A Guide To The Best Compression Socks For Seniors (2024)

Compression socks gently squeeze the leg, moving blood up the leg and preventing fluid retention that can cause swelling. Compression stockings can help prevent blood clots and are often prescribed for people with varicose veins, spider veins or those who just had surgery. They can also help with vascular conditions, such as deep vein thrombosis (characterized by a blood clot in the deep vein), post-thrombotic syndrome (a complication of deep vein thrombosis) and chronic venous insufficiency (when circulation of blood in the leg veins is impaired).

“Compression stockings are really important, especially for people with swelling in their legs,” says Jessica Kalender-Rich, M.D., the post-acute medical director for the continuum of care with the University of Kansas Health System in Kansas City, Kansas. “Chronic swelling in legs can lead to debility and decline in the ability to walk because the leg can get heavy. In addition, it can lead to wounds on the legs, which is then harder to heal because swelling is the enemy of healing.”

Shifting fluid around the body can be problematic for people with heart failure or liver disease. Additionally, compression generally isn’t a good idea for those with active infections, and people with peripheral arterial disease shouldn’t restrict blood flow with compression.

You don’t need a prescription to buy socks with relatively low levels of compression. Higher levels of compression, though, do require a prescription from your doctor, as certain contraindications may put you at risk. A prescription can help you find the right type of sock for your specific needs.

In general, compression stockings are made of elastic fabric. But different styles are designed to meet different needs.

“It’s a good idea to consult with your physician or advanced practice provider to make sure they agree with the kind of compression stocking you’re choosing,” says Dr. Kalender-Rich. “It’s good to know your goal.”

There are several kinds of compression stockings:

Graduated Compression Stockings

These stockings are tighter at the bottom (at the ankle) and help push fluid up the leg. If the goal is to get rid of swelling and prevent it from coming back, Dr. Kalender-Rich says graduated compression stockings are your best bet. You’ll take them off nightly before bed and put them on in the morning after bathing.

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TED Hose

Thromboembolism-deterrent (TED) hoses are often used by patients after they’ve undergone surgery, including heart surgery. They’re designed to push blood up the leg, toward the heart. The idea is to avoid blood clots or deep vein thrombosis. You generally take them off daily when you bathe, but talk to your doctor about whether or not you should wear them while you sleep.

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Non-Medical Support Hosiery

Tired, heavy and aching legs can often find relief from nonmedical support hose. These socks provide less compression than other options and the compression is consistent throughout the length of the sock. You can purchase non-medical support hosiery without a prescription. They don’t meet the medical and technical specifications of other compression hosiery, but might be beneficial for people who are pregnant, people who take long and frequent flights or people who are on their feet all day for work.

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Talk to your doctor to see what specific elements you should look for in a compression sock so you are directed to the features best suited to your needs. Here are a few factors to keep in mind:

Tightness

Tension in compression stockings is measured in millimeters of mercury (mmHg). In general, pressure of less than 20 mmHg is considered low compression while 20 to 30 mmHg is medium compression. Pressure that exceeds 30 mmHg is deemed high compression. Some studies show low pressure is just as effective as medium pressure for general swelling^[1]Lim CS, Davies AH. Graduated compression stockings. Canadian Medical Association Journal. 2014;186(10);E391-E398. .

Low pressure can help mild swelling and aching legs or feet, while medium compression can treat varicose veins and sports injuries. Seniors often find compression in the 20 to 30 mmHg range to be helpful. High compression is used for conditions like severe edema, deep vein thrombosis, serious wounds and lymphedema, and anything over 30 mmHg typically requires a prescription, so talk to your doctor.

Length

You can find compression stockings in knee-high, thigh-high and full-length styles. Most people find that knee-high socks are easier to put on. The length that works best for you will depend on your needs. In general, though, most common leg conditions can benefit from knee-high compression socks, while thigh-high compression socks are typically used to treat severe varicose veins and other conditions that extend above the knee.

Fit and Comfort

Compression socks should feel secure, but not too tight.

“You don’t want them to feel like they’re cutting into your leg,” says Dr. Kalender-Rich. “More than that, you don’t want any creases or pushing into the top of the leg. These can put you at risk for wounds.”

And remember—the best compression sock is the one you’ll wear.

“This is not a time to seek perfection if it means not doing anything,” says Dr. Kalender-Rich. “Sometimes, we have to choose the stocking that is perhaps less beneficial medically but will actually get worn.”

You can find compression stockings at several price points. Expect to spend at least $10 a pair. Higher-compression and more specialized stockings (such as ones that include unique grip tops or are made of fashionable fabric) can exceed $100. You can find compression socks at online retailers, pharmacies, medical supply stores and stores that focus on comfort footwear.

Does Insurance Cover Compression Socks?

Generally, insurance will cover the cost of compression stockings if they’re part of a diagnosis and treatment plan. Be sure to check with your insurance provider on what your coverage includes. You might be able to use health savings account (HSA) or flexible spending account (FSA) funds to pay for prescription compression socks, so be sure to ask your provider.

Compression socks can be trickier to put on and require a little more TLC than a standard pair of socks.

Here are a few helpful hints from Vascular Cures, a non-profit organization that promotes resources for vascular disease:

• Put on the socks first thing in the morning, when your leg is less swollen.
• Pull the socks up your leg gently, smoothing the fabric as you go. Make sure the seams are straight and the heels are in the correct spot.
• Use talcum powder on your legs to make the socks go on more smoothly. If you use lotion, make sure it’s dry before you put your stockings on.
• Make sure the socks are smooth, especially at the ankle or behind the knee. Don’t fold the stockings down if they seem too long.

Tools like metal frames, called donners, and nonslip gloves can make it easier to put compression socks on and take them off.

You also need to take extra care whenever you aren’t wearing the socks. “Anytime the compression garment is changed, whether daily or in a doctor’s office every few days, it’s always important to do a skin check,” says Dr. Kalender-Rich. “You want to look for any wounds or rashes. We always want to be doing more good than harm.”

She also recommends having more than one pair of compression socks so you can wash one and wear one simultaneously. Hand washing and air drying help make the elastic last longer.

You don’t need fancy compression stockings to reap the benefits. Low and medium-pressure socks are available without a prescription. You can find them online at retailers like Zappos and Bombas. Stores that specialize in comfort footwear are a good place to shop as well. However, you’ll likely need a prescription if you need stockings with compression of 30 mmHg or more.

“If the over-the-counter version is working to keep swelling away, then that’s fine,” says Dr. Kalender-Rich. “Frequently, people get to the point where that no longer works. Then, it’s critical to move to the next strength. Get your doctor involved to prevent long-term problems.”

Start with your primary care physician, but if they are uncomfortable prescribing compression garments, seek out a vein specialist or a vascular doctor.