Varicose veins are enlarged and twisted veins most commonly affecting the veins of the legs. This article gives a detailed view of varicose veins.
Varicose veins are large, ugly-looking veins in the legs that can cause pain, itching, skin darkening, and even skin ulceration over the feet. Varicose veins mostly affect the veins of the legs because walking and standing can increase the pressure in the veins of the lower body. Superficial veins can become varicose. For some people, they are only a cosmetic concern. And in some cases, they cause discomfort, pain, and some serious problems. They are also known as varicosities. They are usually uncomfortable and make people look embarrassed.
The symptoms of varicose veins include:
Serpent-like veins (purple or blue color veins) in the legs are seen especially after standing for a long period of time.
Pain in the calves.
Pain gets worse after sitting or standing for a long time.
Skin darkening over the feet.
Itching around one or more veins.
Muscle cramping and swelling in lower legs.
Muscles of the legs may feel tired and heavy.
Spider veins look like the varicose veins but they are smaller. Spider veins can affect the veins of the legs and face and have a spider web-like appearance. They are found close to the surface of the skin and spider veins are purple or blue. Spider veins are not painful.
The factors which increase the risk of varicose veins include:
Age: Old age can cause wear and tear of the valves of the veins which can cause the pooling of blood.
Sex: Women are more likely to get varicose veins. Being pregnant, taking a birth control pill, and having menopause can increase the risk of varicose veins.
Family history: There is a high risk of varicose veins in a positive family history of varicose veins.
Obesity: Being overweight can increase the pressure on the veins of the legs.
Pregnant: Some pregnant women get varicose veins because the blood volume increases during pregnancy which in turn causes enlarged veins. They go away on their own after the delivery.
Sitting or Standing for a Very Long Period:It decreases the circulation and causes varicose veins.
Smoking: People with tobacco use and smoking are more likely to get varicose veins.
Constipation: Chronic constipation and some tumors can increase the pressure in the legs leading to varicose veins.
The two groups of veins in the feet are superficial and deep systems. These veins have valves in them, which prevent blood backflow. When these valves in the superficial venous system of the leg start malfunctioning, it results in superficial venous reflux. The blood pools in the legs increase venous pressure, causing dilated and tortuous veins. Any condition which puts more pressure on the legs can result in varicose veins.
A clinical examination and venous Doppler ultrasound would be able to diagnose this condition. A venous Doppler ultrasound is a diagnostic test that uses sound waves to examine the blood flow of the veins through the valves. This test is done by moving a transducer (small handheld device) against the skin of the legs. The transducer sends images of the veins to the monitor.
Treatment includes simple self-care measures, compression stockings, and surgeries.
Self-care: Raising the legs when sitting or lying down and exercising can help reduce the pain or prevent them from getting worse.
Compression Stockings: Wearing compression stockings can improve the blood flow to the leg. Compression stockings are mostly available at all medical stores.
Surgery: If self-care and compression stockings did not work, the physician recommends surgery or other procedure.
Traditionally, open surgery, stripping, and ligation of the great saphenous vein were the only treatments available. But this would be an extensive surgery and can cause a large scar on the thigh. Microphlebectomy is the insertion of special surgical tools through minor cuts and removing the varicose veins. They are done alone or with vein stripping.
Treatments like minimally invasive ablation of the long saphenous vein are done by a pinhole puncture in the lower thigh. These treatments effectively manage this condition and leave no scars behind, and it is a daycare procedure.
Sclerotherapy is a procedure in which the doctor injects a solution or foam into the veins which closes the varicose veins. They need one or two injections and can be done without local anesthesia. Sclerotherapy can cause side effects like redness in the area of the skin in which the needles are inserted.
This condition can progressively worsen and cause the veins to become larger, and the skin over the feet can become dark and eventually break open, causing an ulcer. Sometimes, the enlarged veins can cause blood clots, or the veins may burst, resulting in minor bleeding. Phlebitis is one of the complications, which is the inflammation or swelling of the veins.
Improving the blood flow to the legs can reduce the varicose veins. The following can be done to prevent varicose veins:
Avoid standing for a long time.
If your job requires standing for a long time, wear compression stockings.
Avoid sitting cross-legged for a prolonged time.
Raise your legs when sitting or lying down.
Changing positions when sitting for a lengthy time.
Regular exercises, like walking, would help.
Avoid high heels.
Maintaining a healthy weight.
Eating a high-fiber diet.
Reducing the salt intake.
Avoid tight clothing.
Quit tobacco use.
During pregnancy, sleeping on the left side rather than on the back can improve blood flow.
Varicose veins get worse over time. But they do not cause any long-term medical problems. They mainly cause esthetic issues and in some cases discomfort and pain.
Varicose veins are usually treatable but they can return in some cases if the patient is overweight and has a sedentary lifestyle.
Varicose veins are caused by the abnormal functioning of the valves in the superficial veins due to their weakness or damage. This leads to backflow and pooling of blood in the veins, making them dilated and twisted.
Varicose veins are treated by conventional invasive methods of ligating the saphenous vein through surgery. Other minimally invasive techniques available are laser surgery, endovenous ablation therapy, endoscopic vein surgery, sclerotherapy, and microsclerotherapy.
No, the varicose veins do not go away. But, the development of new varicose veins and the condition of the existing ones can be controlled.
If left untreated, the varicose veins will become worse as the condition progresses and the development of new varicose veins occur.
Yes, drinking water helps in making the blood thinner and in better blood circulation. It also helps in making the muscles supporting the veins strong and controls the swelling and blocking of the veins.
Avoid wearing high heels and tight hosiery, prolonged sitting or standing, a high-salt diet, sedentary activities, being overweight, and keeping feet down for long.
Varicose veins should be massaged as massaging them helps in relieving swelling and pain temporarily, but it does not provide the permanent treatment of the condition.
Varicose veins can be prevented from getting worse by working out regularly, maintaining appropriate body weight, avoiding tight-fitting garments and sitting or standing posture for a long time, wearing compression socks or stockings, and keeping feet at a raised position.
Coffee contains a high amount of caffeine which decreases blood flow to the peripheral tissues and increases blood flow to the heart and the brain. This, along with malfunctioned vessel walls and constricted blood vessels, further damages the existing varicose veins.
While sleeping, the legs should be elevated by keeping pillows or cushions under the legs.
The pain in the varicose veins worsens at night because of the pooling of blood caused during the day due to prolonged sitting or standing positions.
Heat has a negative effect on varicose veins as heating causes dilatation of blood vessels more pooling of blood, and thus, aggravating the symptoms. Whereas ice or cold therapy helps in relieving the symptoms by constricting the blood vessels and decreasing swelling and other related manifestations.
Vitamins C and E act as powerful antioxidants, and vitamins B3 and B12 improve blood circulation by reducing cholesterol. Vitamins B complex and E also help repair varicose veins, so they should be taken consistently.
Ibuprofen and other over-the-counter painkillers and anti-inflammatory drugs alleviate pain and swelling in varicose veins.
If a varicose vein bursts, then immediately the affected leg should be raised, and pressure should be applied at the bleeding site with a towel or a cotton cloth. Secondly, the doctor should be consulted, and accordingly, the required treatment can be given.
Besides experiencing the usual manifestations of varicose veins, the warning signs are painful and hot veins, bleeding, discoloration of the skin, sores, ulcers, consistent swelling, and pain.
A burst varicose vein usually causes the overlying skin to rupture, leading to mostly rapid and profuse bleeding. But, in certain cases, the skin may remain intact, and there may be internal bleeding causing bruising.
The sensations followed by the bursting of a varicose vein include bruising or bleeding, increased swelling and pain, dizziness, fatigue, and even fainting.
The commonly seen symptoms of varicose veins are purple or bluish discoloration of veins accompanied by bulging and tortuous appearance. There may be pain, heaviness, swelling, itching, and muscle cramping. The pain aggravates after prolonged standing or sitting position.
Yes, walking is beneficial for those having varicose veins as it strengthens the muscles and improves circulation without straining the body.
Last reviewed at:
10 Jun 2022 - 4 min read
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