Varicose veins are basically gnarled & enlarged veins. While any vein may be likely to become varicose, most commonly affected veins which become varicose are those in legs & feet. This is generally because standing & walking upright increase pressure in veins located in lower body. Spider veins, for many people are a common & mild variation of varicose veins & are simply a cosmetic concern. However, for many other people varicose veins cause discomfort & aching pain. Quite often, varicose veins also lead to more serious problems. Apart from these varicose veins also signal higher risk of circulatory problems. Treatments of varicose veins involve a number of self-care measures & surgical procedures by surgeons so as to close or remove veins.
Signs & Symptoms of Varicose Veins
Although varicose veins do not cause any pain, they display many signs & symptoms which are listed below.
- Veins appear blue or dark purple in color.
- Veins look bulging & twisted & often like cords on legs.
- Heavy or achy feeling in legs.
- Muscle cramping, throbbing, burning & swelling in legs.
- Pain is worse after standing or sitting for a long time.
- Itching sensation around one or more veins.
- Bleeding from varicose veins.
- Red discoloration of skin with painful cord in vein.
- Color changes & hardening of vein.
- Inflammation of skin or skin ulcers near ankle which denotes that the patient is suffering from a serious type of vascular disease which requires medical attention.
Spider veins are quite similar to varicose veins, but are smaller. Moreover, spider veins are located closer to skin’s surface & are most often red or blue in color. Spider veins occur on legs, but are also at times found on face. Apart from varying in size, they often look like a spider’s web.
Causes of Varicose Veins
While arteries carry blood from heart to all tissues of the body, veins return this blood from tissues to the heart as circulation. Veins in legs must therefore work against gravity so as to fulfill returning blood to heart. Muscle contraction within lower legs act like pumps & elastic walls of veins help blood return to heart. Tiny valves within veins eventually open as blood flows towards heart & subsequently close so as to stop blood flowing backward into legs.
Common Causes of Varicose Veins
- Age – Veins lose elasticity & eventually stretch as people get older. Valves within veins also become weak & may therefore allow blood moving towards heart to flow backwards. Blood therefore pools in veins which enlarge & become varicose. Quite often these veins appear blue as they contain deoxygenated blood which is stuck up in the process of being re-circulated through the lungs.
- Pregnancy – Quite a few pregnant women also develop varicose veins. Pregnancy normally increases the volume of blood within the body, while decreasing the flow of blood from legs to the pelvic region. This change in circulation pattern of blood is designed to support the fetus which is growing. However, it can produce an unfortunate condition resulting in enlarged veins within legs of pregnant women. Varicose veins may therefore surface for the first time or worsen during late pregnancy due to the uterus exerting greater pressure on veins within legs. Apart from this, changes in levels of hormones during pregnancy may also play a part in developing varicose veins which generally improve without any medical treatment in 3 – 12 months time after the woman has given birth to the child.
Diagnosis of Varicose Veins
When self-care like exercise & elevating legs or wearing compression stockings do not help to ease pain of varicose veins, consulting a doctor may help patients prevent further deterioration. It is time to see a doctor when patients are concerned & all self-care measures have not been able to stop this condition from getting worse.
- Doctors will do a physical examination so as to diagnose varicose veins. This will include looking at legs while the patient is standing so as to check for swelling. Doctors may also ask patients to describe pain & aching in their legs.
- Patients may also need to undergo an ultrasound test so as to see if valves in veins of legs are functioning normally or if there is any evidence of blood clots. This is a noninvasive test where the lab technician runs a transducer, which is a small hand-held device about the size of a soap-bar, against the patient’s skin over the area where the patient needs to be examined. This transducer transmits images of veins in legs to a monitor which helps technicians & doctors understand the situation.
Treatments for Varicose Veins
The good news is that treatment for varicose veins does not require any hospital stay or lengthy & uncomfortable recovery. Less invasive procedures can generally be employed as treatment for varicose veins on an outpatient basis.
- Self-Care – These include exercising, elevating legs, losing weight, not wearing tight clothes & avoiding sitting or standing for long periods of time. This can often relieve pain & prevent varicose veins from further worsening.
- Compression Stockings – Wearing compression stockings throughout the day is most often the first approach for varicose veins before moving on to other types of treatment. Compression stockings steadily squeeze legs & help blood circulate more efficiently within veins & leg muscles. Amount of compression however varies according to the type & brand. Compression stockings are available at many pharmacies & medical supply stores. Prescription-strength stockings are also available at most of these stores.
Treatments for Severe Varicose Veins
Patients who do not respond to compression stockings or self-care or those whose varicose veins conditions are more severe are suggested by doctors to undergo one of the following additional treatments.
- Sclerotherapy – This is a procedure where doctors inject small & medium sized varicose veins with a solution meant to scar & close these veins. Treated varicose veins should fade after this within a few weeks time. Sometimes, the same vein may however be needed to be injected more than once. Sclerotherapy is generally effective if it is performed correctly. Moreover, sclerotherapy does not require administration of anesthesia & can be done at a clinic.
- Foam Sclerotherapy for Large Veins – Injecting large veins with foam solution is also a possible treatment which can close veins & effectively seal them. However, this is a newer technique which is now practiced.
- Laser Surgeries for Varicose Veins – Surgeons are now using another new technology which involves laser treatments so as to close smaller spider veins & varicose veins. Strong bursts of light are targeted onto veins through lasers which make veins fade slowly & disappear. However, no needles or incisions are used for this purpose.
- Catheter Assisted Procedures Using Radiofrequency or Laser Energy – Surgeons insert a thin tube called catheter into the enlarged vein in this procedure. The tip of the catheter is heated using either laser energy or radiofrequency. When the catheter is pulled out, heat at the tip destroys the vein by causing it to collapse & seal shut at the same time. This procedure however, is a preferred treatment for large varicose veins.
- High Ligation & Vein Stripping – This treatment procedure involves tying off the vein before it joins the deep vein. The vein is also subsequently removed through a small incision. High ligation & vein stripping is an outpatient procedure for most people. However, removal of vein does not adversely affect circulation in legs since veins located deeper inside leg take care of large volumes of blood.
- Ambulatory Phlebectomy – Surgeons remove small varicose veins through a series of tiny punctures made in skin for this purpose. Parts of leg which will be pricked during treatment are generally numbed for this outpatient procedure. Scarring also is normally minimal following ambulatory phlebectomy.
- Endoscopic Vein Surgery – This operation is only done in advanced cases of varicose veins involving leg ulcers. Normally performed when all other techniques have failed, surgeons during this procedure use a thin video camera which is inserted in leg so as to visualize & close varicose veins. These varicose veins are then removed through small incisions. Endoscopic Surgery is usually performed as an outpatient procedure.
Recovery from Varicose Veins Treatment
Although it is hard to believe, veins which are essential to body’s circulatory system can turn into varicose veins. Since superficial veins are closer to surface of skin & not a necessary part of blood circulation can be effectively treated without harming the systems of the body. Moreover, improvements can be impressive when they are treated while they are still small. While most mild cases require only about two treatment sessions, moderate varicose veins may need 3 – 4 treatment sessions. Patients may feel some stinging at the injection site for about an hour following varicose veins treatment & will be up & back on their feet again the next day. However, they will need to wear full pants since bruising can last for up to 2 weeks of time.
Varicose Veins Risk Factors
Following factors increase risk of developing varicose veins.
- Age – Risk of developing varicose veins increases as people age. Aging normally causes wear & tear on valves in veins which help in regulating blood flow. This wear & tear causes valves to allow some blood to flow back into veins where it collects instead of flowing upwards to the heart.
- Gender – Women are found to be more likely to develop varicose veins. Premenstruation, hormonal changes during pregnancy or menopause are also risk factors as female hormones have a tendency to relax vein walls. Taking birth control pills or undergoing hormone replacement therapy might also increase risk of developing varicose veins.
- Obesity – Being overweight adds extra pressure on veins & especially on veins within legs.
- Family History – There is a greater chance of a person developing this condition when other members of his family are having varicose veins.
- Sitting or Standing for Long Periods of Time – Staying in the same position for long periods of time does not allow proper blood circulation.
Complications of Varicose Veins
Although rare, complications of varicose veins include the following.
- Ulcers – Extremely painful ulcers can form on skin nearby varicose veins, especially near ankles. These ulcers are generally caused by long-term fluid buildup within these tissues that is caused by increase in blood pressure within the affected veins. A discolored spot on skin is usually first formed before appearance of an ulcer. Varicose veins patients must therefore immediately see a doctor when this complication develops.
- Blood Clots – Sometimes, veins which are deep within legs become enlarged. Affected leg may also considerably swell in such cases. Sudden leg swelling therefore warrants urgent medical attention since it may also indicate a blood clot & which is a medical condition known as thrombophlebitis.
- Bleeding – Veins located close to surface of skin may also occasionally burst. While it usually causes only minor bleeding, this may warrant medical attention as there is high risk that it may happen again.
Quite a few people progress from having no symptoms to development of varicose veins & then further on to problems like leg swelling & finally to ulcers which are caused by stagnant blood flow.
- Small number of such cases may have deep vein clots which developed during the progression & which could be the cause of signs & symptoms; but this is not so in most cases.
- More severe problems like skin ulcers are therefore very difficult to effectively prevent. These ulcers are also very difficult to cure once they occur.
- Quite often even after elimination, these ulcers ten to recur.
Blood clots within deeper veins have the potential to travel through blood stream & eventually lodge inside lungs. This condition is called pulmonary embolism. However, pulmonary embolism does not occur from development of varicose veins.
- Pulmonary embolism is a life-threatening condition as blood clot can interrupt circulation of blood in the body.
- Common pulmonary embolism symptoms include pain in chest & shortness of breath.
Varicose Veins Preventive Measures
Changing genes is beyond human control, but patients can definitely take certain preventive measures so as to avoid developing varicose veins. These include regular exercise, keeping weight under control, eating a healthy high-fiber diet & trying to stick to loose, & comfortable clothing as far as possible. However, individuals who are genetically inclined to develop varicose veins may still develop this condition despite all efforts. Wearing Thromboembolism-deterrent (TED) stockings are the best nonsurgical treatment method for varicose veins. These effectively prevent breakdown of skin & worsening of varicosities. Most patients also experience less tiredness & decreased swelling in feet at the end of the day by using TED stockings.
Varicose Veins Treatment Outcome
Varicose veins will not go away without treatment. They will require treatments like ligation, sclerotherapy & stripping. Quite often these veins may even seem more prominent in warm weather. Nevertheless, once they are here, they will not fade away on their own. Prevention, in fact is the key & patients must begin modifications in lifestyle which are outlined in self-care instructions. These will improve chances of preventing newer varicose veins from forming. Moreover, in some cases varicose veins may only be just one stage in the continuum of chronic poor functioning of veins.
Varicose Veins Treatment in India
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