Do Compression Stockings Help With Orthostatic Hypotension? A Comprehensive Guide
Yes, compression stockings can significantly help manage orthostatic hypotension by improving blood flow and stabilizing blood pressure upon standing. They are often recommended as a first-line treatment.
Orthostatic hypotension, also known as postural hypotension, is a condition that causes a sudden drop in blood pressure when standing up from a sitting or lying position. This can lead to dizziness, lightheadedness, blurred vision, and even fainting. Managing this condition often involves a multifaceted approach, and compression stockings play a crucial role in many treatment plans.
Understanding Orthostatic Hypotension
Orthostatic hypotension occurs because gravity pulls blood downwards when we stand. Normally, the body compensates by constricting blood vessels and increasing heart rate to maintain blood pressure. In people with orthostatic hypotension, these mechanisms are impaired, leading to a temporary drop in blood pressure. This can be caused by a variety of factors including:
- Dehydration
- Certain medications (like diuretics and blood pressure medications)
- Nervous system disorders (like Parkinson’s disease)
- Heart problems
- Prolonged bed rest
Diagnosing orthostatic hypotension typically involves measuring blood pressure in both a sitting or lying position and again after standing for a few minutes. A significant drop in systolic blood pressure (the top number) of 20 mmHg or more, or a drop in diastolic blood pressure (the bottom number) of 10 mmHg or more, is considered diagnostic.
How Compression Stockings Work
Compression stockings exert pressure on the legs, helping to squeeze blood back towards the heart. This counteracts the pooling of blood in the lower extremities that contributes to the drop in blood pressure in orthostatic hypotension. The graduated compression, where the stocking is tighter at the ankle and gradually looser towards the top, is particularly effective.
Here’s a breakdown of how they work:
- Increased Venous Return: They constrict superficial veins, forcing blood into the deeper veins, increasing blood flow back to the heart.
- Reduced Venous Pooling: The external pressure prevents blood from pooling in the legs, minimizing the decrease in blood pressure upon standing.
- Improved Blood Pressure Stability: By maintaining blood volume in the upper body, compression stockings help stabilize blood pressure and reduce the symptoms of orthostatic hypotension.
Choosing the Right Compression Stockings
Not all compression stockings are created equal. It’s crucial to choose the right type and level of compression for your needs. Considerations include:
- Compression Level: Measured in mmHg (millimeters of mercury), with higher numbers indicating greater compression.
- Length: Knee-high, thigh-high, or pantyhose. Knee-high stockings are typically sufficient for orthostatic hypotension.
- Material: Options include nylon, spandex, cotton blends, and others. Choose a material that is comfortable and breathable.
- Fit: Proper fit is essential for effectiveness. Measure your ankle and calf circumference to ensure you select the correct size.
Here’s a table comparing different compression levels:
| Compression Level (mmHg) | Purpose |
|---|---|
| 8-15 | Mild support; often used for tired legs |
| 15-20 | Moderate support; helps with mild edema and varicose veins |
| 20-30 | Orthostatic hypotension; Moderate varicose veins; Edema |
| 30-40 | Severe venous insufficiency; Lymphedema |
Important: Consult with your doctor to determine the appropriate compression level for your specific condition.
Tips for Using Compression Stockings
Getting the most out of compression stockings requires proper application and care.
- Apply in the Morning: Put them on before getting out of bed, or as soon as you wake up, when your legs are least swollen.
- Smooth Out Wrinkles: Ensure the stockings are smooth and wrinkle-free to avoid constricting blood flow.
- Donning Devices: Use a donning device if you have difficulty putting them on.
- Wash Regularly: Wash them daily or every other day with mild soap and water to maintain elasticity.
- Replace Regularly: Replace the stockings every 3-6 months, or sooner if they lose elasticity.
Other Treatments for Orthostatic Hypotension
While compression stockings are beneficial, they are often used in conjunction with other treatments, including:
- Lifestyle Modifications: Increasing fluid intake (especially water), adding salt to your diet (under medical supervision), and avoiding prolonged standing.
- Medications: Some medications can help raise blood pressure, but these should be prescribed and monitored by a doctor.
- Elevating the Head of the Bed: Sleeping with the head of the bed elevated can help reduce nighttime fluid loss and improve morning blood pressure.
- Avoiding Triggers: Identify and avoid activities or situations that trigger symptoms, such as hot showers or large meals.
Potential Side Effects and Precautions
While generally safe, compression stockings can cause some side effects in certain individuals.
- Skin Irritation: Redness, itching, or blisters can occur. Make sure the stocking fits properly and that you’re not allergic to the material.
- Discomfort: If the stocking is too tight, it can cause discomfort.
- Infection: Poor hygiene can lead to skin infections. Keep your legs clean and dry.
- Contraindications: People with severe arterial disease, peripheral neuropathy, or uncontrolled heart failure should consult with their doctor before using compression stockings.
Frequently Asked Questions (FAQs)
Can I wear compression stockings all day?
Yes, you can generally wear compression stockings all day, especially if you have orthostatic hypotension. It is essential to remove them before going to bed to allow for unrestricted blood flow while lying down.
How do I know if my compression stockings fit properly?
The stocking should fit snugly but not feel too tight. You should be able to insert two fingers comfortably under the top band. Improper fit can reduce effectiveness or cause discomfort.
Are there different types of compression stockings?
Yes, there are knee-high, thigh-high, and pantyhose options, as well as varying compression levels. For orthostatic hypotension, knee-high stockings are often sufficient, but consult your doctor for specific recommendations.
Can I wear compression stockings while exercising?
Yes, you can wear compression stockings while exercising. They can help improve blood flow and reduce muscle fatigue. However, ensure the compression level is appropriate for exercise, typically lower than what’s used for treating orthostatic hypotension.
How often should I wash my compression stockings?
You should wash your compression stockings daily or every other day with mild soap and water. This helps maintain their elasticity and prevents the buildup of bacteria.
Can I dry my compression stockings in the dryer?
No, it is generally not recommended to dry compression stockings in the dryer, as the heat can damage the elastic fibers. It’s best to air dry them.
What if I have trouble putting on my compression stockings?
Several donning aids are available to help you put on compression stockings. These devices can make the process easier and less strenuous.
Do I need a prescription for compression stockings?
You can purchase compression stockings with lower compression levels (below 20 mmHg) without a prescription. However, for higher compression levels, it’s best to consult your doctor.
Are there any alternatives to compression stockings for orthostatic hypotension?
Alternatives include lifestyle modifications, medications, and abdominal binders. However, compression stockings are often the first-line treatment due to their effectiveness and relatively low risk.
Can compression stockings cure orthostatic hypotension?
No, compression stockings do not cure orthostatic hypotension. They help manage the symptoms by improving blood flow and stabilizing blood pressure.
Can I wear compression stockings if I have diabetes?
If you have diabetes, it’s essential to consult your doctor before using compression stockings. You need to ensure that your circulation is adequate and that you don’t have any neuropathy that could be worsened by the stockings.
How long will it take to see results from wearing compression stockings for orthostatic hypotension?
Many people experience immediate relief from symptoms like dizziness and lightheadedness when wearing compression stockings. However, it may take a few days or weeks to notice a more significant improvement in your overall condition.