Subscribe to RSS
DOI: 10.1160/th14-05-0430
Graduated compression stockings to treat acute leg pain associated with proximal DVT
A randomised controlled trial Financial support: This study was funded by Canadian Institutes of Health Research (MCT 63142, MOP 102610), with active and placebo stockings provided as in-kind support by Sigvaris.Publication History
Received:
14 May 2014
Accepted after major revision:
05 July 2014
Publication Date:
20 November 2017 (online)
Summary
Acute deep venous thrombosis (DVT) causes leg pain. Elastic compression stockings (ECS) have potential to relieve DVT-related leg pain by diminishing the diameter of distended veins and increasing venous blood flow. It was our objective to determine whether ECS reduce leg pain in patients with acute DVT. We performed a secondary analysis of the SOX Trial, a multicentre randomised placebo controlled trial of active ECS versus placebo ECS to prevent the post-thrombotic syndrome.The study was performed in 24 hospital centres in Canada and the U.S. and included 803 patients with a first episode of acute proximal DVT. Patients were randomised to receive active ECS (knee length, 30–40 mm Hg graduated pressure) or placebo ECS (manufactured to look identical to active ECS, but lacking therapeutic compression). Study outcome was leg pain severity assessed on an 11-point numerical pain rating scale (0, no pain; 10, worst possible pain) at baseline, 14, 30 and 60 days after randomisation. Mean age was 55 years and 60% were male. In active ECS patients (n=409), mean (SD) pain severity at baseline and at 60 days were 5.18 (3.29) and 1.39 (2.19), respectively, and in placebo ECS patients (n=394) were 5.38 (3.29) and 1.13 (1.86), respectively. There were no significant differences in pain scores between groups at any assessment point, and no evidence for subgroup interaction by age, sex or anatomical extent of DVT. Results were similar in an analysis restricted to patients who reported wearing stockings every day. In conclusion, ECS do not reduce leg pain in patients with acute proximal DVT.
-
References
- 1 Pierson S, Pierson D, Swallow R. et al. Efficacy of graded elastic compression in the lower leg. J Am Med Assoc 1983; 249: 242-243.
- 2 Noyes LD, Rice JC, Kerstein MD. Hemodynamic assessment of high-compression hosiery in chronic venous disease. Surgery 1987; 102: 813-815.
- 3 Blattler W, Partsch H. Leg compression and ambulation is better than bed rest for the treatment of acute deep venous thrombosis. IntAngiol 2003; 22: 393-400.
- 4 Kahn SR, Shapiro S, Wells PS. et al. Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial. Lancet 2014; 383: 880-888.
- 5 Ginsberg JS, Hirsh J, Julian J. et al. Prevention and treatment of postphlebitic syndrome: results of a 3-part study. Arch Intern Med 2001; 161: 2105-2109.
- 6 Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs 2005; 14: 798-804.
- 7 Farrar JT, Young JP, LaMoreaux L. et al. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001; 94: 149-158.
- 8 Raju S, Hollis K, Neglen P. Use of Compression Stockings in Chronic Venous Disease: Patient Compliance and Efficacy. Ann Vasc Surg 2007; 21: 790-795.
- 9 Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres?. Pain 1997; /8 72: 95-97.