July 2019

STANDING ON THE JOB: How at-risk occupations put a strain on veins

Cindy Asbjornsen, DO, FACPh

version of this article first appeared in Vein Health News, a magazine published by the Vein Healthcare Center. Dr. Asbjornsen is the founder of Vein Healthcare Center and the Editorial Director for Vein Health News and certified by the American Board of Venous and Lymphatic Medicine. She cares for all levels of venous disease, including spider veins, varicose veins and venous ulcers.

Nurses and doctors. Teachers, hairdressers, and food servers, not to mention, bank tellers, assembly line workers, toll collectors, pharmacists – there are many occupations where people are on their feet for hours on end. These jobs often take a physical toll, especially on the legs and feet. One reason for discomfort in the lower extremities is poor circulation, but what exactly does that mean?

The major parts of the circulatory system (also known as the cardiovascular system) are the heart, arteries and veins. The heart pumps blood to the arteries, which take the oxygenated blood to all parts of the body. Healthy veins carry deoxygenated blood back up to the heart, and the “muscle pumps” in our feet and calves help blood travel against gravity.

If you are standing on your feet all day, your circulatory system may not work as efficiently as it should. And if you have venous (vein) issues, the problem can be exacerbated. In leg veins, there are valves that open to allow the blood to flow one way: up. If the valves in the veins become damaged, some blood will flow back into the legs or feet and “pool” there, resulting in a feeling of heaviness, leg pain, varicose veins or other symptoms. This is sometimes referred to as venous congestion or reflux.

Recognizing the symptoms
Karen Bragdon, 53, is a Physical Therapist and Orthopedic Certified Specialist at York Hospital in Wells, Maine. Her tasks vary depending on her caseload, but on average she’s on her feet 80 percent of the day.

At first Bragdon noticed “very unsightly bulging veins” in her legs, behind the knees and at the ankles. But there were other symptoms showing up that she did not realize were warning signs of venous disease. By the end of the workday, her feet and legs would be extremely tired and, many times, swollen. She also began having leg cramps at night. A runner, she also realized that running wasn’t feeling as good as it used to, either during or afterward.

Bragdon’s leg problems – both visible and not-so-obvious – gradually became worse, until a new condition presented itself, one she affectionately named “twitchy legs.”

“I started having this annoying thing happen more and more where I constantly had to fidget,” she said. “I could not stop moving my legs, even when I was just sitting on the couch watching TV.”

Bragdon didn’t put all the pieces together until she was talking to one of her patients who had experienced similar symptoms before she sought vein treatment. After her “a-ha” moment, Bragdon made an appointment for a consultation with a Board certified phlebologist.

A diagnostic ultrasound confirmed venous reflux; the vein valves in both legs were not functioning properly, her left leg worse than the right leg. The treatment plan included endovenous laser ablation (EVLA) to fix the reflux on Bragdon’s left leg and ultrasound-guided sclerotherapy to treat the source of the dysfunctional vein valve on the right leg. She described both procedures as “a piece of cake.”

Four months later and her leg twitching and nighttime cramping were 90 percent gone. Bragdon’s stamina at work has improved, and her body continues to reabsorb the once-faulty veins as she awaits her final check-in with the phlebologist this Fall.

“I encourage anyone to get a consult if they’re having any questions about possible symptoms – or chronic issues with their legs,” said Bragdon. “The biggest surprise to me was that all of those things that I was feeling could be caused by veins.”

Bragdon’s experience is far from unique. Several studies in the past five years have attempted to investigate the prevalence of varicose veins among professionals who work long hours on their feet.

Vein specialists’ number one suggestion for people on their legs all day is to wear a good, trusted brand of medical graduation compression stockings. In addition to preventing leg swelling and fatigue, wearing compression can also be a good diagnostic tool. If the compression makes a profound difference, it may be aiding a “hidden” venous issue, one that could be very treatable.


Learn about the Juzo compression stockings and socks that can help those suffering from poor circulation and working long “on-your-feet" shifts.