What are varicose veins?
Varicose veins are enlarged and twisted/gnarled veins in your body. Even though veins anywhere in your body can become like this, you will find that the veins close to the surface of your skin in the legs and feet are commonly affected. Although they don’t pose a threat to your health, for most people they are commonly a cosmetic concern. But if the varicose veins are associated with discomfort of any sort then they should be further investigated. Since these veins are raised and swollen, you can easily feel them and they are commonly bluish in color making them easily visible as well.
How common is the condition?
It has been found that varicose veins is found in about 25% of the adult population around the world. And the condition is more prominently found in women rather than in men.
What causes it?
Veins are the vessels in your body that return blood to your heart so that the arteries can carry them from the heart to the rest of the tissues. To carry the blood from your legs to the heart the veins in your legs have to work against the force of gravity. In order to make this possible there are two mechanisms that work together, one is the muscle pump of your legs and the other is the one way valves that are present within the veins. These two mechanisms ensure that the blood within the veins move only in one direction. Failure of the valves is the main reason behind the development of varicose veins. When the valves in your veins are not functioning properly, the blood starts to collect within the veins rather than travelling upwards towards the heart, causing them to swell up and become twisted. Risk factors include increased age, obesity, pregnancy as well as a strong family history of the disease.
Signs and Symptoms:
It is not always necessary to have symptoms accompanying varicose veins, because you will usually be able to see these misshapen and discolored veins in your legs. But occasionally you will find that there are other symptoms such as:
- A dull ache or heavy feeling of your legs
- The pain worsens after long periods of standing or towards the end of the day
- It is sometimes associated with cramping muscle pain or swelling at the ankles.
- Itching over or around the varicose vein
- Bleeding from the varicose vein
- Formation of ulcers in the ankle region
Bleeding from the varicose vein and ulceration of the skin around your ankles indicate that the vascular disease you have is at a severe stage and requires immediate medical attention.
Diagnosis:
The diagnosis of varicose veins is usually clinical, meaning that it is done through the information obtained from the history and the physical examination. In the history your doctor will ask you questions like previous illness related to blood vessels, family history of varicose veins as well as pain and ulceration in the past.
During the physical examination, your doctor will probably ask you to keep standing while he/she examines your legs and feet. Feeling along the length of them for the swollen vessels as well as for any tender areas on the leg. Sometimes they will carry out some tests that require them to tie several tourniquets around different regions in your leg and release them one by one observing the return of blood flow to your leg.
There will also be instances when you will be asked to do a Doppler Ultrasound scan, which is like any other normal ultrasound scan, that can detect any back flow within the veins as well detect the presence of any clots within the vessels. This test is mainly done if the doctor has advised you that the best form of treatment for you is to undergo surgery for the varicose veins.
Treating the condition:
If the varicose veins are not very severe, not causing you any discomfort but merely a cosmetic issue then your doctor will advise you on the non-surgical methods that are available to improve the condition, such as:
- Losing weight and exercising if you are obese
- Avoiding long periods of standing
- Sit with your legs elevated whenever possible
- Avoid wearing tight clothes that will further prevent the flow of blood upwards
- Wearing compression stockings daily, which apply extra pressure and will act along with your muscle pump in helping to move the blood in the upward direction. These stockings can be easily bought in your local drug store.
When these methods fail to improve the existing condition, or when you have complications such as bleeding or ulceration, then your doctors will advise you to try a more surgical approach, such as:
- Sclerotherapy – where your doctor will inject a solution or foam into your swollen veins which will cause them shrink and close up.
- Laser surgeries – where doctors use light energy to close up the vein.
- Venous ligation and stripping off the vein – is a surgical methods which requires anesthesia, where your surgeon will be making two incisions on either side of the swollen vein and removing it completely.
Which method of treatment you will be undergoing is a decision that you and your doctor should come to after weighing in all the pros and cons.
Long term care:
Following surgery you will be required to continuously wear compression stockings for a period of time to ensure proper circulation of blood within your venous system in the legs. And it is also necessary that proper care is given to incision sites.
Prevention:
Once the veins have started to swell up, it is usually very difficult to stop them from progressing and getting worse. But regular use of compression stockings and lifestyle modifications such as exercise, loose fitting clothes and losing weight can slow down the progression. And also result in the prevention of complications and therefore will result in better disease outcome.
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