People with moderate to severe heart failure should exercise care before using compression stockings, which put the leaked-out fluid back into the circulation and can worsen heart failure. Again, this is an issue to discuss with your regular doctor or cardiologist prior to using compression stockings on your own.

Finally, severe venous insufficiency can cause breakdown in the skin. A person with ulcers or open wounds, or with any kind of acute infection, should be evaluated and treated prior to using compression stockings. A wound care nurse is an ideal consultant in this case.

I have a friend who is 75 years old and has large blue veins directly under the skin on her hands, arms, feet and calves. What causes them, and can they be treated? They are noticeable, and I think she is unhappy because of this issue.

In fair-skinned people, it is common to see blue veins under the skin. This is not a problem. The blood isn’t really blue. The color is due to light scattering.

People with enlarged veins, such as varicose veins, may have more noticeable veins, but they do not need to be treated unless they are symptomatic, or if it is cosmetically important to the patient.

There are many different types of treatments available, and an expert, such as a vascular surgeon, can discuss these options with the patient.