Varicose Veins

A common condition, varicose veins appear as swollen, twisted veins that are visible just under the skin’s surface. Although they usual occur in the legs, they also can form in other parts of the body. 

Varicose veins, characterized by large bulging veins usually visible in the legs, can occur in almost anyone. According to the Society for Vascular Surgery, the condition affects as many as 35% of Americans. Because standing and walking increase the pressure on the veins in the legs, these are the veins most frequently affected by varicose veins. For some people with the condition, concern simply centers on the appearance of the prominent veins. However, for others, varicose veins involve aching pain and discomfort and sometimes lead to more serious problems.

Factors that can increase your risk for developing varicose veins include family history, gender, older age, pregnancy, obesity, sedentary lifestyle and leg trauma. Weak or damaged valves in the veins can cause varicose veins. After arteries and capillaries deliver oxygenated blood to the body, the veins return the blood to the heart. Leg veins must work against gravity to achieve this. One-way valves within the veins allow blood flow, and then close to prevent blood from flowing backward. Damaged or weakened valves can allow blood to back up and pool in the veins, causing them to swell.

The walls of the veins are usually elastic. But weakening may cause them to lose their elasticity, becoming overstretched and causing the valves’ flaps to separate. When this occurs, blood can flow backward through the valves, filling the veins and stretching their walls even more. This causes the veins to swell and often twist as they attempt to squeeze into their normal space.

Symptoms of varicose veins include a heavy or aching feeling in the legs, burning, throbbing muscle cramping and swelling in the lower legs, skin discoloration around a varicose vein, increased pain after sitting or standing for a long period, and itching around one or more veins. Spider veins are similar to varicose veins but are smaller. Usually found closer to the skin’s surface, they can appear red or blue. They can occur in the legs, and often appear on the face. Your provider can usually diagnose varicose veins based on a physical exam alone.

Initial treatment for varicose veins typically involves lifestyle changes to prevent the condition from becoming worse, reduce pain, and reduce the chance for other varicose veins to form. Lifestyle changes can include avoiding sitting or standing for long periods of time. When sitting, avoid crossing your legs and keep legs elevated. Additionally, it’s important to perform physical activities to keep your legs moving and improve your muscle tone. This promotes blood movement through your veins. If you’re overweight or obese, losing weight will be helpful in improving blood flow and reducing pressure on you veins.

Avoid wearing tight clothes, particularly those that restrict your waist, upper thighs and legs. Tight clothing can exacerbate varicose vein problems. Also, avoid wearing high heels for extended periods. Your provider may recommend wearing compression stockings, which create gentle pressure on your legs, keeping the blood from pooling and decreasing the swelling in your legs.

In severe cases of varicose veins or when self-care fails, surgical interventions may be necessary. These treatments can include procedures such as sclerotherapy, performed in a doctor’s office, in which the doctor injects varicose veins with a solution or foam that scars and closes the veins. Laser treatments send strong bursts of light onto the affected vein, making the vein slowly fade and disappear.

Catheter-assisted procedures using radiofrequency or laser energy, usually reserved for larger varicose veins, is performed by insertion of a catheter into an enlarged vein and heating the tip of the catheter via radiofrequency or laser energy. As the catheter is removed, the heat destroys the vein by causing it to collapse and seal itself closed. High ligation and vein stripping, an outpatient procedure for most patients, involves tying off a vein before it joins a deep vein and removing the vein through small incisions. In ambulatory phlebectomy, the doctor removes smaller varicose veins through a series of tiny skin punctures. Used in advanced cases involving leg ulcers or when other techniques fail, endoscopic vein surgery, an outpatient procedure, uses a thin video camera inserted into the leg to visualize and close varicose veins and then removes the veins through small incisions.

If you have varicose veins, consult with your provider to determine the best methods of treatment for your particular condition. It will be beneficial to explore the options together with the benefit of your provider’s suggestions and your input.





Ithaca Primary Care

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