Compression Socks vs. Stockings—What's the Difference?

Compression Socks vs. Stockings—What's the Difference?

Compression socks and stockings both come in a variety of compression levels, measured in millimeters of mercury (mmHg). There’s no difference between the pressure applied by socks and stockings. In other words, a 15-20 mmHg compression sock offers the same pressure as a 15-20 mmHg compression stocking. The main difference between socks and stockings comes down to the design and material. For example, you can buy compression stockings in a knee-length, thigh high, or hosiery style. You can also find stockings with an open toe. On the other hand, compression socks typically come in ankle length or knee-high length with a closed toe. 

What Is the Purpose of a Compression Garment? 

Compression socks and stockings both serve the same purpose. All compression garments are designed to improve blood flow by constricting the veins. When the circumference of a vein becomes smaller, the velocity of the blood increases. Less stagnant blood means a lower risk of blood clots, varicose veins, chronic venous insufficiency, and other venous disorders. Graduated compression, where the pressure varies over the length of the sock, is particularly useful for helping the veins push blood against the force of gravity. Graduated garments apply more pressure at the ankle and less at the calf, in turn assisting the movement of blood and waste fluid from the feet to the heart. The symptoms of medical conditions such as lymphedema and leg ulcers can be greatly improved with the use of graduated compression stockings and socks. 

Some compression stockings serve a different purpose. Anti-embolism stockings (also called TED hose) are designed to prevent deep vein thrombosis (DVT) and pulmonary embolism in non-ambulatory patients. For instance, after a surgery, a doctor might prescribe anti-embolism stockings for a patient recovering in bed. Once patients return to their feet, they would usually transition to wearing graduated compression socks or stockings. Graduated compression garments have also been proven to reduce the risk of DVT; however, they work best for patients who are able to walk or sit upright. 

How Does Compression Therapy Work? 

The arteries carry oxygenated blood and nutrients to the lower extremities, then the veins of the legs carry deoxygenated blood and waste fluids back to the heart. For many people, especially those with a family history of venous disease, the vein valves and vein walls begin to weaken over time. Especially during long periods of standing or sitting, the circulatory system has to work hard to overcome the force of gravity. In some cases, the pressure against the vein walls causes them to become distended, and the one-way valves that keep blood flowing in the correct direction can fail, allowing for reflux. Venous insufficiency leads to all kinds of venous disorders, including spider veins, varicose veins, severe edema, and blood clots. Unfortunately, venous disorders often have a compounding effect, and the failure of one valve can impair blood flow, leading to venous stasis and further stress on the vein. (Ligi 1)

Luckily, compression garments help to reduce the pressure within the veins and prevent blood from pooling in the lower leg. They can reduce the symptoms of uncomfortable venous disorders and prevent chronic venous insufficiency from worsening. Unfortunately, no support hose or sock will eliminate existing varicose veins. At this time, there's no way to repair a damaged one-way valve inside the vein. 

To eliminate a varicose vein, doctors usually recommend a procedure like sclerotherapy, a non-surgical way of removing the vein from use by the circulatory system. ("Varicose") If left unchecked, varicose veins and other venous disorders may worsen. Advanced chronic venous insufficiency can progress, causing skin changes and venous ulcers. Deep vein blood clots sometimes lead to further complications, as well, including fatal blockages in the lungs and long-term damage from post-thrombotic syndrome. Compression therapy offers one of the most cost-effective and easiest ways to halt the progress of chronic venous disorders. 

Shopping for Compression Garments 

When you shop for compression socks, you'll notice a lot of different materials and levels of compression on the market. Because graduated compression provides pressure on a gradient, these garments are labeled with a pressure range. The higher number describes the pressure rating at the ankle, whereas the lower number describes the pressure on the calf. Typically, over-the-counter socks measure under 20 mmHg. Medical grade socks start at 20-30 mmHg. At Comrad, we sell a unique sock that falls between over-the-counter and medical grade: 15-25 mmHg. We call this measurement "the compression sweet spot" because it offers all the benefits of medical grade compression with the comfort of mild compression. 

When it comes to choosing a compression garment, we recommend selecting based on comfort, durability, and fashion. Studies show that improper compliance stops some patients from benefiting from compression therapy. (Lim E391) When choosing a sock or stocking, pick a material that you'll feel good about wearing everyday. Companions, made with premium breathable fabric, have extra toe and heel padding and slide-free cuffs. This prevents them from bunching or sagging. Plus, we bind silver to the material on a molecular level to kill odor-causing bacteria. SmartSilver socks can be worn multiple times between each wash, allowing them to last longer. Our socks may look like fashion garments, but they offer real medical benefits and practical features. With a range of sizes that include extra-wide calves, we make it easier than ever to wear compression socks. 

At our factory, we measure compression with a Swisslastic MST MK V pressure measuring device for medical compression socks and stockings. So, whether you buy a 15-20 mmHg compression sock from our site online or a 15-20 mmHg stocking from a medical supply store, you can expect to find 20 mmHg of compression at the ankle and 15 mmHg of compression at the calf. In a 2013 study of sports compression garments, researchers determined, "There is no clear relationship between percentages of material composition with the pressure delivery generated..." (Troynikov 162) No matter what a compression garment is made from—pantyhose material, merino wool, or SmartSilver fabric—you can look at the mmHg label to determine the strength of the compression. 

What Medical Conditions Improve With Compression Therapy? 

People with the following conditions may benefit from compression therapy:

  • Varicose Veins
  • ​Spider Veins
  • ​Chronic Venous Insufficiency
  • Deep Vein Thrombosis
  • Post-Thrombotic Syndrome
  • Edema
  • Lymphedema 
  • Orthostatic hypotension
  • Postural Orthostatic Tachycardia Syndrome (POTS)
  • Shin splints
  • Plantar Fasciitis  

Talk to your doctor to see if compression socks or stockings would be a good choice for you. For most people, compression therapy works to promote a healthy circulatory system. A few conditions—peripheral neuropathy, peripheral artery disease (PAD), skin infections, and dermatitis—may contraindicate the use of compression socks. If you have any of these conditions, ask your doctor before beginning compression therapy. 

For many people with venous disorders, compression socks bring immediate relief for painful symptoms. Dr. Claire Griffin, a vascular surgeon, explains, "They make a difference, and often people notice an immediate symptomatic improvement in how their legs feel at the end of the day." ("Compression") For most doctors, compression socks are the go-to treatment for venous disorders. In reference to varicose veins, the Mayo Clinic website describes compression therapy as the first approach that doctors try before moving on to other treatments. ("Varicose") Aside from treating medical conditions, compression socks and stockings can also be used to improve athletic recovery and prevent sore legs. Even people without venous disorders enjoy the feeling of faster blood flow and reduced swelling. 

Making Legs Feel Great 

To understand why compression socks and stockings make your legs feel so much lighter, it's helpful to examine how waste fluids accumulate in the legs. Stephen M. Roth, an expert in kinesiology from the University of Maryland, explains the pain associated with lactic acid build-up: 

...The production of lactate and other metabolites during extreme exertion results in the burning sensation often felt in active muscles, though which exact metabolites are involved remains unclear. This often painful sensation also gets us to stop overworking the body, thus forcing a recovery period in which the body clears the lactate and other metabolites.

The body clears lactic acids and other metabolites through the circulatory and lymphatic systems. By pushing the deoxygenated blood and waste fluids (including lactic acid) out of the extremities, graduated compression socks and stockings seem to help aid functional muscle recovery. (Armstrong) Athletes ranging from Serena Williams to Lebron James have worn compression garments during competitive sporting events. Visit any track or basketball court and you’re likely to see compression garments being used by sports enthusiasts. So, not only can compression therapy benefit those with health problems, but even the healthiest among us can appreciate improved circulation. 

We have over 2,500 reviews on our website, and 99% of those customers report that they would recommend our socks. Jennifer B., who bought Companions, explains why: "They really do make your legs feel better, and they’re super stylish." 

When it comes to the difference between compression socks and stockings, the answer is simple. They both work wonders for your circulatory system. The choice mainly reflects your personal style. In the past, compression was ugly, expensive, and uncomfortable. That’s why we spent two years developing the perfect compression socks. Simply put, we’re here to help our customers feel great, do more, and go further. We designed socks to make your legs feel (and look) great. 

 

Sources:

Armstrong, Stuart A., Till, Eloise S., Maloney, Stephen, & Harris, Gregory A. "Compression Socks and Functional Recovery Following Marathon Running," The Journal of Strength & Conditioning Research, Vol. 29, Iss. 2, 2015, pp. 528-533, https://journals.lww.com/nsca-jscr/Fulltext/2015/02000/Compression_Socks_and_Functional_Recovery.30.aspx.

“Compression socks can help prevent varicose veins.” The Scope, University of Utah, Jan 10, 2018, https://healthcare.utah.edu/the-scope/shows.php?shows=0_u6yd3xaw.

Health Quality Ontario. “Compression Stockings for the Prevention of Venous Leg Ulcer Recurrence: A Health Technology Assessment.” Ontario health technology assessment series vol. 19, 2 1-86. 19 Feb. 2019, https://pubmed.ncbi.nlm.nih.gov/30828407/.

Ligi, Daniela et al. “Chronic Venous Disorders: The Dangerous, the Good, and the Diverse.” International journal of molecular sciences vol. 19, iss. 9, 2544. 28 Aug. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164218/pdf/ijms-19-02544.pdf

Lim, Chung Sim and Alun H. Davies. “Graduated compression stockings.” CMAJ. Vol. 186, Iss. 10 pp. E391-E398. July 08, 2014, https://www.cmaj.ca/content/cmaj/186/10/E391.full.pdf.

Pierson, S et al. “Efficacy of graded elastic compression in the lower leg.” JAMA, vol. 249, iss. 2 , pp. 242-243, 1983, https://pubmed.ncbi.nlm.nih.gov/6848811/.

Roth, Stephen M. “Why Does Lactic Acid Build Up in Muscles? And Why Does It Cause Soreness?” Scientific American, Springer Nature America, Inc., 23 Jan. 2006, www.scientificamerican.com/article/why-does-lactic-acid-buil/.

"Sclerotherapy for Varicose and Spider Veins." Healthline, Healthline Media, https://www.healthline.com/health/sclerotherapy#cost

Troynikov, Olga, et al. “Influence of Material Properties and Garment Composition on Pressure Generated by Sport Compression Garments.” Procedia Engineering, vol. 60, 2013, pp. 157–162. ScienceDirect, https://www.sciencedirect.com/science/article/pii/S1877705813011053.

"Varicose veins." Mayo Clinic, Mayo Foundation for Medical Education and Research, https://www.mayoclinic.org/diseases-conditions/varicose-veins/diagnosis-treatment/drc-20350649.