Medical hosiery is a simple and effective way to improve blood flow and prevent circulation problems, but with so many options available, it can be difficult to know which type is right for you. Three of the most commonly used types of medical hosiery are compression stockings, support hose, and TED or anti-embolism stockings. Each of these hosiery types is designed to provide specific benefits and serve different purposes, based on the level of compression and support they provide.
While these hosiery types may look similar at first glance, they are designed to serve different purposes and have different compression levels. To help you choose the right type of medical hosiery for your needs, I will take a closer look at the differences between compression stockings, support hose, and TED or anti-embolism stockings.
Compression Stockings
Compression stockings provide stronger compression strength and are typically made of thick, durable material. Designed to prevent and treat medical conditions such as deep vein thrombosis (DVT), lymphedema, and chronic venous insufficiency, compression stockings come in different lengths (knee-high, thigh-high, or panty-hose) and in different compression strengths.
Compression stockings are available in different levels of compression, measured in millimeters of mercury (mmHg), ranging from mild (8-15 mmHg) to extra firm (40-50 mmHg). They are designed to apply graduated pressure with compression strength that is highest, or tighter, around the ankles and decreases toward the top of the stocking. For example, with 20-30 mmHG compression stockings, the compression strength is 30 mmHg around the ankles and gradually decreases up your leg to 20 mmHg at either the ankle or thigh, depending on the length of your stockings. This compression helps improve blood flow and prevent blood from pooling in the legs, reducing the risk of blood clots, varicose veins, and other circulation problems.
Most insurance companies will require a conservative trial waiting period prior to approving treatment for a vein condition, which includes the use of stockings. Interestingly, I know from experience that the 30-40 mmHG stockings can cause problems like nerve injury in the calf and surface of the foot. In an effort to reduce the number of approved treatments, insurance companies required these stockings before approving treatments, knowing they were very uncomfortable and that people would not want to comply, and would not be eligible for coverage. For the people that did comply, there was a high incidence of nerve injury that lasted months to years. Fortunately, the insurance company dropped this requirement after a year, and now only requires no more than 20-30 mmHg compression.
Often, your medical provider will give you a prescription for compression stockings and can take measurements to ensure you get the right size and strength.
Support Hose
Support hose are a type of hosiery that provides mild to moderate compression to the legs. They are usually made of lighter material than compression stockings and provide less compression strength and also don't last as long. They are the easiest to put on and the most comfortable to wear. Support hose are often worn by people who stand or sit for long periods of time, such as nurses, flight attendants, and office workers. They may also be worn by people who experience mild leg discomfort due to pregnancy, age, or other factors.
TED or Anti-Embolism Stockings
These stockings are designed to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE), which are serious complications that can occur after surgery or during periods of prolonged immobility. TED (thromboembolism deterrent) stockings are typically knee-length and have a lower compression level than regular compression stockings, emphasizing promoting blood flow in the deep veins of the legs. They are a kind of support stocking and are not considered medical-grade.
Size Matters
It’s important to always ensure you're getting the correct size. Support hose do not have a lot of options for range in the sizing. Your prescription compression stockings have a little chart on the manufacturer’s website or the box itself. To get the right size, you have to measure the circumference of different points on your leg: the ankle, the calf at its maximum dimension, and for thigh-high stockings, the upper thigh as well as the length from the groin to the ankle. Matching these measurements to the chart will tell you which size is appropriate.
If you get stockings that are too small first of all, they're very difficult to get on and second of all, they're very painful. And third, they can actually cause nerve damage to the sensory nerves of the skin, especially along the shin and ankle.
Visit our Resource section for our “Comprehensive Guide to Compression Stockings.” You’ll find videos that demonstrate how to take proper measurements, tips for getting them on, and how to easily remove them.
I know first-hand how absolutely essential compression stockings can be to your ability to function and be free of discomfort since I wore compression stockings for 25 years. I wore them every day because if I missed a day, I was in absolute misery that day, that night, and all the next day. Also, I know what it's like to wear compression stockings that are too small! My wife also wore compression stockings for her own vein treatment, and I inadvertently wore her compression stockings for a day. It caused pain, numbness, and tingling that lasted several weeks due to the small size of the stockings.
In summary, compression stockings are designed to improve blood flow and reduce the risk of circulation problems, support hose provide less compression and more support, and TED or anti-embolism stockings are designed specifically to prevent blood clots and promote blood flow in the deep veins of the legs. If you have questions about which option to use or proper sizing, your best resource will be the staff of a vein care specialty clinic or a pharmacy that dispenses compression stockings.
