Compression therapy in plain terms
What is compression therapy for legs? It is steady, measured pressure applied to the lower leg with wraps, stockings or similar garments. The pressure helps your veins move blood back toward the heart and pushes extra fluid out of swollen tissue.
For leg ulcers caused by vein problems, compression is usually the center of the treatment plan. A dressing covers the wound. Compression works on the reason the wound is there.
Why leg veins need the help
Leg veins have to move blood uphill. Small one-way valves inside the veins keep blood from sliding back down, and your calf muscle squeezes the veins every time you take a step.
When those valves weaken or are damaged, blood pools in the lower leg. Pressure inside the veins stays high and fluid leaks into the surrounding tissue. Over time you may notice swelling, a heavy or aching feeling, brownish staining near the ankle, and skin that turns itchy, hard or fragile. A sore in this area that will not close is often a venous leg ulcer.
Compression gives the calf muscle a firm wall to push against. Blood moves upward more effectively, swelling goes down and wound drainage often lessens.
Common types of compression
- Multilayer wraps. Layers of padding and bandage applied by a nurse or clinician. They usually stay on between visits and are common while a wound is open and draining.
- Adjustable wraps. Garments with hook-and-loop straps that can be loosened, tightened and taken off.
- Compression stockings. Fitted by measuring the leg and chosen by pressure level. They are often used after a wound closes to help keep it from returning.
Most leg compression is graduated: firmest at the ankle and gentler toward the knee.
Why circulation is checked first
Compression squeezes everything under it, including the arteries that bring blood down to the foot. If those arteries are narrowed, a condition called peripheral artery disease, strong compression can cut into a blood supply that is already limited and damage the skin.
That is why the treating clinician looks at blood flow before ordering compression. The check may include:
- Feeling for pulses in the foot and looking at skin color and temperature
- Asking about leg pain with walking, diabetes, smoking and past vascular procedures
- An ankle-brachial index (ABI), a test that compares blood pressure at the ankle with blood pressure in the arm
- Toe pressures or a vascular ultrasound when more detail is needed
The results guide the order: full compression, lighter compression, or none until a vascular specialist has weighed in. The clinician also considers heart failure, a possible blood clot and skin infection. The guide to circulation tests before compression explains the testing, and the page on circulation and vascular health covers long-term follow-up.
Living with compression day to day
Compression should feel snug and supportive, not painful. Keep wraps dry, and ask how to bathe. You may need a roomier shoe for a while. Walking and ankle movement, as your clinician allows, help the calf muscle do its work. For rubbing, slipping and itching, see the guide to keeping compression wraps comfortable.
What to ask and what to report
Good questions to bring to a visit:
- Was my circulation checked, and what did the result show?
- Which type of compression am I getting, and who puts it on?
- What should I do after hours if the wrap slips, gets wet or hurts?
Report these changes to the treating clinician promptly:
- Toes that look pale, blue or dusky, or feel cold, numb or tingly
- New or sharply worse pain in the foot, calf or under the wrap
- A wrap that has slid down or rolled into a tight band
- Drainage soaking through, or a foul smell
- New redness, warmth or fever
Ask in advance whether you should remove the wrap if your toes change color or go numb, so you are not deciding alone at night. Call 911 for chest pain, sudden shortness of breath, or a foot that suddenly turns cold, white and very painful.
How Gateway helps with compression
Gateway arranges visits with partner clinicians across Greater St. Louis and the Metro East. We coordinate the circulation testing the clinician orders, the visit schedule and the supplies, and we keep your other providers informed. The treating clinician decides whether compression is safe for you and at what level.
To ask about compression therapy for leg wounds, call 314-325-0126 or send a request for care.
Common questions
What do the numbers on compression stockings mean?
They show how much pressure the stocking applies, measured in millimeters of mercury (mmHg), the same unit used for blood pressure. A higher number means a firmer squeeze. The treating clinician chooses the level based on your circulation results, your skin and whether you can get the stocking on.
How many hours a day is compression worn?
It depends on the type. Multilayer wraps applied by a clinician usually stay on day and night until the next visit. Stockings and adjustable wraps are commonly put on in the morning, when swelling is lowest, and taken off at bedtime. Ask the clinician to write down your own schedule.
Why do my wraps feel loose after a few days?
Usually because they are working. As fluid leaves the leg, the leg gets smaller and the wrap no longer fits as closely. A loose wrap gives less support and can slide down and bunch at the ankle, which creates a tight band. Let the care team know instead of waiting for the next scheduled change.
Is compression therapy only for people with open wounds?
No. Clinicians also order compression for leg swelling, varicose veins, lymphedema and skin changes from vein disease, and to help keep a healed venous ulcer from coming back. If you have swelling in your legs but no wound, ask a clinician what is causing it before buying compression garments on your own.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.
Updated October 2026