In the 1970s and 1980s, there were quite a few research studies suggesting that people who stood for long periods of time got more varicose veins
. These studies confirmed that people who stand a lot had worse varicose veins
than those who didn’t stand so much. However people then made the incorrect assumption that it was the standing that caused the varicose veins
. This was incorrect.
Research by Mark Whiteley from the 1990s has shown that teenagers who are susceptible to varicose veins
, lose the valves in their veins as they get older. By the age of 18, one in nine 18-year-olds were found to have lost their valves and therefore have "hidden varicose veins
" (venous reflux disease or venous incompetence). This meant that as they stand, blood that should be pumped back to the heart actually falls backwards down these veins, causing damage to the vein walls further down the leg, stretching the vein walls and causing varicose veins
When people are still young and the process has only just started, the veins are strong enough to withstand this constant battering. Therefore we call this state "hidden varicose veins
" as nothing can be seen on the surface, but duplex ultrasound
shows us that the valves are not working and blood is refluxing the wrong way down the veins on standing. Without duplex ultrasound
or another other medical test, it is impossible for anyone looking at the leg to know that are hidden varicose veins
When children grow up and go to work, many of those who have hidden varicose veins
will slowly start to develop visible varicose veins
. The speed at which these become visible will depend upon several factors. Some will never become visible because the veins are too deep. These are the veins that will go on to cause venous eczema
, skin discolouration at the ankles and leg ulcers
in later life.
Those that have tributary veins closer to the surface of the skin will start to see these as varicose veins
if these veins continue to dilate. Things that will cause this dilation to occur include; how many valves have been lost in the underlying veins, which veins are affected, the diameter of the veins, the strength of the vein walls and how often blood is allowed to reflux down the veins, hitting the walls of these veins and causing them to dilate.
In people who stand a lot at work, the heart is much higher than the ankles compared to someone who is sitting at work. Therefore the column of blood from heart to ankles which causes pressure on the vein walls is higher when standing, if there are no valves in the vein to interrupt this column of blood. Therefore when a person who has got hidden varicose veins
stands up, a surge of blood falls down the veins, hitting the walls of these veins under the skin and starting to stretch them. The longer someone is on their feet, the more often this happens and therefore the quicker these veins are likely to dilate.
Therefore it is not standing for long periods of time that causes varicose veins
. Rather if someone has already lost their valves due to their genetic make-up, then they are more likely to see varicose veins
early and to develop worse varicose veins
quicker if they have a job that makes them stand for long periods of time.
However people who have valves that work in their veins and who work in jobs where they have to stand for long periods of time, do not go on to get varicose veins
unless the valves fail.
Simply, standing for long periods of time does not cause varicose veins,
but if you already have “hidden varicose veins
” then standing for long periods of time will make your varicose veins