Do compression stockings help to treat varicose veins?

A varicose vein is a highly visible vein located just beneath the surface of the skin. Compression stockings may help to reduce the appearance and painful symptoms associated with varicose veins in some people.
Varicose veins occur when blood collects behind the small valves in a person’s veins instead of flowing smoothly back to the heart.
They are more common in the legs and feet, because blood returning to the heart has farther to travel.
Doctors often recommend compression stockings to improve circulation, stop varicose veins from getting worse, and reduce pain or discomfort.
Here, we look at evidence that supports the use of these stockings, as well as associated risks. We also discuss how to choose the right size and shape.
How do compression stockings work?
Compression stockings on white background for varicose veins.
Compression stockings may help to improve circulation and treat the symptoms of varicose veins.
Compression stockings are traditionally used to improve circulation. According to the authors of Sclerotherapy: Treatment of Varicose and Telangiectatic Leg Veins,
Roman soldiers often wrapped their legs in leather straps to improve circulation during long marches.
Modern compression stockings are more sophisticated and designed to provide consistent pressure in the legs, helping blood to flow back toward the heart. Stockings usually exert more pressure near the ankles and feet, providing an extra squeeze that promotes blood flow.
Studies suggest that compression stockings can improve some symptoms of varicose veins, but little evidence supports the idea that stockings alone will eliminate them.
Different types of stockings exert different amounts of pressure.
Some recent research into varicose veins includes:
A 2018 study, which found that wearing compression stockings with pressures of 18 to 21 millimeters of mercury (mm Hg) for 1 week helped to reduce aches and pain associated with varicose veins, compared to normal stockings.
A 2017 study, which determined that wearing stockings of 22 mm Hg for 6 months helped to control leg swelling during pregnancy in people with varicose veins. However, the authors noted that an oral medication called pycnogenol was more effective than using stockings.
A 2014 study, which concluded that surgery to remove varicose veins was a more effective treatment than compression stockings.Overall, results are mixed. A review from 2015 found that little reliable evidence supports compression stockings as a treatment for varicose veins.