Let’s Talk Spoonies and Compression Socks!

I’ve been hearing people buzz about compression socks/stockings for a while, but I’ve never invested in a pair myself. They’re basically what they sound like– socks or stockings that… compress. Basically, by squeezing on your feet and legs, they’re trying to keep blood from doing what gravity naturally wants it to do– pool by your feet. They’re popular among different groups of people: runners swear by them, pregnant (and non-pregnant) people wear them to prevent varicose and spider veins, and those at risk for deep vein thrombosis use them to minimize the risk of dangeous bloodclots– especially in situations like longs flights that exacerbate the risks. Another group of people who benefit from compression stockings are people with dysautonomia– which is an umbrella term for dysregulation of the autonomic nervous system (the part that controls things you don’t think about, like breathing, digestion, and blood flow.) Some forms of dysautonomia are rare; some aren’t. Some forms are just underdiagnosed, like postural orthostatic tachycardia syndrome (POTS), a condition that causes problems with blood flow and can lead to fainting among other symptoms.

I was recently looking into purchasing compression socks for an unnamed one of the above reasons, and I found the process surprisingly confusing. The sizing is weird! Some go up to the knee, others include abdominal compression too! There are different levels of compression! I’m not sure when you’re supposed to wear them! Are they comfortable? How do you get them on? A lot of them are expensive! I still haven’t bit the bullet and ordered a pair, so get ready for a follow up article in a bit– but for now, here’s what I’ve found useful in my search for the right socks.

Do you need a prescription from doctor? Does insurance cover them?

Sometimes! Doctors do prescribe compression stockings for a variety of conditions– and going to a doctor might be good, since they’ll be able to factor in your specific needs into consideration– and because if you’re hoping to use insurance, the prescription may be necessary. However, you can also order them on your own or buy some from a medical supply store. As for insurance– and this is an answer specifically catered towards those in the US– coverage varies. A lot depends on your provider and policy. Medicare generally won’t cover compression stocks, besides graduated below-knee compression stockings used specifically for treatment (an not prevention) of an open venous stasis ulcer.

My insurance doesn’t cover compression stockings. Are they expensive?

The fact that not all plans cover compression stocks kind of stinks, because they can get pricey. While some people have luck with ordering inexpensive ones online for ten-ish dollars or lower— other socks can be over a hundred dollars. Most will fall somewhere in between. Of course, for some people investing in expensive stockings might make sense– different stockings are made to treat different conditions. Some are more comfortable than others, or make you feel more stylish– and if you’re wearing them every day, that’s a big deal. Because I personally love lingering in a state of indecision before making online purchases, I’ve been lurking through Reddit threads to see what experiences everyone has had.

What does mmHg mean which number should I choose?

MmHg technically stands for millimeters of mercury, which is a measurement of pressure because of… chemistry or something! While my memory of science class is vague, the more important part– choosing your pressure level– depends on what you’re trying to do. This guide and this chart were pretty helpful.

How does sizing work?

Unfortunately, this is the kind of sizing where you you might want to break out the tape measure. Here’s a guide. Also, different providers use different methods of sizing, so you want to check out the measurements of the company you’re checking out. If swelling increases during the day for you, it’s best to take your measurements in the morning.

If you’re talking about the vertical sizing– like how high your stockings should go– that’s also variable. Many socks only come up to the knee, but others are cut like thigh highs, tights, or go up further and include abdominal compression. DVT ones tend to go below the knee, but POTS might go higher. There are multiple factors that could impact your decision. As this killer summary from Dysautonomia International points out– while experts recommend waist high compression stockings for dysautonomia, they might be uncomfortable! If they’re going to be so uncomfortable that you won’t wear them, then that’s ultimate making them less effective.

How do I put them on?

They’re not elastic support stockings– which is great if you have a latex-allergy (although look out for the band at the top). Putting this garment on is complicated enough that MayoClinic has an illustration on it. First, make sure your legs are dry– if there’s lotion or water, it’s going to be hard. I like this explainer, which has the tips and tricks of a seasoned compression-stockings-wearer: do it in the morning, wear rubber gloves if you have to, maybe use a chair. One important thing to remember is not to wear them rolled over– this could mess with your circulation in a dangerous way.

How do I know if something’s wrong?

Check for irritation, redness, and other skin changes, and contact your doctor!

How often do I have to wear them?

Again, this, of course, depends on your purpose. Maybe you’ll just wear them when you’re running, during a long flight, or after surgery. If you’re trying to manage daily symptoms of a chronic condition, you might wear them more. Generally, you put them on in the morning and only wear them in the day– it can be unsafe to sleep in them. Some people only like wearing them a few hours at a time.

Where else can I go for information?

Most of the sites linked above included enough information to go down a rabbithole for hours, but two resources I particularly liked were this one and this one.

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