Your veins have the important job of returning blood back to the heart. Because being on your feet for a long time can make it harder for the veins in your legs to pump against gravity, jobs that require prolonged standing may increase your risk for varicose or spider veins.
“Think about your vein as a column of blood. If you’re standing, all the blood is in a pool in your feet,” explained Sophia Afridi, MD, ProMedica Physicians Jobst Vascular. “Over time, that’s going to stretch the vein open and the valves in the vein won’t be functional. If you overwhelm that pump system, the veins become leaky and blood overflows to the veins under the skin.”
Dr. Afridi compares leaky veins to the flippers at the bottom of a pinball machine. In a healthy vein, the one-way valves in a vein come together to prevent blood from flowing back into the legs. In a stretched vein, the valves separate like pinball flippers, allowing the blood to flow backward between them just as a pinball may fall between the flippers. This can lead to varicose or spider veins.
The two conditions – varicose and spider veins – are more or less the same disease on a different spectrum.
“Spider veins are the capillaries that are more prominent under the skin. Varicose veins are larger veins that have become more extended,” explained Dr. Afridi. “It’s more or less the same etiology, but the size of the vein dictates whether it’s a spider or varicose vein.
Although 60% of varicose and spider vein cases are genetic, certain lifestyle issues can predispose you to these conditions. Consistently standing for long periods is one of them. That’s why Dr. Afridi often sees teachers, nurses, physicians and factory workers with these vein issues. Women who are pregnant and people who are overweight also have a higher risk because of the added pressure on the veins.
Reducing Your Risk
If your job has you on your feet for hours, you may want to consider compression stockings, which put pressure on the outside of the vein to keep the vein walls from expanding and stretching the vein out. You can find these in a variety of stores and even online, but the quality will vary.
“For compression stockings, ideally they need to be prescription strength,” said Dr. Afridi. “If you have no family history of vein issues and you’re just worried about general maintenance, over-the-counter compression stockings are OK. But you need at least 20-30mmHG to make a difference.”
A prescription for compression stockings from a primary care provider or vascular specialist is likely to be covered by insurance. Plus, you can take it to a medical supply store to be measured to ensure the right fit. If the stockings hurt or don’t fit properly, you’re less likely to wear them or they won’t work as they should.
In addition to compression stockings, elevating your legs may help prevent veins from stretching and reduce the achy, tired feeling in your legs at the end of the day.
“The feet have to be above the heart,” explained Dr. Afridi. “Ideally, you could lay on the floor and put your feet up on the wall for at least 5-10 minutes. Or, when you get home if you lay on the couch, put your feet up on the arm of the couch for at least 5-10 minutes.”
Treatments for Varicose and Spider Veins
It’s easy to blame long days on concrete floors or even aging for an achy, heavy feeling in your legs. But this can be a sign of venous disease, especially if you notice swelling or see varicose or spider veins.
“If you try stockings or elevate your legs and you notice an improvement, or if you feel better on the days you’re not working or it’s normal in the morning but gets worse as you’re on your feet, you may have an issue with your veins,” said Dr. Afridi.
Talking with your doctor or a vascular specialist can help you learn more about your symptoms and your treatment options.
“A lot of times we are able to make a difference in your quality of life with minor lifestyle changes, such as wearing compression stockings, losing weight, exercise, elevating the legs,” explained Dr. Afridi. “If those changes don’t work for you, there are some procedures that are minimally invasive with a limited downtime of typically three days off of work. They are done in outpatient settings, easy to recover from and usually have good results.”
Prevention, however, is key, especially if you are at a higher risk for varicose or spider veins.
“If you know you have a family history or you’re in one of those occupations that keep you on your feet, wearing compression stockings early on is the best thing to do to prevent symptoms from developing,” said Dr. Afridi.