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Compression Stockings for Dysautonomia

Compression Stockings for Dysautonomia

Compression stockings worn throughout the day can alleviate symptoms of dysautonomia and Orthostatic Hypotension (OH). Dysautonomia is a disease that affects the autonomic nervous system, often manifested by a low blood pressure and/or a high heart rate upon standing (also, called Orthostatic Hypotension and/or POTS, Postural Orthostatic Tachycardia Syndrome).

They also come in a variety of different styles and grades to suit everyone’s needs while making work and daily activities easier. Compression stockings are different than regular socks or hosiery. They are constructed to provide a certain amount tensile support around the ankle that gradually lessens up the leg (aka “graded compression” usually denoted in “mmHg”). This support can help to alleviate the symptoms of OH and POTS, helping to normalize the heart rate and blood pressure and reducing fatigue.

How compression stockings can help:
The compression of the stocking is able to promote better circulation throughout the entire body by creating better blood flow through the veins of our legs. Putting the right amount of pressure around the legs improves the functioning of the one-way valves within the veins and prevents the old blood from pooling (aka “venous stasis”). The old blood can then make it back to the heart and lungs where it receives a fresh oxygen supply. Improving the circulation in your legs will thereby make your legs less fatigued because they are not being fueled by the pooled, oxygen-deprived blood.

Wearing compression stockings promotes health in other parts of the body as well. For example, with less blood pooling in the legs, more blood is able to reach the brain. This can decrease the dizziness or lightheadedness that occurs with standing such as in those with orthostatic hypotension. In addition, increasing the amount of blood returning to your heart and lungs may help with other symptoms of dysautonomia to some extent (ie: tachycardia, palpitations, SOB, general fatigue).

What compression stockings can prevent:
There are a variety of venous disorders that benefit from the use of compression stockings. Daily appropriate use can help with the management of spider veins and varicose veins, while preventing the new occurrence of unsightly veins. Open leg ulcers, thrombosis, inflammation (of veins) are some of the more serious conditions that may warrant compression therapy under the supervision of a healthcare professional.

For those without any apparent venous disease, compression stockings can still help to alleviate swollen ankles at the end of a hard workday, while protecting against future venous disease.

Who should wear compression stockings:
Individual needs may vary depending on your medical issues and level of activity. It certainly may help with the venous disorders listed above and for those with dysautonomia. There are also compression stockings designed specifically for times of pregnancy and for athletics as well. For overall healthy individuals, wearing compression stockings during times of prolonged standing may improve leg fatigue and prevent venous problems later in life. SIZE DOES MATTER! It is also important to realize that not all brands that market their socks as “compression” offer the same quality of medical grading as more reputable suppliers. Be wary of one-size fits all companies that don’t provide detailed instructions on how to fit yourself before purchasing their product. Better yet, many medical supply stores will provide you with a free fitting for compression stockings from a trained professional.

The level of compression delivered by the stocking depends very much on the size and length of your calf or leg. Therefore, it is important to take careful measurements and wear the right size stocking. A poorly fitted stocking may feel very uncomfortable and may not provide very much symptomatic relief. Your height will also affect the size of hosiery that you should buy. Many companies therefore provide both petite and regular sizes.

Caution should be taken if you have any type of hypertension, neuropathy, or arterial disease, however. Compression stockings may not be useful in these cases. It is always good to consult your healthcare provider about wearing stockings, especially if you have a serious medical condition.

When to use compression stockings:
Compression stockings can be worn throughout the day, although it is best to put them on in the morning before any blood has pooled in the legs. The benefits of compression stockings can definitely be felt during periods of prolonged standing where gravity is most likely to cause blood to pool. In addition, many athletes wear them to improve their performance during physical activity and to help with muscle recovery.

It is very important to remove compression stockings before sleeping or lying down, however. Removing the stockings before lying down will help your body to sense the right amount of fluid in your body, which is needed to prevent the worsening of your symptoms when you are not lying down.

On a personal note, I have worn compression stockings myself for the last 5 years to help lessen the orthostatic symptoms of my dysautonomia. In conjunction with medication and lifestyle changes, I feel like they played an important role in helping my recovery and reconditioning. When I am at school or Zumba, I’ll use the 30-40 mmHg knee-high; when I’m at home (sitting usually), I’ll wear the 20-30 mmHg. Although stockings alone are not a cure-all for dysautonomia, I have found that they lessen my feelings of lightheadedness and general fatigue, especially when I have to stand for extended periods of time. However, it is important thing to realize is that everyone is different and unique, as will be their journey to health. Trial and error is often necessary along the way, but eventually you will find what works best for you. Fortunately, compression stockings come in a variety of different grades and styles to suit everyone’s individual needs as they are on their path to wellness.

Best wishes to everyone for better health and wellness!

Linda Nguyen, DINET Volunteer
Dysautonomia/NCS since 2008
M.D. candidate University of Miami Miller School of Medicine c/o 2016 Learn more about Dysautonomia at the Dysautonomia Information Network –

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