Skip to content
Medical InsightsKoreaMedical Insights Korea

Varicose Veins

Do compression stockings actually do anything for varicose veins?

They relieve symptoms — that much was measured. Whether they stop the disease progressing was never tested, and it is the claim most often made for them.

Reported by

Reporter

Sources
2 cited
Published
Reading time
4 minutes

Answer

Compression stockings help the symptoms of varicose veins and are unproven for anything else. In a randomised controlled trial of 50 patients with uncomplicated varicose veins, four weeks of class I stockings (18 to 21 mmHg) cut a symptom sum score from 8.90 to 6.37 (P = 0.004) while the untreated group did not change (7.46 to 7.67, P = 0.293), with pain, swelling and heaviness all improving — but the trial ran five weeks in total and measured symptoms only, so it shows relief and says nothing about whether stockings prevent progression, prevent ulcers, or avoid a later procedure.

Key takeaways

  • 50 patients with uncomplicated varicose veins (CEAP C2s to C4a) were randomised, 25 to class I compression stockings and 25 to no treatment.
  • The symptom sum score fell from 8.90 to 6.37 in the stocking group (P = 0.004) and was unchanged in the control group (7.46 to 7.67, P = 0.293).
  • Pain, leg swelling and the feeling of heaviness all improved significantly.
  • In the untreated group the pain score significantly increased over the follow-up period.
  • Leg itching was numerically more frequent among patients wearing the stockings.
  • The trial was one week of baseline plus four weeks of treatment, and could not blind participants to whether they were wearing a stocking.
  • Progression of disease, ulcer prevention and the need for a later procedure were not measured.

Compression stockings are the first thing suggested to most people with varicose veins, and they are suggested for two different reasons that are usually said in the same breath: that they will make the leg feel better, and that they will stop things getting worse. Only the first has been tested.

What the trial measured

A randomised controlled trial enrolled 50 patients with uncomplicated varicose veins and gave half of them class I medical compression stockings delivering 18 to 21 mmHg under the German RAL-GZ 387 classification. The other half received nothing. Symptoms were recorded daily through an app for one baseline week and four treatment weeks.

8.90 → 6.37

symptom sum score after four weeks of class I compression stockings; the untreated group went from 7.46 to 7.67Stücker M et al., VASA, 2025

The direction is not ambiguous. Pain, swelling and heaviness each improved, and in the control group the pain score significantly increased over the same period — so the comparison is not between improvement and standing still but between improvement and getting worse.

The gap between what was tested and what is claimed

There is also a detail in the results that explains why so many pairs of stockings end up in a drawer. Leg itching was numerically more frequent among the patients wearing them. Adherence is the whole mechanism here — a stocking not worn does nothing — and the trial recorded the most common reason people stop.

What this means in practice

If the aim is relief, stockings have randomised evidence behind them and are reasonable to try, with the understanding that the benefit lasts as long as the wearing does. If the aim is to avoid an eventual procedure, there is no evidence that they achieve it, and choosing them over a procedure on that basis is choosing on a claim that has not been tested.

Korean practice has been moving the other way regardless. National data show treatment for chronic venous disease shifting decisively towards endovenous procedures between 2010 and 2020, which is a statement about what is being done rather than about what works best.

Sources

  1. 1

    Stücker M, Braß D, Möckel L, Hartmann K, Rabe E

    Efficacy of medical compression stockings class I on the reduction of symptoms in patients with uncomplicated varicose veins

    VASA. Zeitschrift fur Gefasskrankheiten 2025;54(1):67-72

    doi:10.1024/0301-1526/a001163 · PMID:39585803

    https://doi.org/10.1024/0301-1526/a001163
  2. 2

    Shon S, Kim H, Kim HC, Cho S, Lee SH, Joh JH

    National trend of the treatment for chronic venous diseases in Korea between 2010 and 2020

    Annals of Surgical Treatment and Research 2023;104(1):27-33

    doi:10.4174/astr.2023.104.1.27 · PMID:36685771

    https://doi.org/10.4174/astr.2023.104.1.27