Everything POTS, Lifestyle

Compression for POTS Treatment

Compression for POTS management

I’ve gone over why you need a diet high in salt, and I’ve touched on the importance of water. Now I’m going to talk about the benefits of compression for POTS treatment and how this basic lifestyle change can lessen your symptoms.

Whether it’s stockings, socks, or leggings, compression helps to squeeze any blood pooling in your lower extremities back up to your heart and brain where it’s needed to keep you movin’ and groovin’. It can improve:

  • Fatigue
  • Dizziness
  • Lightheadedness
  • Tachycardia
  • Muscle pain 
  • Low blood pressure
  • Syncope (fainting)
  • Brain fog

Compression for POTS symptom management

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When Should POTS Patients Wear Compression?

The simple answer? Anytime!

Compression is important when we POTSies have to be on our feet for a long time. I’m looking at you, work, shopping trips, concerts, and vacations. 

Standing causes blood to drop to the lower half of our bodies thanks to gravity. Normally, our bodies compensate for this change in position by balancing blood vessel constriction and heart rate to maintain adequate circulation so you don’t pass out [1].

But people with POTS have trouble compensating for positional changes. The microcirculation associated with POTS doesn’t allow for sufficient recirculation of blood when upright, so significant amounts of it can pool in the feet, legs, and abdomen, causing many of our symptoms [2].  

But don’t let that fool you into thinking you should be sitting all day. In fact, that’s just as bad for POTS symptoms. 

That being said, compression is important when we need to sit for long periods, such as traveling on airplanes or in cars or even working at a desk for eight hours a day. These extended periods of sitting encourage blood pooling, so that when you finally do get up, you may experience symptoms. For me, I get very dizzy, feel pressure in the back of my head, and even experience presyncope until my body stabilizes. 

Now, when I travel long distances, I make sure I’m wearing some sort of compression garment, whether that’s knee-high compression socks or high-waisted leggings that boast compression capabilities (many athletic brands sell these).

If you work in an office job or one where you spend most of the day sitting, then it’s also a good idea to wear compression garments like stockings or socks under your clothes. 

compression socks for POTS syndrome treatment
Wearing VIM & VIGR Brooks Stripe in Plum Compression Socks (15-20 mmHg)

Do you know another time when compression for POTS treatment is vital? In the hot summer heat! 

Summer is arguably when POTSies need compression the most! Heat promotes vasodilation of blood vessels, meaning that you’re more susceptible to blood pooling because there’s not enough constriction to drive blood upward against gravity. So the heat, plus microcirculation, equals poor overall circulation. And that poor circulation, as we learned earlier, leads to intensified POTS symptoms. 

But be aware…

Sometimes, if you wear compression for too long it can get uncomfortable. The band at the top of my socks can get too tight and dig into my skin if I wear them overnight, and I can only tolerate my high-waisted leggings sucking my stomach in for so long. So I like to give my body breaks, and I don’t wear compression twenty-four seven. But if you experience too much discomfort, or struggle to get them on, then you should consider a different size or another pair with less compression. 

Types of Compression For POTS Treatment I Use

I have seen very positive results from wearing compression socks. I use them instead of the compression stockings you can get at the pharmacy. Why? Well, to be blunt, I just don’t want to wear those stockings. I already feel like a granda some days; I have no desire to start looking like one, too! There are two brands that I’ve used and both are products I’d recommend for fellow POTSies.

The first pair of compression socks I ever tried was Copper Fit Energy Knee High Compression Socks. They’ve worked really well for me in the two years I’ve been using them, and they are a relatively inexpensive option. However, they only come in black. That’s not necessarily a drawback for me because I think it gives a sporty look when I pair them with exercise clothes. But I have been longing for some more fashionable compression sock options…

Which brings me to the second pair of compression socks for POTS that I use!

Recently, I’ve started using VIM & VIGR compression socks too, and I am IN LOVE! Like I just said above, I have no desire to look like a grandma while I’m still in my twenties, and I feel like VIM & VIGR designed compression socks with fashionistas in mind. They come in a large array of stylish colors and patterns that you’ll actually want to wear! Plus, they sell different levels of compression from 15-20 mmHg, to 20-30 mmHg, and 30-40 mmHg, so no matter what level of compression you need, you can look cute while managing symptoms. Check them out below!

I also own several pairs of high-waisted compression leggings and shorts. 

Last Christmas, I bought a pair of Lululemon “Hugged Sensation” compression leggings that was totally worth the investment. I feel the difference when I wear them, and I believe that’s because the compression extends up to my waist. I live in these for exercising and traveling. Who am I kidding? I live in them just for lounging, too. 

I also own a pair of Lululemon high-waisted shorts. I’ll wear these for when I go biking outside in the summer because I can’t stand biking in long leggings in the heat. Obviously, these don’t do much for circulation in the legs but let me tell you, I feel that tight compression in my waist and upper thighs. I like to think it’s better than nothing!

Compression socks and shorts for POTS Syndrome

How Compression Has Helped My POTS Symptoms

Overall, for me, compression has been truly amazing for my POTS symptoms. Let me tell you why. 

When I underwent my hemodynamic echocardiogram, one of the major findings was that a significant amount of blood pools in my abdomen and legs because of insufficient vasoconstriction. (Surprised?) Wearing knee-high compression socks or waist-high leggings has made a noticeable difference in recirculating that pooling blood back up to the rest of my body that craves it. You know what that means? It means fewer POTS symptoms for me!

When I first started wearing compression socks, I noticed almost immediately that my pulse dropped to under 100 bpm while standing. This was HUGE for me! It used to consistently range from 100-115 bpm just standing still — sometimes spiking even higher than that — but with the socks on, my pulse went down to about 90-95 bpm standing. (I use my Fitbit Sense smartwatch to track my heart rate daily.)

That might not seem like a lot, but it was enough for me to notice a reduction in my POTS symptoms. I no longer could feel the forceful thumping of my heart against my chest while I stood, and it wasn’t as exhausting to simply stand and do normal everyday things. Like, make a sandwich. Or put my makeup on. It was the first glimpse I had of the life I used to know before POTS. 

Effects of Compression On My Chronic Pain

Compression has also been miraculous for me in another way. Since I first started getting intense POTS symptoms a few years ago, my feet have sucked. 

I’m not exaggerating. 

I suffered from multiple foot injuries, with each one taking forever to heal. Some of them — like the plantar fasciitis I suffered in both feet — wouldn’t heal at all. Every time I had to stand longer than 15 minutes, my arches screamed in resistance, and I was in and out of physical therapy for almost a year. It became impossible for me to walk long distances or to stand without pain in my feet.

As a former competitive dancer turned into a recreational runner who never formerly had ANY foot problems, this was devastating. I used to jump, leap, sprint, and sashay without a single complaint from my arches. 

But when POTS took over my life three years ago, none of that was possible without pain. I stopped running and attending Zumba classes. I resorted to cycling on stationary bikes because that was all my feet could handle. Also, I couldn’t even hike because my feet would swell and throb (plus exercise intolerance did me in).

All along, I had no idea that all of that excruciating foot pain was caused by my POTS–more specifically, blood pooling. In my hemodynamic echocardiogram, it showed almost two liters of blood sitting in my lower half. No wonder I was in so much pain! 

Can you start to see now how helpful compression has been for my POTS? 

How My Quality of Life Has Improved

A year ago, I was beside myself because I couldn’t walk long distances or stand for a long time. Shopping trips became a chore. I came to dread vacations and the associated walking. Nights out dancing with my girlfriends left me in pain for a full day afterward. I was convinced I’d never run in another race, or maybe even run at all, again.

But…flash forward to now. With the combination and increased exercise tolerance, my foot pain and injuries have practically vanished. I can stand much longer than before without pain. I can walk 10 miles in an entire day in New York City. Plus, I can even go out for a night of dancing and not feel so remorseful the next day. Shopping trips are enjoyable again. 

And you want to know what else? I’m able to run again with POTS. Well, more like jogging. Okay, it’s actually jogging and walking intervals, but that’s not the point. The point is that I’m able to experience life with less pain, and I’m getting back to doing the things I love! Slowly, but surely, I am seeing progress.  

And compression coupled with my medication and the other POTS lifestyle changes has made that possible. 

The Takeaway on Compression For POTS Treatment

Ask your doctor if compression is something you should try. Everyone is different and experiences POTS differently, so some people may feel more or less benefit from it. Regardless, I encourage you to give compression a chance. It may not be the most stylish thing in the world, but it can have such a positive effect on your POTS symptoms. Try out different styles, compression levels, lengths, and brands to see if it’s as helpful to you!

What have your experiences with compression been like?

Stay strong, POTSies! Remember, any progress, no matter how small or inconsequential it may seem, is a step in the right direction. Keep fighting for your health and happiness!

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[1] “POTS, Symptoms, Treatments I Cleveland Clinic.” Cleveland Clinic. Accessed January 26, 2020. https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots.

[2] “Postural Orthostatic Tachycardia Syndrome (POTS).” Johns Hopkins Medicine. Accessed January 26, 2020. https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots.

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9 thoughts on “Compression for POTS Treatment

  1. Pyrostigmine is terrible for me. And compression hose to not make appreciable changes. 6G of salt(6 salt tabs ) and 2+ L of fluids do help some. Propanalol 5mg bid and Midodrine 10mg tid help with the tachycardia and hypotension
    But I am still pre syncope with any position changes. So we have not found a management plan that works well, in the last 12 mo.

    1. Hi Kathy, I’m sorry to hear you’re having trouble finding a management plan. Yes, compression does not work as well for some people, unfortunately. And finding the right combo of medication can be trial and error. I can relate to the presyncope with position changes; if I don’t wear compression I get that much worse, especially in the morning. Make sure to move slowly when changing positions, but I’m sure you already know that. Fingers crossed you find more relief in the near future. Take care! 🙂

  2. Thanks for info! I’m taking guanfacine and want to help up my BP..compression is a helpful tool.
    Blessings, praying for you..

  3. Hi, I just came across your site, and was so happy to find this article. I have not been diagnosed with POTS, but my symptoms align with it. My heart rate will go up 30-50 bpm upon standing, and it makes me so dizzy. But it will drop when I sit down. It has recently started affecting me nearly every day. Do you have any suggestions for how to get properly diagnosed? When I brought up that I had read about POTS to my doc and he didn’t really even know what I was talking about. Thanks!

    1. Hi Meg! Unfortunately, I’ve had experiences with doctors not knowing about POTS or not believing that it’s an actual condition, which is why it took me a few years to get diagnosed. My best advice is to seek out a specialist who treats POTS. This can be a neurologist or a cardiologist. This also may involve traveling to see a doctor. But for me, it was worth waiting on a waitlist and traveling to get in with a doctor who treats POTS because I got the help I needed right away. I hope you feel some symptom relief soon! 🙂

      1. Hi Laurie – just found your site when searching for info on compression garments to help with symptoms. Can you share where you went (who the dr was or who the clinic was) to get diagnosed? I’m on month 13 of being unwell and having a hard time finding a dr who even knows what dysautonomia is. Thank you. Hope you are doing well. I am definitely bookmarking your site! Thanks for sharing to help others like me 🙂

  4. Thank you for your post, I just came across this as I’m trying to find good compression socks.
    May I ask what your symptoms were with the blood pooling in your abdomen? I was diagnosed with POTS in November. I’m 18 and had to defer from college to give me time to get my health back in line. Take care!!

  5. My 45 year old daughter has POTS. She is a college professor and has to stand a lot when teaching. She has worn compression socks, which helps a little bit. I was wondering if air compression leg wraps (that are often used in hospitals to help the blood circulation flow of patients) would be a good idea to help the blood flow of my daughter’s legs. I saw some advertised on Amazon but didn’t see anything mentioned that it would be good for POTS patients to use. These electronic air compression leg wraps squeeze and release the muscles in the legs and feet. Thank you for any advice you might have.

  6. I have POTS mostly when I first get up in the morning. I also have Ehlers Danlos Syndrome (EDS), hyper mobility type. Most people with EDS also have POTS, so you might want to look into it, it causes painful joints among other things. I did not believe I had EDS until I read the list of symptoms and then it was like a light bulb went off, definitely me. Thanks for the article, I am going to try putting on compression socks first thing in the morning and see if it helps.

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