How they actually differ
The word "compression" appears in both names, which causes confusion. But the mechanisms are fundamentally different.
Compression socks (and stockings) use graduated static pressure. The fabric is tightest at the ankle and gradually looser toward the knee or thigh. This constant squeeze helps support your veins' one-way valves, making it slightly easier for blood to flow upward against gravity. The pressure is always on, always the same - typically 15-30 mmHg for over-the-counter pairs and up to 40+ mmHg for medical-grade.
Pressotherapy uses dynamic sequential compression. Inflatable chambers fill with air one after another, creating a wave of pressure that physically pushes fluid from your feet toward your heart. Then the chambers deflate and the cycle repeats. The pressure is active, rhythmic, and significantly more forceful - typically 20-80 mmHg in pulsing waves.
The analogy: compression socks are like holding a sponge (constant gentle pressure). Pressotherapy is like squeezing a sponge in a wave motion (active pumping). Both move fluid, but one does dramatically more work.
Side-by-side comparison
| Factor | Pressotherapy | Compression Socks |
|---|---|---|
| Compression type | Dynamic, sequential (active pumping) | Static, graduated (passive support) |
| Pressure | 20-80 mmHg, pulsing waves | 15-40 mmHg, constant |
| Lymphatic drainage | Actively drives lymph flow through vessels | Mild support - doesn't actively pump |
| Venous return | 200-300% increase during treatment | Modest improvement (~20-30%) |
| Swelling reduction | Rapid, significant - visible after one session | Gradual, preventative - slows swelling progression |
| Muscle recovery | Strong evidence for reducing DOMS | Mixed evidence - some benefit reported |
| Wearability | Sessions only (20-30 min) | All day, every day - under normal clothes |
| Portability | Home use (some portable models) | Wear anywhere - no device needed |
| Comfort | Relaxing massage-like feeling during sessions | Can feel tight, especially in warm weather |
| Price | £50-£1,200 (one-off device cost) | £10-£50 per pair (replace every 3-6 months) |
| Medical evidence | Extensive for DVT prevention, lymphoedema, recovery | Well-established for DVT prevention and mild varicose veins |
| Best for | Active recovery, lymphoedema treatment, post-exercise | Daily prevention, travel, long periods of sitting/standing |
What the research says
Compression socks
Graduated compression stockings have strong evidence for preventing DVT during long-haul flights and in hospital patients. They're recommended by NICE (National Institute for Health and Care Excellence) for managing mild varicose veins and chronic venous insufficiency. For sports recovery, the evidence is more mixed - a 2017 meta-analysis in Sports Medicine found small but statistically significant benefits for reducing DOMS, though the effect size was modest compared to active compression.
The key limitation: compression socks can only support your existing circulatory function. They can't actively drive fluid the way sequential compression does. This matters most when circulation is significantly impaired (lymphoedema, severe oedema, immobility).
Pressotherapy
Intermittent pneumatic compression (IPC) has decades of clinical evidence. It's a standard hospital treatment for DVT prevention in surgical patients and a first-line therapy for lymphoedema. For sports recovery, the 2023 meta-analysis in the International Journal of Sports Physiology and Performance demonstrated significant reductions in DOMS and faster restoration of muscle function. The active pumping mechanism means pressotherapy can move substantially more fluid per minute than static compression alone.
When to choose each
Choose pressotherapy if you...
- Need active treatment for swelling or lymphoedema
- Want post-exercise recovery that actually clears metabolic waste
- Have significant fluid retention or heavy legs
- Are recovering from surgery (with medical approval)
- Find compression socks alone aren't managing your symptoms
- Want the most effective recovery tool available at home
Choose compression socks if you...
- Need all-day support during work or travel
- Want to prevent swelling rather than treat existing swelling
- Fly frequently or sit for long periods
- Have mild varicose veins or spider veins
- Want something cheap, simple, and always available
- Are pregnant and need gentle circulatory support
Can you use both?
The best approach for most people
Yes - and for many conditions, using both is the recommended medical approach. This is especially true for lymphoedema management, where the clinical protocol is: pressotherapy to actively reduce swelling, then compression garments to maintain the reduction throughout the day.
For athletes: use pressotherapy after training for active recovery (20-30 minutes), then wear compression socks during the rest of the day or during travel to support ongoing circulation.
For circulation issues: pressotherapy sessions several times a week for treatment, compression socks daily for maintenance between sessions.
Important: Do not wear compression socks during a pressotherapy session. Remove them before putting on the device to ensure even pressure distribution.
Our recommendation
If you already wear compression socks and feel they're not doing enough for your symptoms (still getting heavy legs, persistent swelling, slow recovery), pressotherapy is the logical upgrade. It doesn't replace your socks - it adds the active treatment component they can't provide.
If you're choosing your first compression product, start with what matches your primary need. For daily prevention and comfort during long days, compression socks are the practical first step (£15-30). For active recovery after sport or treatment of existing swelling, go straight to pressotherapy.
If you have lymphoedema or chronic oedema, you likely need both. Speak to your lymphoedema specialist about a combined protocol.
Frequently asked questions
No. Remove compression socks before using a pressotherapy device. The device needs even contact with your skin (or thin clothing) to distribute pressure correctly. Wearing compression garments underneath could create uneven pressure or restrict the sequential compression pattern.
For different purposes. Compression socks provide mild, continuous support ideal for daily wear during long periods of sitting, standing, or travel. Pressotherapy delivers more intensive, therapeutic treatment that actively pumps fluid. For recovery, lymphoedema, or significant swelling, pressotherapy is substantially more effective. For all-day prevention, socks are more practical.
For general comfort, travel, and mild symptoms, over-the-counter socks (15-20 mmHg) are fine. For diagnosed venous conditions, significant swelling, or post-surgical use, your GP or vascular specialist may prescribe medical-grade stockings (20-40 mmHg). These are sometimes available on the NHS.
Compression socks lose their elasticity over time. Most manufacturers recommend replacing them every 3-6 months with daily wear. Medical-grade stockings may last slightly longer with proper care (hand washing, air drying). A pressotherapy device, by comparison, typically lasts 3-5+ years, making it more cost-effective for long-term use despite the higher upfront cost.
Compression garments are part of the standard lymphoedema management protocol, but they play a maintenance role - keeping swelling down after it's been reduced by active treatment (manual lymphatic drainage or pressotherapy). On their own, compression socks rarely reduce lymphoedema significantly. The recommended approach is active treatment + daily compression garments.