Compression Tights For PoTS
Compression tights are sometimes recommended in PoTS, vaso-vagal syncope or orthostatic hypotension (very low blood pressure on standing). Compression of the lower limbs causes an increased blood return to the heart from the superficial veins in the legs. There has not yet been any research to prove that compression tights improve symptoms in PoTS, but some patients have reported them to be helpful.
Patients can buy compression tights from their pharmacist or order them from the internet. Some brands are available on prescription. Before ordering the more heavy duty and expensive ones that are recommended in PoTS, consider trying lighter support tights which are available from some department stores. If you cannot tolerate the lighter ones you are unlikely to manage to wear the stronger tights that are recommended for PoTS.
For the fashion conscious, manufacturers have worked hard to improve compression garments over the last few years. They are available from many companies in the UK. They now offer a wide range of sizes, colours and compression classes, but not all are available on prescription. Black or navy ones are available on prescription and can be worn as leggings or with boots. Some can be found by searching on the websites listed below.
It may be helpful to put compression tights on in the morning before rising from bed. They should be removed at bed-time. Ideally they should be replaced with new ones every 3-6 months.
Strength of Compression Tights
Compression tights for PoTS should be waist high for maximum benefit.
There are different ways of describing the strength of compression which is measured in millimetres of mercury (mmHg).
European standard (also called RAL) is most the most commonly used classification in the UK. RAL class 2 tights provide the recommended pressure for use in PoTS which is 23-32 mmHg at the ankle.
Rarely the following are also available and can be used in PoTS:
British Standard (BS) – class 3 (which provides 25-35 mmHg)
French Standard – class 3 (which provides 21-36 mmHg)
Top Tips For Comfort
Wearing compression garments may feel strange at first, but will soon feel more comfortable. Always read the manufacturer’s instructions on how to apply and remove your compression tights. If your tights cause redness or irritation keep a close eye on the area. Petroleum jelly smeared on an affected area can help. Check you have the correct size. Make sure you have followed the washing and drying instructions carefully. Soap residue can build up and cause skin irritation, so rinse them thoroughly.
Compression tights may be quite difficult to apply in the morning. Advice about how to apply them tends to be available with the hosiery. It is possible to buy appliances to help with getting hosiery on and off and some companies will supply a simple foot slider. Using a pair of Marigold gloves or applying them on a carpet will help to grip the tights.
If compression tights remain uncomfortable, and especially if there is evidence of fluid retention in the tissues of the leg, you may need a garment that is of a different knit. Most are made of a round/ circular knit material, but sometimes a made to measure flat knit garment may be more comfortable. However these are thicker and less aesthetically pleasing than circular knit. They also require measurement by a specialist practitioner such as a specialist lymphoedema nurse.
European Standard (RAL) class 3 compression are stronger than class 2 and consequenctly they may be more difficult to get on and off; however they can still be very comfortable and supportive if they are needed.
Compression Tights Available On Prescription
Below are some examples of suitable compression tights for PoTS. Some companies have helpful tips, internet links and downloadable apps to assist.
- Haddenham Veni (tights, closed toe, beige or black, patterned, size I-VIII, regular, short and long) Size chart here:
- Mediven Elegance (tights, closed toe, beige or black, normal or petite, size I-VII). Click on "size chart" from this link
- Sigvaris Magic (tights, closed toe, skin or black, extra small-large plus, short or long) Size chart here:
- Jobst Opaque -from BSN (tights, closed toe, black navy or sand, sizes I-VI, short or long). Click on 'Size Chart' on this link
Not Available On Prescription - colourful tights
Juzo make colourful compression tights. UK telephone 01832 826620
Asking your GP to prescribe compression tights
Previously GPs were only permitted to prescribe stockings (not tights) and some GPs do not know that regulations have changed and that some tights can now be prescribed.
It is probably best to make an appointment to discuss only this one issue i.e. the prescription of compression tights. This is because it can take the doctor a very long time (i.e. a whole appointment) to find the correct size on their computer and issue the prescription.
Before the appointment, consider looking on the websites suggested above, choose a style and make your own measurements at home to take to the consultation.
Prescribing guidance for your GP
Compression tights are difficult to find on a GP computer on the medication screen; the range is enormous. In general the GP will need to search on:
- the company name e.g. Haddenham, Jobst, Sigvaris etc.
- then look for the type e.g. opaque, veni
- look for tights, pantyhose or waist high
Take a printout of this leaflet to assist your GP.
Many of the companies now have Apps to assist with measuring and prescribing codes.
When Compression Tights Should Not Be Used
It can be harmful for people who have conditions which reduce the blood supply to the legs (e.g. peripheral vascular disease, diabetes) to use compression garments. Their doctor should request a Doppler ultrasound test, which measures the blood flow in their legs, before prescribing them. If skin is very fragile, compression garments can cause damage.
Alternative to Compression Tights
Compression garments are commonly used by athletes, such as "Skins" and can be purchased from a number of running or sports shops. They are available as leggings, shorts, and upper body compression garments. Although the level of compression is likely to be lower than suggested for PoTS and inconsistent, they provide an alternative to compression tights and may be more appealing to some.
Written by Dr Lesley Kavi
Approved by: Beverley Lenton RGN, BSc (v1), Natalie Lee RGN, BSc - Lymphodema Clinical Nurse Specialists (v1,2)
Review date 1/10/2019