What Compression Level Do You Need for POTS?

If you have POTS (Postural Orthostatic Tachycardia Syndrome), your doctor has probably told you to wear compression socks. But the next question is always the same: what compression level do I actually need?

Compression is measured in mmHg (millimeters of mercury), and the number tells you how much pressure the garment applies to your legs. Higher numbers mean firmer compression.

Compression Levels at a Glance

• 8–15 mmHg — Light support. Often marketed for travel or mild fatigue. Generally not enough for POTS.
• 15–20 mmHg — Moderate support. Better than nothing, but most POTS patients find this insufficient for symptom management.
• 20–30 mmHg — Firm compression. This is the most commonly recommended level for POTS by clinicians. It provides meaningful blood return support without being difficult to put on.
• 30–40 mmHg — Extra firm / medical-grade. Recommended for patients with more severe symptoms or those who don't get enough relief from 20–30 mmHg. May require a prescription.

What Do Clinicians Recommend?

Most dysautonomia specialists recommend starting at 20–30 mmHg. This level provides enough graduated pressure to assist with venous return and reduce blood pooling when you stand.

If your symptoms are more severe — frequent pre-syncope, significant tachycardia on standing, or poor response to lower compression — your doctor may suggest stepping up to 30–40 mmHg.

Tips for Choosing

1. Start with 20–30 mmHg if you're new to compression. It's effective for most people and easier to get used to wearing.
2. Try 30–40 mmHg if you still have significant symptoms with lower compression, or if your doctor recommends it.
3. Avoid anything under 20 mmHg if you're wearing compression specifically for POTS — it likely won't make a noticeable difference.
4. Get properly sized. Compression level matters, but so does fit. Measure your ankle, calf, and (for thigh-highs) thigh circumference and check the sizing chart.

Graduated vs. Uniform Compression

Look for graduated compression socks — these apply the most pressure at the ankle and gradually decrease up the leg. This design actively assists blood flow upward and is what clinical research supports for orthostatic intolerance.

Uniform compression (the same pressure throughout) does not have the same benefit and is generally not recommended for POTS management.

The Bottom Line

For most POTS patients, 20–30 mmHg graduated compression is the sweet spot. It's the most widely recommended starting point by dysautonomia specialists, and it balances effectiveness with wearability. Talk to your doctor about whether stepping up to 30–40 mmHg makes sense for your symptoms.

PotsSocks is building compression garments at both levels — designed specifically for the POTS community. Sign up for our email list to get notified when they're ready.