Compression Stockings for Leg Swelling: Do They Help?

Ankles that look puffy by evening, shoes that feel tight and legs that feel heavy are some of the most common leg complaints. Many people turn to compression stockings for leg swelling, and for the right cause they can help a lot. This guide explains how they work, when they are a good fit, how to choose and wear them, and when swelling needs a proper medical check first.

Why legs swell

Gravity pulls blood towards the feet when you stand or sit. In a healthy leg, the calf muscle pump and one-way vein valves push it back up. If the valves are weak, as in chronic venous insufficiency, or you are still for hours, fluid collects in the tissues of the ankle and foot. This is called oedema (edema in American spelling).

Leg swelling has many other causes, including:

• heart, kidney or liver conditions
• some medicines, such as certain blood pressure tablets
• pregnancy
• a blood clot in a deep vein (deep vein thrombosis)
• problems with the lymphatic system
• long flights or long periods of sitting
• hot weather

This is why the cause should be identified. Stockings are a good answer to some of these and a poor or even unsafe answer to others.

How compression stockings work

Medical compression stockings are tighter at the ankle and gradually looser up the leg. This graded compression squeezes the veins slightly, so they carry blood more efficiently, and it reduces the amount of fluid leaking into the tissues. The effect is a bit like having your calf pump supported from the outside.

Because they work only while worn, swelling generally returns when you take them off. They manage swelling; they do not cure the cause.

Support hose for leg swelling: what is the difference?

You will see many names: support hose, compression socks, compression stockings, flight socks, anti-embolism stockings. The terms overlap, but there are important differences:

• Medical-grade compression hosiery has specified pressure levels at the ankle and is sized from measurements.
• Support hose sold in general shops often provide light and uneven compression, and are fine for mild tiredness but may do little for real swelling.
• Anti-embolism stockings used in hospital have a particular use after surgery or during bed rest and are not the same as everyday stockings.

If you want swelling to improve, choose properly graded products and get measured. Our compression stockings guide explains strengths and types in more detail.

Swollen ankles support stockings: how to choose

Get measured

Ankle circumference, calf circumference and leg length determine size. Measuring first thing in the morning, when swelling is least, gives the most reliable number. A pharmacist or trained fitter can do this.

Choose a length

• Knee-high is the most popular and usually enough for ankle and foot swelling.
• Thigh-high or tights are used when swelling or veins extend above the knee. They are harder to keep in place.

Choose a pressure level

Compression is measured in millimetres of mercury (mmHg). Lighter levels are used for tired legs, travel and mild swelling. Firmer levels are used for medical conditions such as venous disease. The right level depends on your diagnosis, so check with a healthcare professional rather than guessing.

Consider open or closed toe

Open-toe stockings are easier for some people with foot problems. Closed-toe are more common and are generally more comfortable for foot swelling.

Compression socks for swollen ankles: how to wear them

• Put them on early. Apply them in the morning, before the legs swell.
• Smooth them out. Wrinkles or rolled tops can cut into the skin. Never fold the top band down.
• Use aids if needed. Rubber gloves, donning aids or a thin plastic bag over the foot can make them easier to pull on.
• Wear them during the day. Most people remove them at bedtime, unless advised otherwise.
• Look after your skin. Check your skin every day, especially around the ankles and heels, and moisturise at night rather than before putting stockings on.
• Wash and replace. Wash according to the label and replace them regularly, since the elastic wears out. Many people find a pair lasts a few months of daily use, though this varies.

Compression stockings for edema and foot swelling

For compression stockings edema from venous disease, they are often a first-line self-care measure and are part of the approach in guidelines for chronic venous disease. For compression stockings for foot swelling, a knee-high stocking that includes the foot gives support from the toes upwards. A very short ankle sock gives less support to the calf muscle pump and may do less.

Edema due to other causes is different. If you have heart failure, kidney disease, liver disease or lymphoedema, compression may be prescribed in some cases and harmful in others. Always ask your doctor first. Related reading: how to reduce leg and ankle swelling and swollen legs and ankles.

Who should be careful with compression stockings

Stockings are unsuitable or need medical advice if you have:

• reduced blood supply to the legs (peripheral arterial disease), which can show up as leg pain when walking, cold feet or slow-healing sores
• severe heart failure or uncontrolled fluid overload
• diabetes with reduced sensation in the feet
• skin infection, open wounds, weeping eczema or fragile skin on the legs
• allergy to latex or other materials
• suspected clot

Our article on side effects of wearing compression stockings goes into these risks more fully.

Stockings are one tool among several

For vein-related swelling, other measures work well together with compression:

• keep active, with regular walking and calf exercises
• raise your legs above hip level for short periods during the day
• avoid long stretches of standing or sitting still
• manage your weight and moderate salt intake
• consider treatment of faulty veins if swelling is due to reflux. See venous insufficiency treatment

If you also have varicose veins, see compression socks for varicose veins.

When to see a doctor

Swelling that is new, one-sided, painful or unexplained should be checked before you reach for stockings. See a doctor if:

• swelling appears in only one leg, especially if it is painful, warm, red or tender
• swelling does not go down overnight or keeps getting worse
• you notice shortness of breath, breathlessness lying flat or swelling in your belly as well
• the skin on your ankles is darkening, hardening, weeping or has a sore
• your legs feel cold, pale or painful when walking
• you are pregnant and develop sudden swelling, headaches or vision changes

Call 995 immediately if you have sudden chest pain, sudden breathlessness or you cough up blood. If these occur with a swollen, painful leg, a clot may have travelled to the lungs, which is an emergency. For help organising your symptoms, use the vein symptom check, or read how to find a vein specialist.

This article is general information, not personal medical advice. Please speak to a doctor about your own symptoms. How we create our content.