If you suffer from peripheral neuropathy (PN), you may have noticed advertising for "neuropathy socks" or "diabetic socks." There’s no single definition for a diabetic or neuropathy sock. Although these socks have the same label, they can work in different ways. All "neuropathy socks" have something in common: they promise to reduce the pain and numbness that comes from nerve damage.
Depending on the manufacturer, they may apply light therapy, electrical current, gel pads, compression therapy, or other healing modalities in order to provide relief.
In this article, we'll share scientific evidence that supports the use of graduated compression socks to reduce pain, improve stability, and increase blood circulation. In many cases, compression socks provide excellent protection against the symptoms and complications of peripheral neuropathy, but it's important to talk to your doctor before you treat PN symptoms with compression therapy.
What Is Peripheral Neuropathy?
Peripheral Neuropathy describes damage to the peripheral nerves, the nerves located outside of the brain and spinal cord. The most common causes of peripheral neuropathy include diabetes, hypothyroidism, and nutritional deficiencies. About 8% of people over the age of 55 suffer from this condition, and the percentage is much higher among diabetic patients. Neuropathy symptoms sometimes involve sensory loss, muscle weakness, numbness, tingling, pain, and burning sensations.
PN patients can damage the nerves in their peripheral nervous system in a number of ways—through injury, infection, lesions, degenerative conditions, etc. Often, the first symptoms impact the distal portion of the nerves, located in the hands, feet, and lower legs. For this reason, clinicians describe the most common onset of symptoms as forming a "stocking-glove" pattern.
In addition to causing irritation and discomfort, PN can sometimes lead to serious complications such as diabetic foot ulcers, gangrene, and cardiovascular autonomic neuropathy (CAN). At the same time, high blood sugar from diabetes is associated with circulation problems that limit your ability to heal wounds.
As a result, "diabetic feet" are particularly at risk for complications from peripheral neuropathy. Research also shows that peripheral neuropathy is a factor that contributes to postural instability and falls within elderly populations.
Treatment Options for Peripheral Neuropathy
The treatment protocols to address PN normally fall into two major categories. First, there are treatments to address any underlying disease that may be causing nerve damage. Second, doctors prescribe medications and provide recommendations to ease the burdensome symptoms of neuropathy.
Since some of the PN symptoms contribute to dangerous medical complications (for example, numbness in the feet may make you more likely to injure your foot and develop an infection), it is particularly important to treat the symptoms of this condition.
Neuropathy socks are most useful for the second category of treatment. In other words, they are effective at treating the symptoms of peripheral neuropathy, rather than the underlying causes. In particular, graduated compression socks can improve your circulation, reduce pain, and help you to heal dangerous injuries.
Evidence Supporting the Use of Compression Therapy
Because PN contributes to postural instability, people with this condition may be more likely to experience injuries from falling. A number of scientific studies suggest that compression socks and stockings work to improve balance and stability. In fact, researchers have shown improvements in balance for female netball players, people with low proprioceptive acuity (ability to sense joint position), and elderly people when they wear compression socks and stockings.
In addition, compression socks have been shown to improve your overall blood circulation, which may help you avoid neuropathy complications related to poor blood flow. In particular, research suggests that patients who suffer from both lower extremity edema and diabetes can benefit from wearing mild graduated compression socks.
Furthermore, studies have shown high-quality evidence that graduated compression garments help to heal certain kinds of ulcers that commonly occur on the legs and feet. Since open wounds make you more prone to infection, healing existing ulcers is an important step in the prevention of gangrene. Taken together, these benefits appear to reduce the risk of dangerous complications that can sometimes result from PN symptoms.
What Makes a Good Peripheral Neuropathy Sock?
People with PN have a greater likelihood of developing abrasions, cuts, ulcers, and sores that don't heal properly. When these become infected, your tissue can die and release toxins into the bloodstream. In the most extreme cases, gangrene can lead to amputation and even death.
As you're looking for socks, it's essential to find materials that reduce your exposure to bacteria and germs. Comrad socks are made with silver ions bonded to the lightweight nylon and spandex fabric, so they're naturally antimicrobial and moisture-wicking. Our proprietary SmartSilver treatment enables you to keep your feet clean, free from odors, and protected.
Since PN can cause painful feet and aching legs, it's important to make sure that the compression socks you buy are as comfortable as possible. Look for a seamless toe area that won't rub against your feet and cause blisters or callus formation. For example, all of our socks feature a handlinked toe cap for a smooth fit across the toes. We've also designed our knee-high socks with extra toe and heel padding, as well as a stay-up cuff.
It's important to find compression socks that fit you properly. Socks that are too loose-fitting can bunch and sag. The ideal fit requires a non-binding top that won't cut off your circulation; however, your socks should be tight enough to stay up all day. Because proper fit across the calf muscle is essential, we offer extended sizing options. Our socks accommodate calf sizes ranging from 10 to 20 inches.
Lastly, look for socks with True Graduated Compression. Most of the scientific literature about compression socks and stockings explores the impact of graduated compression on the body. Research indicates that this style of compression can reduce edema (swelling) and improve vascular function, among other benefits.
This style of compression offers more pressure at the ankle and less at the calf. Manufacturers label graduated compression socks with a pressure range that shows the strength at the calf and the ankle, written in millimeters of mercury (mmHg). For instance, Comrad socks are 15-25 mmHg, which puts them in the "compression sweet spot" between mild and medium strength.
Compression for People with Diabetes
Diabetes is an underlying condition that often leads to PN. If you have diabetes, you're also more likely to develop complications that inhibit your overall circulation, such as peripheral edema, peripheral arterial disease (PAD), and chronic venous insufficiency (CVI). By improving your blood flow, compression socks can help with a number of these complications. Read more about the ways that compression socks benefit diabetic patients.
For patients with a PN diagnosis, it's important to seek medical advice from your doctor before wearing compression socks. In some cases, severe PAD and PN may make the use of compression therapy unsafe. But, for a large number of neuropathy patients, graduated compression socks provide soothing comfort from the sharp pain, burning, and tingling sensations associated with nerve damage.
Sources:
Control of Lower Extremity Edema in Patients with Diabetes | NCBI |
Graduated compression stockings | NCBI
Peripheral Neuropathy: A True Risk Factor for Falls | The Journals of Gerontology
Peripheral Neuropathy: Differential Diagnosis and Management | American Family Physician
PERIPHERAL NEUROPATHY | University of Rochester Medical Center
The Causes, Classification, and Treatment of Peripheral Neuropathy | NEJM
The Effect of Graduated Compression Stockings on Lower Limb Venous Haemodynamics | Sage Publications