Every cardiology practice encounters them: individuals experiencing swollen, painful legs accompanied by protruding varicose veins. We discuss conservative approaches: exercise, elevating the legs, and, certainly, compression stockings. Almost inevitably, patients respond politely, nodding, and then confess at their next appointment: “I couldn’t wear them. They’re too tight, too hot, too uncomfortable.”

The irony of a straightforward remedy

Compression stockings rank among the most effective noninvasive therapies for varicose veins and venous insufficiency. Randomized studies validate that they help decrease swelling, enhance symptoms, and may even slow the condition’s progression. Yet adherence rates are notoriously low. Why? Because what appears simple in concept is not necessarily straightforward in application.

Reasons patients face challenges

• Physical discomfort: Stockings can be warm, itchy, and constricting.
• Practical obstacles: They can be hard to put on, particularly for elderly patients suffering from arthritis or limited movement.
• Psychological barriers: For many, stockings represent “illness” and aging, rendering them emotionally uninviting.
• Inconsistent encouragement: If doctors present stockings as optional instead of necessary, patients are less inclined to continue using them.

Insights from research

Research published in Phlebology and the Journal of Vascular Surgery indicates adherence rates for compression stockings can be as low as 30-40 percent. However, patients who wear them regularly report notable enhancements in life quality and symptom relief.

Actions patients can take

• Select the appropriate size: Professional fitting can significantly increase comfort levels with stockings.
• Introduce gradually: Starting with just a few hours a day can help build tolerance before committing to full-time use.
• Combine with healthy habits: Elevating the legs, regular exercise, and proper hydration can boost the benefits.
• Shift the perspective: Stockings are not indicative of decline; they represent a proactive approach in self-care.

Conclusion: adherence is about human behavior, not failure

Compression stockings remind us that the most effective treatment isn’t always the most advanced; sometimes, it requires the greatest resolve because it demands daily commitment. As healthcare providers, we should go beyond simple prescriptions and collaborate with patients, recognizing obstacles and seeking practical solutions. For patients, the focus should be on persistence rather than perfection. Every hour spent in stockings is a step toward healthier legs.

Monzur Morshed is a cardiologist. Kaysan Morshed is a medical student.