# Compression therapy

> Compression therapy uses firm, graduated pressure from bandages, stockings or devices to help blood and fluid move back up the leg. It works best for venous leg ulcers, and it should be chosen and fitted by a health professional after a circulation check.

Guide in [Treatments](https://footanklelowerlimb.com.au/learn/topics/treatments), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/compression-therapy
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026.
Next review by 27 October 2027.

- **It's firm pressure on the leg:** bandages, stockings or devices press most at the ankle and less up the leg, to help blood and fluid move upwards.
- **It works best for venous leg ulcers,** where it helps ulcers heal and eases pain.
- **Your circulation needs checking first,** because poor blood flow to the leg can make compression unsafe.
- **Fit matters:** a garment that's too loose won't do its job, and one that's applied wrongly can cause harm.
- **Take it off and see your GP or a podiatrist the same day** if your toes change colour or you get new numbness, pins and needles or pain.

## What is compression therapy, and how does it work?

Compression therapy is firm pressure applied to your leg and foot with bandages, stockings, tights or devices, to help blood and fluid move back up the leg [1]. It's used for venous leg ulcers (slow-healing sores caused by weak leg veins), lymphoedema (long-term swelling from fluid build-up) and lower leg swelling [1].

The pressure is graduated: snug at the ankle, and less tight as it goes up the leg [2]. That gently squeezes the calf muscles so they can push blood back towards your heart [2]. Options include layered bandages, stockings, wraps with hook-and-loop fasteners, and pump devices (intermittent pneumatic compression) [3].

## What is it used for, and does it work?

Compression works best for venous leg ulcers. Bandages or stockings probably help ulcers heal sooner and more completely than no compression, and probably reduce pain [4]. Firmer pressure heals active ulcers better, but bandages are often applied too loosely: only about 10% reach the target pressure [5][6]. After an ulcer heals, firm (class 3) stockings may reduce the chance it comes back over six months, although this is less certain [7].

Other uses are less clear. In hospital patients, mostly after surgery, stockings are linked with fewer deep vein thromboses (DVT, blood clots in the leg) [8]. That doesn't show everyday stockings prevent clots in other people. For lymphoedema, compression is widely used and may reduce infections caused by swelling, though trial evidence is limited [9]. For long-term leg pain and swelling after a DVT (post-thrombotic syndrome), it isn't clear yet how much stockings help [10].

## Is compression therapy right for me?

It suits many people with venous problems such as varicose veins and leg swelling, and some people having surgery [11]. It should be prescribed by a healthcare professional, who screens you for risks and checks the fit [2][9]. They'll check the blood supply to your legs first (your pulses, and sometimes a test called ABPI), because poor blood flow can make compression dangerous [9]. With significant arterial disease or critical ischaemia (a severely reduced blood supply), compression must not be used without advice from your treating team [1].

It shouldn't be applied with an acute infection of the leg or foot, signs of sepsis, limb-threatening ischaemia, a suspected DVT, suspected skin cancer, bleeding varicose veins, or signs of worsening heart failure [12]. Heart problems alone don't rule it out: it's possible with milder heart failure, but not recommended in severe heart failure [9]. Children need individual advice from a health professional.

> [!see] If you have diabetes, numb feet or poor circulation
> Have compression chosen and checked by a health professional before you start, and don't buy strong compression for yourself. Tell them about diabetes, numbness, heart problems, arterial disease, a past DVT and any skin problems.

## What happens when I have compression therapy?

A clinician checks your legs and circulation, then chooses the type and strength for you. For venous leg ulcers, that's often firmer socks or wraps (class 2 to 3), a hosiery kit or a bandage system; a lighter class 1 sock may be offered for mild disease or a small wound [1]. It's best to have bandages applied by a trained person.

Ask how long to wear it each day, how to put it on, what to expect over time and when you'll be reviewed. Wear it as advised, and keep your follow-up appointments so healing can be checked.

Check your skin and toes each day and whenever you take it off. Stockings lose their support, so replace them every 3 to 6 months [11].

## What are the risks and side effects?

Compression is safer when risks are screened for first and the fit is checked [7]. The usual problems are skin irritation and itching. Rarely, serious problems happen, including heart failure getting worse, nerve damage, blood clots and skin damage [7].

Bandages applied wrongly can cause pressure damage, pressure ulcers, skin death and nerve damage [5]. Stockings applied wrongly can cause discomfort, leg swelling, DVT and reduced blood supply to the leg [8]. Nerve damage usually shows as foot drop (a foot that drags) with numbness [9]. Regular skin care and daily checks help you catch trouble early.

## How does it compare with other options?

For venous leg ulcers, compression is the first treatment usually tried [4]. Between types, no clear difference in healing has been found for bandages versus stockings, elastic versus inelastic material, or four-layer versus fewer-layer bandages [13]. A two-layer stocking system healed ulcers about as well as a four-component bandage [5]. A hosiery kit is often considered first, after a full leg ulcer assessment [14].

It isn't clear yet how compression compares with treating varicose veins, exercise alone or other treatments. Ask whether they could be used alongside it, and if you can't tolerate compression, ask about alternatives rather than stopping on your own.

## When to see a podiatrist

Take your compression off, and don't put it back on, if your toes turn white, blue, purple or mottled, you get new numbness, pins and needles or more pain, it feels too tight, or your leg swells or goes red [2][15]. Then contact your treating team.

Call 000 and ask for an ambulance if you have chest pain or pressure, sudden severe breathlessness, a leg or foot that suddenly turns cold and pale or blue with pain or numbness, or signs of sepsis with a wound or infection: confusion or slurred speech, severe shivering or muscle pain, passing little or no urine, or mottled skin.

See your GP or a podiatrist the same day if you have:

- a wound, sore, blister or colour change on your foot, and you have diabetes;
- toes that change colour, or new numbness or pins and needles;
- a break in the skin under your compression [16];
- spreading redness, heat, swelling or pus in your foot or leg;
- a calf that's hot, swollen and painful;
- sudden severe pain or numbness in a leg or foot, or a foot that drags with numbness;
- worsening breathlessness, waking up breathless or rapid weight gain.

For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic.

See your GP soon if you get itching or redness under the garment [16], or an ulcer or swelling isn't improving as expected or gets worse.

Ask a podiatrist about compression if you have a leg ulcer, ongoing leg swelling or varicose veins. If you're going into hospital or having surgery, ask whether stockings are advised for you.

## Common questions

### How tight should compression stockings be?

Your clinician chooses the strength for you after checking your circulation, so it's best not to guess. A good fit feels snug at the ankle and gets lighter up the leg. If it feels tightest higher up, or rolls over at the top, it isn't fitting as intended and needs checking.

### How long should I wear compression stockings each day?

It depends on why you're wearing them, so there's no single answer. Ask your clinician how long to wear them each day, how to put them on and take them off, and when you'll be reviewed. Keep those follow-up appointments so your progress can be checked.

### What is an ABPI test and why do I need it before compression?

An ABPI compares the blood pressure at your ankle with the pressure in your arm. It shows whether enough blood is reaching your feet. If blood flow is poor, strong compression can be dangerous, so the result helps your clinician decide whether to use compression, and what type and strength.

## Further reading

- [Compression therapy on Clindice](https://clindice.com/compression-therapy)
- [Compression therapy - Leeds Community Healthcare](https://leedscommunityhealthcare.nhs.uk/our-services-a-z/tissue-viability-service/compression-therapy/), NHS
- [Why compression is important for the treatment and prevention of venous leg ulcers](https://www.hct.nhs.uk/download/nwcspcompressionpis28mar23pdf.pdf?doc=docm93jijm4n13645.pdf&ver=18204), NHS
- [Lower limb](https://oxfordhealth.nhs.uk/tissue-viability/conditions/lower-limb/), NHS
- [Leg ulcers - guide for patients and carers - Bradford District Care NHS Foundation Trust](https://www.bdct.nhs.uk/leg-ulcers-guide-for-patients-and-carers/), NHS

## Sources

1. Compression therapy - Leeds Community Healthcare · NHS · 2025. https://leedscommunityhealthcare.nhs.uk/our-services-a-z/tissue-viability-service/compression-therapy/
2. Compression hosiery - South Tees Hospitals NHS Foundation Trust · NHS · 2024. https://www.southtees.nhs.uk/resources/compression-hosiery/
3. Canadian Consensus Statement for the Management of Venous Leg Ulcers · Stacey MC, Sibbald RG, Evans R et al. · International Wound Journal · 2025. https://doi.org/10.1111/iwj.70415
4. Compression bandages or stockings versus no compression for treating venous leg ulcers · Shi C, Dumville JC, Cullum N et al. · The Cochrane Database of Systematic Reviews · 2021. https://doi.org/10.1002/14651858.cd013397.pub2
5. Medical compression therapy of the extremities with medical compression stockings (MCS), phlebological compression bandages (PCB), and medical adaptive compression systems (MAC) : S2k guideline of the German Phlebology Society (DGP) in cooperation with the following professional associations: DDG, DGA, DGG, GDL, DGL, BVP · Rabe E, Földi E, Gerlach H et al. · Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, und Verwandte Gebiete · 2021. https://doi.org/10.1007/s00105-020-04706-z
6. Compression therapy in venous diseases: current forms of compression materials and techniques · Berszakiewicz A, Sieroń A, Krasiński Z et al. · Postepy Dermatologii I Alergologii · 2020. https://doi.org/10.5114/ada.2019.86991
7. Compression for preventing recurrence of venous ulcers · de Moraes Silva MA, Nelson A, Bell-Syer SE et al. · The Cochrane Database of Systematic Reviews · 2024. https://doi.org/10.1002/14651858.cd002303.pub4
8. Graduated compression stockings for prevention of deep vein thrombosis · Sachdeva A, Dalton M, Lees T · The Cochrane Database of Systematic Reviews · 2018. https://doi.org/10.1002/14651858.cd001484.pub4
9. Risks and contraindications of medical compression treatment - A critical reappraisal. An international consensus statement · Rabe E, Partsch H, Morrison N et al. · Phlebology · 2020. https://doi.org/10.1177/0268355520909066
10. Compression therapy for treating post-thrombotic syndrome · Azirar S, Appelen D, Prins MH et al. · The Cochrane Database of Systematic Reviews · 2019. https://doi.org/10.1002/14651858.cd004177.pub2
11. Compression stockings: MedlinePlus Medical Encyclopedia · National Institutes of Health · 2024. https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000597.htm
12. Initial Presentation 2 Weeks Diagnosis Treatment Review · NHS. https://oxfordhealth.nhs.uk/wp-content/uploads/sites/51/2025/12/Lower-Limb-Care-Pathway-v4.2-Oct-25.pdf
13. A meta-review of the impact of compression therapy on venous leg ulcer healing · Patton D, Avsar P, Sayeh A et al. · International Wound Journal · 2023. https://doi.org/10.1111/iwj.13891
14. City Health Care Partnership CIC Compression Formulary · NHS. https://www.northernlincolnshireapc.nhs.uk/wp-content/uploads/2025/04/CHCP%20Compression%20Formulary%20V13.pdf
15. Compression Advice (Tissue Viability) (print version) · NHS · 2024. https://www.whittington.nhs.uk/mini-apps/leaflet/Default.asp?id=448&print=1
16. Taking care of your legs and your compression hosiery - Leeds Community Healthcare · NHS. https://leedscommunityhealthcare.nhs.uk/our-services-a-z/tissue-viability-service/taking-care-of-your-legs-and-your-compression-hosiery-tvs/

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This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.