Varicose Veins

What Are Varicose Veins and What Causes Varicose Veins?

Abnormally enlarged non-working leg veins are varicose veins. The most common questions people have are what causes varicose veins, how can they be prevented, why do they cause pain and how can they be treated.First understand that arteries carry blood from the heart out to all the parts of the body. The veins function is to return the blood from the body back to the heart. This is constantly occurring and most often functions very effectively. The blood from the legs has a more difficult time returning to the heart then blood elsewhere. This is due to a variety of factors, including:

  • Blood in the leg veins has to travel “uphill” against gravity
  • It has to flow against the bodies weight
  • It must travel a few feet in distance to reach the heart
  • It lacks a continuous heart-like pump to push it, although the muscles of the legs, when contracting, squeeze the veins and thus help act as a ‘calf-pump’ to aid blood flow
Varicose veins always have non-working valves, which allow blood to collect in the legs instead of returning upwards towards the heart. Normally, the leg veins have working one-directional valves to help keep the blood circulating correctly. The vein valves however, can stop functioning and create a situation where the blood is flowing backwards into the leg due to the forces of gravity and weight. This is a major cause of varicose veins.
These varicose veins become increasingly enlarged, and often appear as ropey and tortuous blood vessels. Varicose veins can occur anywhere in the legs but are most often seen in the lower leg and on the inner thighs. This flowing in the wrong direction and ‘holding’ of blood in the legs is also called venous insufficiency. The situation often snowballs with the veins becoming more and more varicose over time.

What Causes Varicose Veins

All of these factors may cause varicose veins to occur in the legs.

  • Family history- some patients have a family history of venous insufficiency and varicosities and if it is a genetic condition its ‘in the genes’. We see more women who say their fathers had enlarged veins then their mothers but there is no scientific study to date to support this.
  • Pregnancy- some women develop varicose veins with pregnancy for a variety of reasons, including
    1. Increased pressure on the veins
    2. Increased blood volume while pregnant
    3. Hormonal changes that effect the circulation
    4. The constantly enlarging uterus that only adds more pressure and weight to the leg veins
  • Prior blood clots (Phlebitis)- a history of phlebitis, a blood clot in the deep or superficial veins, even if it was never diagnosed and healed on its own also can scar the one-way-vein valves and make them ineffective
  • Prolonged standing
  • Obesity

Varicose Veins Symptoms

Varicose vein pain symptoms are extremely variable, but the most common complaints include:

  • Heaviness
  • Achiness
  • Tiredness
  • Crampy pains and restlessness more often experienced at bed-rest
  • Swelling
  • Dryness and itching of the skin
  • ‘Tightness’ in the leg

Some patients with even very large veins have no pain but rather only swelling in the effected leg. Women sometimes experience more heaviness and aches when they are menstruating and this is believed to be due to hormones. Often prolonged standing will cause more severe leg symptoms while walking or other leg movements can help provide relief.

Treatment for Varicose Veins

Fortunately, there are many outstanding methods to treat varicose veins today. Lasers, microsurgery, ultrasound aided methods, and injection therapy or combinations of these methods are all used to help patients. The classic varicose vein stripping and ligation surgery your grandmother had, with its numerous large scars from incisions has been replaced with more effective, less invasive, and pain free outpatient vein therapy. These are discussed in further detail on our varicose vein treatments page.

How To Prevent Varicose Veins

  • The best way of preventing varicose veins from effecting you is to choose your parents wisely. Now that you have already done that, understand that most often the occurrence of venous insuffiency or varicosities is not within your control.
  • While diet, lifestyle and smoking do directly effect the arteries, they have no direct effect on veins. Indirectly, conditions such as constipation can cause an increase in abdominal pressure, which can increase pressure on the veins of the legs.
  • Support hose can be worn and may even give someone with symptoms from varicose veins relief but compression stockings will not prevent varicose veins from enlarging or cure them.
  • Maintain a normal body weight as obesity does contribute to varicose veins.
  • Does exercise cause veins to worsen is a common question, and the answer is we just don’t know. Both varicose veins and spider veins often show up more with intense exercise but then look better when returning to normal non-exercising activity. Even simple walking is an exercise so it’s not possible to say if exercise helps or worsens leg veins.
  • Leg elevation is sometimes suggested but often impractical for most busy people. Even if you were to elevate your legs daily for an extra hour they would still be dependent (below the heart) for the majority of the day. Elevation at bed rest is certainly not bad, but at night when the heart and the leg veins are at the same height is when elevation is actually least necessary.

Click here to view some of our Varicose  Veins before and after treatment photos

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