As the founder of Comrad, I field a lot of questions about compression socks. One of the most common has to do with swelling. People ask me, "What are the best compression socks for swelling, and how do I know what to look for in a pair of socks?" With thousands of compression socks available on Amazon, at your local pharmacy, and online, it can be tricky to figure out what makes a sock better equipped to prevent edema (also known as swelling) in the lower legs. To make things simple, I decided to write this guide so that customers can learn—once and for all—how to find the best compression socks for swelling.
Graduated vs. Uniform Compression
The first thing that you should ask yourself when you look at a pair of compression socks is, "What form of compression therapy does this sock offer?" Uniform compression exerts the same level of pressure throughout the length of the sock. In contrast, graduated compression provides pressure on a gradient—with more pressure near the ankle and less pressure at the calf. In practical terms, this means that the graduated pressure of the sock pushes blood up the leg against gravity, preventing fluid from pooling in the lower legs, feet, and ankles. Uniform compression doesn't provide the same anti-gravity boost to your veins. Most of the studies showing the medical benefits of compression therapy examine the efficacy of graduated compression. For anyone hoping to prevent swelling, check to make sure that the socks or stockings you buy provide graduated compression.
How will you know whether a pair of socks has graduated or uniform pressure? In addition to being labeled as graduated compression, you can look for a pressure measurement that shows a numeric range. For instance, we clearly label our Companions as 15-25 mmHg. This means that the ankles provide 25 mmHg of pressure and the calves provide 15 mmHg of pressure. If the sock does not describe a pressure range in mmHg, or offers no mmHg rating at all, you know that you're not looking at a graduated compression garment.
Millimeters of Mercury
After you've established that a pair of socks offers graduated compression, you'll want to check the pressure measurement. The higher the rating in millimeters of mercury (mmHg), the greater the force of compression. According to a review of the existing scientific literature published in 2014, "A meta-analysis of 11 RCTs [randomized controlled trials] reported that compression of 15–20 mm Hg showed beneficial effects on edema and symptoms, as compared with compression of less than 10 mm Hg or no compression..." (Lim E393) Based on this evidence, in order to reduce edema, you'll want to select a sock with a pressure range of at least 15-20 mmHg.
The same analysis continues, offering recommendations for lymphedema, swelling caused by blockages within the lymphatic system, saying, "Generally, the highest level of compression (20–60 mm Hg) that the patient can tolerate is likely to be the most beneficial. However, lower compression can be used for milder lymphedema or general leg edema." (Lim E396) So, depending on the cause of your swelling, a stronger compression level may enable further reduction in size. Keep this in mind: to reap sustained benefits from compression therapy, you'll need to wear compression socks regularly. For that reason, we recommend balancing comfort and strength.
Our Companion socks, measuring 15-25mmHg, work well to prevent and reduce edema. They occupy "the compression sweet spot" between mild compression (15-20 mmHg) and medium compression (20-30 mmHg). These socks feel comfortable all day long, while offering optimal support for vascular health.
Now that you've found socks or stockings with a minimum of 15-20 mmHg of pressure and graduated compression, think about the type of fabric that you'd feel comfortable wearing everyday. Knee-high socks are easier to wear than thigh high socks or pantyhose, so try to find knee-high socks made out of a comfortable and stylish fabric. If you're looking for the best compression socks to prevent swelling, seek a versatile material that can take you from the boardroom to the hiking trail.
Many people ask whether graduated compression stockings and socks offer the same benefits, and that's a great question. A 2013 study of sports compression garments examined the elasticity differences between different types of compression garments. According to the researchers, "No clear relationship between percentage of fabrics composition and generated pressure was established." (Troynikov 160-161) Therefore, when you look for graduated compression garments, the most important measurement to look for is the mmHg rating. The fabric composition—whether you're wearing a garment made of stocking material, merino wool, or a high-tech antimicrobial blend—won't have a reliable impact on the strength of the compression. Instead, it's best to defer to the mmHg rating.
Since you'll get the most out of compression socks when you wear them everyday, we recommend looking for high quality, breathable fabrics that stay fresh for multiple wears. We created our best-selling socks out of an innovative SmartSilver antimicrobial material, which binds metal to the fabric on a molecular level. The silver embedded in the fabric kills odor-causing bacteria, keeping socks fresher longer. Over time, all compression garments will lose their stretch with repeated washing. Thanks to SmartSilver fabric, you can count on each pair of Companion socks to last three to five times as long between washes as those made with regular poly-spandex blends. Plus, extra toe and heel cushioning keeps you comfortable, so you can wear your socks all day long.
Our merino wool collection will keep your feet temperature-regulated thanks to a natural loft that traps heat. The moisture-wicking material allows your feet to stay dry through any weather condition and keeps you cool when it's hot outside. These lightweight socks also prevent odor. One of our customers, Eddy, explains why he chooses to wear merino wool, saying, "They’re amazing, and the merino wool makes them super breathable. I also like that these look like normal socks, and don’t have that nylon see through look you get from other materials used for compression socks."
Additional Advice for Selecting Great Socks
- Some people have wider calf muscles than others, so it's important to choose socks that fit snugly without cutting off circulation. For that reason, we also offer socks with wide calf sizes.
- No matter which graduated compression socks you choose, they'll do a better job at preventing edema if you put them on early in the morning before you get out of bed.
- Decide whether you like an open-toe or a closed-toe style. Many compression stockings, especially the ones sold at medical supply stores, come with an open toe, which can lead to blisters, sweaty shoes, and socks that roll up on your feet.
- Watch out for cheap synthetic fabrics that cause your feet to overheat.
- Plan ahead; be sure to select a pair of socks that you like and can commit to wearing to get the best results.
- Check the reviews! Comrad customers give our Companion socks 4.9 out of 5 stars, and 98% of them would recommend our socks to a friend.
- Be sure to select a sock that has a good return policy. You should be able to exchange your socks for a different size or get your money back if your socks don't fit.
What Causes Swelling?
To best address your concerns, it's important to understand the cause of your swelling. As an example, a compression sock won’t do anything to help a broken leg! Take a look at this article to learn more about different types of swelling.
Compression therapy may be particularly helpful to reduce swelling for these groups:
- Pregnant women
- People who stand or sit for long periods
- People with lymphedema
- Airline passengers
- Post-surgical patients (with supervision from a doctor)
More Medical Benefits
In addition to preventing swelling, mild-to-medium grade compression can help to prevent painful circulation problems, including chronic venous insufficiency and deep vein thrombosis. Compression socks work by putting gentle pressure on the lower legs, restricting the diameter of the veins. This increases the velocity of the blood moving through the veins, improving blood flow and reducing stress on the heart. When you wear compression socks, you can prevent a number of other health complications and ensure healthy vascular function.
Chronic venous insufficiency, which causes spider and varicose veins, occurs when the one-way valves inside your veins stop functioning properly. The valves fail, allowing blood to flow backwards and pool in your feet. Once varicose veins form, they can only be corrected through surgical means or expensive medical procedures. Luckily, wearing compression socks helps to prevent chronic venous insufficiency and painful varicose veins. ("Compression")
In addition, slow blood flow can cause deep vein thrombosis, blood clots that form in the deep veins. Not only can this condition be painful, but it can also be dangerous. About half of people with deep vein thrombosis will develop secondary health conditions such as post-thrombotic syndrome and pulmonary embolism. ("Data") A blockage in the lung, also called a pulmonary embolism, can be fatal. By improving your blood circulation, compression therapy has been shown to reduce the risk of deep vein thrombosis in a number of at-risk populations, including hospital inpatients (Sachdeva) and airline passengers (Clarke).
Many doctors recommend wearing compression socks during long flights and any prolonged period of standing or sitting. (Bhatt) In studies of compression therapy, wearers report faster muscle recovery after exercise (McDonnell) and faster healing after vascular surgery. (Shouler) So, if you wear graduated compression garments to prevent swelling, you can trust that they also provide medical benefits beyond the immediate reduction in fluid retention.
Making the Best Socks
When we launched our products, we had a simple goal in mind. We wanted to transform graduated compression socks from an old-fashioned medical garment into a modern wardrobe staple. Unlike other fashion items, we wanted to create something that had the potential to improve your life and your health.
A review from a woman named Ann really says it all. She writes, "My Comrad knee high compression socks are the new loves of my life! I had pain and swelling in my lower legs and feet. My ankles and feet are back to normal size, and feel great all day long."
For anyone suffering from edema in the lower legs, we recommend starting with graduated compression therapy. At the ankle, the amount of compression should be at least 20 mmHg. If you can tolerate moderate compression—25 mmHg—you'll receive even more benefits. Once you've taken care of your symptoms, finding the best sock for you will depend on the function of the material and your personal style.
Here are some of our top picks to prevent swelling:
Bhatt, Deepak L. “Ask the Doctor: Compression Stockings for Long-Distance Travel?” Harvard Heart Letter, Harvard Health Publishing, Aug. 2014, www.health.harvard.edu/heart-health/ask-the-doctor-compression-stockings-for-long-distance-travel-.
“Boosting circulation with compression stockings.” Harvard Health Publishing, Harvard Medical School, Nov 2013, https://www.health.harvard.edu/staying-healthy/boosting-circulation-with-compression-stockings.
Clarke MJ, Broderick C, Hopewell S, Juszczak E, Eisinga A. "Compression stockings for preventing deep vein thrombosis in airline passengers." Cochrane Database of Systematic Reviews, Iss. 9, 2016, https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004002.pub3/abstract.
“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.
“Data and Statistics on Venous Thromboembolism.” Centers for Disease Control and Prevention, 7 Feb. 2020, www.cdc.gov/ncbddd/dvt/data.html.
Lim, Chung Sim, Davies, Alun H. “Graduated compression stockings.” CMAJ Vol. 186, Iss. 10 pp. E391-E398. July 08, 2014, https://www.cmaj.ca/content/186/10/E391.short.
McDonnell, Adam C., et al. “The Effect of Post-Exercise Application of Either Graduated or Uniform Compression Socks on the Mitigation of Delayed Onset Muscle Soreness.” Textile Research Journal, vol. 89, no. 9, May 2019, pp. 1792–1806, https://journals.sagepub.com/doi/10.1177/0040517518780002.
Partsch H, Winiger J, Lun B. "Compression stockings reduce occupational leg swelling," Dermatol Surg. Vol. 30, Iss. 5 pp. 737-743. May 2004, https://www.ncbi.nlm.nih.gov/pubmed/15099316.
Sachdeva, Ashwin. “Graduated compression stockings for prevention of deep vein thrombosis during a hospital stay,” Cochrane Vascular Group, Nov 3, 2018, https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001484.pub4/abstract.
Shouler, P J, and P C Runchman. “Varicose veins: optimum compression after surgery and sclerotherapy.” Annals of the Royal College of Surgeons of England vol. 71, iss. 6, 1989, pp. 402-404, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2499037/.
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.