Vanquishing varicose veins

Varicose veins are enlarged and twisting veins.  The term “varicose” literally means abnormally swollen or knotted.  They are usually most evident on the legs.  In general, varicose veins are not harmful; however, they can present cosmetic concerns and, in some, they may be symptomatic.    

Varicose veins are a common problem, occurring in about 10 to 20 percent of men and 25 to 35 percent of women.  The underlying problem is three-fold: dysfunction of the vein’s valves, increased pressure within the viens and weakened vein walls. The valves are designed to move blood up the leg and back to the heart.  They prevent blood from pooling in the legs due to gravity.  

Leg muscle movements help to “milk” the blood upward within the veins.  This is one of the main factors in proper venous circulation.  Picture the valve as an upside down “V” in the venous tube.  Blood is pushed up sequentially through each valve and eventually makes it back to the heart.   

In persons with varicose veins, the valves are weak and don’t keep the blood moving upward.  This allows excess pooling of blood and over time the vein becomes swollen and distorted.  Anything that increases the pressure in the veins can worsen the problem.  This includes prolonged standing, obesity, pregnancy and anything that blocks the veins, such as previous blood clots, growths/tumors or previous surgeries.   

For many people, varicose veins are simply an annoying cosmetic issue.  For others, they can be a source of symptoms such as discomfort, a heavy aching in the legs, an itching/burning sensation, swelling and even skin ulcers.

There seems to be a genetic predisposition to developing varicose veins.  But, there are many things you can do to diminish their severity.  The best step is exercise.  As I stated earlier, leg muscle motion promotes circulation of blood up and out of the legs.

Weight loss can also aid in controlling the development and severity of varicose veins.  Excess weight will increase the pressure within the abdomen and this translates to increased venous pressure in the legs.  This is why many pregnant women will develop varicosities during their pregnancy.

Avoid tight belts and clothes with tight waistbands.  These can interfere with proper blood flow.  Compression stockings worn on the legs can be helpful.  Several different types are available and grades vary depending on the severity of the varicose veins.  Heat from sun-bathing, saunas, hot tubs and tub baths can also dilate and aggravate the veins.

Standing in one place for prolonged periods  of time will exacerbate varicose veins.  If your job necessitates extended standing, try to exercise your legs with tip-toe push ups with your legs.  Take every break opportunity to walk around and stretch your legs.  Elevating the legs will help temporarily.  However, the legs should ideally be higher than the heart.  Just sitting in a chair with your legs propped up can cause blood to pool in the pelvic region.    

Surgical treatment for varicose veins includes laser treatment (usually used on smaller veins), sclerotherapy (injecting the veins with a chemical to cause it to collapse), endovenous obliteration (using energy through a catheter within the vein to collapse the vein) and surgery (tying off the vein and/or removing it entirely).  

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.

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