2025-01-10

Do Compression Socks Actually Help with POTS?

What the evidence says about compression therapy for POTS — how it works, what to expect, and why it's one of the most recommended non-drug treatments.

If you've recently been diagnosed with POTS, one of the first things your doctor probably recommended was compression socks. But do they actually work? And if so, how much of a difference can they make?

Here's what the evidence and the POTS community experience tell us.

How POTS Affects Blood Flow

POTS (Postural Orthostatic Tachycardia Syndrome) is a disorder of the autonomic nervous system. When you stand up, your body is supposed to constrict blood vessels in the lower body to push blood back to the heart and brain. In POTS, this process doesn't work properly.

The result: blood pools in the legs and abdomen, your heart rate spikes to compensate, and you get symptoms like dizziness, lightheadedness, brain fog, fatigue, and in some cases, fainting.

What Compression Does

Compression garments apply external pressure to the legs (and in waist-high versions, the abdomen). This pressure:

  • Reduces the diameter of veins, which increases the velocity of blood flow back to the heart
  • Limits blood pooling in the lower body when you stand
  • Supports your body's impaired ability to constrict blood vessels on its own

In other words, compression socks do mechanically what your autonomic nervous system is struggling to do: keep blood moving upward.

What Does the Research Show?

Compression therapy is one of the most widely recommended non-pharmacological treatments for POTS. Here's a summary of the evidence:

  • Graduated compression of 20–30 mmHg or higher has been shown to reduce heart rate increases on standing in POTS patients
  • Abdominal and lower-body compression (waist-high garments) tends to show the most benefit in controlled studies
  • Knee-high compression provides measurable but less dramatic improvement compared to waist-high
  • Compression is typically recommended alongside other measures like increased fluid intake, salt supplementation, exercise, and in some cases medication

Compression socks are not a cure for POTS — no single intervention is. But they are a reliable, drug-free tool that can reduce symptom severity for many patients.

What Patients Actually Report

In the POTS community, experiences vary. Some patients describe compression as a game-changer — the difference between being functional and being stuck in bed. Others notice a more modest improvement. The factors that seem to matter most:

  1. Compression level — 20 mmHg and above tends to be the threshold for noticeable benefit
  2. Coverage area — waist-high generally more effective than knee-high
  3. Consistency — wearing compression daily (especially in the first half of the day) matters more than occasional use
  4. Proper fit — too loose and they don't work; too tight and they're uncomfortable

What Compression Won't Do

Compression socks are not going to eliminate your POTS symptoms entirely. They're one part of a management toolkit. They work best in combination with:

  • Adequate hydration (2–3 liters of water daily for most POTS patients)
  • Salt intake (as recommended by your doctor)
  • A reclined or recumbent exercise program
  • Medication if prescribed by your physician
  • Avoiding prolonged standing when possible

The Bottom Line

Yes, compression socks help with POTS. The evidence supports it, clinicians recommend it, and most patients who wear them consistently report improvement. The key is wearing the right compression level (20 mmHg or higher), getting a proper fit, and being consistent.

PotsSocks is building compression garments specifically for the POTS community — the right levels, the right designs, made for people who depend on compression every day. Join our waitlist to be notified when we launch.

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