Before we delve into this topic one should be aware that extra firm compression stockings are considered “prescription strength stockings” and should only be utilized according to doctor’s orders.

This means that the individual should be under the care of a physician and/or a vein specialist who will prescribe these strong compression stockings if necessary based on the requirements of his/her condition and course of treatment.

Extra firm compression socks, stockings or pantyhose have a compression level of 30-40 mmHg *) or more.

The purpose of the higher compression is that these stockings will relieve the symptoms more effectively than compression stockings of lower compression levels.

To be most effective, the compression stockings must virtually mold themselves to your legs, without any wrinkling or bunching of material. A less than perfect fit would not only be counterproductive but could even be dangerous.

To achieve the best possible fit and find a stocking size that is just right for you it may be best to have yourself measured and fitted by a trained “Fitter” of compression stockings.  Your healthcare provider can likely recommend a fitter or you can take your prescription to a medical supply store.  In most cases they will have such professionals on staff that are ready and willing to assist you.

While purchasing compression stockings from a medical supply store may not be the most economical way to go, you will have the advantage of personalized customer service.  This means your leg measurements for the stockings will be taken by a professional.  You can pick out the compression stockings you find most fashionable and you may even be able to try them on right at the store.

If you are not used to compression stockings, simply teaching yourself how to put them on and take them off the best way may not only be challenging but may actually present quite a learning curve.  Depending on your dexterity and strength, you may very much appreciate a little help and coaching from the fitter until you really get the hang of it.

*) mmHg is a unit of measure in millimeters of mercury for the pressure applied by compression stockings – it is also the same measuring unit that is used to determine blood pressure

For more information about proper sizing and fit, we recommend reading some of our other blog posts…

Problems Associated with Graduated Compression Stockings – The Importance of Correct Measurements and Sizing

What Is The Purpose Of Extra Firm Compression Stockings?

Stockings with a high graduated compression of 30-40 mmHg or even higher are frequently suggested for:

• Relieving aching, heaviness and fatigue in the legs as a result of varicose veins
• Preventing thrombosis
• Preventing deep vein thrombosis (AKA economy class syndrome)
• Post-surgery or after sclerotherapy
• Prophylaxis and treatment of complications from varicose veins
• Post phlebitis syndrome with CVI (chronic venous insufficiency)
• Venous ulcers
• Post-Thrombotic-Syndrome (PTS)
• Severe chronic venous insufficiency
• Varicose veins during pregnancy
• Phlebitis during pregnancy
• Management of edema
• Treatment of active and recurrent ulcers
• Lymphedema
• Severe post-traumatic edema

Stockings with higher graduated compression than 40 mmHg are often suggested for:

• Venous ulcers
• Chronic venous issues after surgery
• Severe lymphedema
• Severe post-thrombotic syndrome

Types and Styles of Firm Support Compression Hosiery

1. Over the calf support socks (sheer or athletic style)
2. Sheer and opaque support knee-high compression stockings (open or closed toe, sandal foot or reinforced toes and heels)
3. Sheer as well as opaque support thigh high compression stockings (open or closed toe, sandal foot or reinforced toes and heels)
4. Sheer and opaque support pantyhose style compression stockings (open or closed toe, sandal foot or reinforced toes and heels)

Due to the strong graduated compression of these extra firm stockings, it is highly recommended to seek professional assistance in selecting and purchasing this hosiery.  Proper fitting and handling instructions for donning and doffing compression stockings must be taught and followed to achieve maximum comfort and efficiency for the wearer.

Finally, it should also be pointed out that different fiber material, knitting techniques, open or closed-toe styles, different types of hold up bands for compression stockings, and waistbands for compression pantyhose all can have an effect on the fit and feel of compression stockings.

Consequently, one should not be disappointed or give up if they have to try different styles and brands before finding compression stockings or hose that meet their needs and feel comfortable.