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Treatment of venous insufficiency: compression stockings
Compression stockings are a first-line treatment for venous insufficiency. Here is how they work, the four compression classes, how long to wear them, and what they can and cannot do.
- Compression stockings speed up blood return and relieve heavy, aching legs.
- They come in four classes, from light support to major venous disorders.
- A prescription ensures the compression level matches your condition.
- Worn too long, they can cause itching, allergies or fungal issues.
- They ease symptoms but do not remove the varicose veins themselves.
Are you looking for ways to fight venous insufficiency? Here is one of the most common: compression stockings.
According to an IFOP study, nearly 17 million people are affected by venous insufficiency in France. It can cause pain, heavy legs, tingling and edema, and in the long term, if poorly managed, phlebitis or, in rare cases, a pulmonary embolism. Compression is one of the most effective ways to limit these problems.
What are compression stockings?
Compression stockings are highly elastic textiles, halfway between socks and tights. They apply a pressure that decreases from the ankle up the leg. By compressing the leg they reduce the calibre of the veins, so dilated veins are tightened and blood flows faster back towards the heart. Blood no longer stagnates in the lower limbs, venous return improves and heavy, aching legs are relieved.
Do not confuse medical compression stockings with simple anti-fatigue socks: the latter are only preventive during prolonged standing and act on the superficial veins alone.
The different classes of compression
There are four classes, based on the pressure at the ankle expressed in mmHg (millimetres of mercury):
| Class | Pressure (mmHg) | Main indications |
|---|---|---|
| Class 1 | 10 to 15 | Heavy legs, trips of 3 to 6 hours, early varicose veins, static work |
| Class 2 | 15 to 20 | Established varicose veins, venous edema, prevention of phlebitis, trips over 6 hours |
| Class 3 | 20 to 36 | Significant varicose veins, lymphatic edema, trophic skin disorders |
| Class 4 | over 36 | Major trophic disorders |
How long should they be worn?
Depending on the indication, compression stockings can be worn for shorter or longer periods:
- Mild heavy-leg discomfort: occasionally, in case of pain or when travelling.
- Genuine venous insufficiency, or reduced mobility (elderly, convalescent): every day.
- Leg ulcers: a compression bandage day and night until the wound heals, then daily stockings.
Wearing them at night is generally pointless, since blood does not pool when lying down, though it can be advised after surgery or for some pregnant women whose circulation is strongly affected.
Compression stockings are excellent at relieving day-to-day discomfort, but they manage the symptoms rather than the cause: the faulty vein is still there. To treat the varicose vein itself without surgery, focused ultrasound (echotherapy) is a non-invasive option worth discussing with a specialist.
Are there risks if I wear them too long?
Worn for a long time, compression stockings can cause side effects that are usually minor:
- Itching in people with very dry skin: moisturise and use dermatological soaps.
- Allergic reactions to the silicone band of hold-up stockings: switch to another type or to tights without an adhesive band.
- Toe or genital fungal infections: open-toe or hold-up options can help.
The main contraindications include a known allergy to the components, severe arterial disease of the legs, advanced diabetic microangiopathy, painful blue phlebitis with arterial compression, and septic thrombosis.
Price and reimbursement
Every compression stocking must be prescribed by a doctor, physiotherapist, midwife or another authorised professional, because the compression level has to match the condition. In France, Social Security reimburses base amounts of 22.40 € for support socks, 29.78 € for stockings and 42.03 € for tights, generally covering about 60% (fully for long-term illnesses), up to 8 pairs per year.
Wondering whether echotherapy is available near you? A growing network of centres is already equipped with the SONOVEIN.
Questions fréquentes
Do compression stockings cure varicose veins?
No. They relieve symptoms by improving blood return, but they do not make existing varicose veins disappear. Treating the veins themselves requires a medical procedure.
How many hours a day should I wear compression stockings?
It depends on your condition: occasionally for mild heavy legs, every day for genuine venous insufficiency, and day and night in the case of leg ulcers until the wound has healed.
Do I need a prescription for compression stockings?
Yes. A doctor, physiotherapist or midwife must prescribe them, because the compression class has to be adapted to your pathology.
Are compression stockings reimbursed?
In France, Social Security covers about 60% of the base amount, up to 8 pairs per year, and fully in the case of long-term illnesses.
Can compression stockings be dangerous?
Side effects are usually minor, such as itching, allergy to the silicone band or fungal issues. They are contraindicated in cases such as severe arterial disease or septic thrombosis.