Table of content

Varicose veins

INDICATION – BRIEF

Varicose veins are swollen, twisted veins that often occur in the legs, resulting from weakened vein valves that allow blood to pool. Aging, sex, pregnancy, obesity, and medical history can contribute to their development. Women, the elderly, and those with a family history of varicose veins are particularly at risk. Non-clinical factors include prolonged standing or sitting, lack of exercise, and a diet low in fiber. These conditions increase pressure on leg veins or reduce circulation, leading to varicose veins. Treatment can range from self-care measures to medical procedures. Always consult a healthcare professional for advice.

INDICATION – DEFINITION

Clinical Factors

Several clinical factors can contribute to the development of varicose veins:

  1. Age: As you get older, your veins can lose elasticity causing them to stretch. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward.
  2. Sex: Women are more likely to develop the condition. Hormonal changes during pregnancy, pre-menstruation or menopause may be a factor because female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.
  3. Pregnancy: Pregnancy increases the volume of blood in your body, but decreases the flow of blood from your legs to your pelics. This circulatory change is designed to support the growing fetus, but it can produce an unfortunate side effect — enlarged veins in your legs.
  4. Obesity: Being overweight puts added pressure on your veins.
  5. Medical History: Having a family history of varicose veins or a personal history of deep vein thrombosis can increase your risk.

Non-clinical factors

Certain lifestyle choices and circumstances can also influence the development of varicose veins:

  1. Prolonged standing or sitting: This is particularly true for jobs that require you to be on your feet for long periods, which can cause blood to pool in the veins of the legs.
  2. Lack of movement: Regular physical activity can help to improve circulation and overall vein health.
  3. Diet: A diet low in fiber can lead to constipation, which can increase pressure on the venous system and contribute to the development of varicose veins.

SYMPTOMS AND DIAGNOSIS

Symptoms

Varicose veins are usually easy to see, as they appear as bulging, bluish cords running just beneath the surface of your skin. They are most often seen on legs, especially on the backs of the calves or on the inside of the legs. Symptoms can vary in severity from person to person, but they generally include:

  1. Veins that are dark purple or blue in color.
  2. Veins that appear twisted and bulging; often like cords on your legs.
  3. An achy or heavy feeling in your legs.
  4. Burning, throbbing, muscle cramping and swelling in your lower legs.
  5. Prolonged pain after sitting or standing for a long time.
  6. Itching around one or more of your veins.
  7. Skin discoloration around a varicose vein.

In severe cases, varicose veins can lead to more serious health problems, such as ulcers, blood clots, or bleeding from the veins.

Diagnosis

The diagnosis of varicose veins typically involves:

  1. Physical Exam: Your doctor will likely examine your legs and visible veins while you’re sitting or standing and ask you about any symptoms you’re having.
  2. Ultrasound Test: If your doctor suspects a deeper problem with the veins, an ultrasound may be performed. This test uses sound waves to create detailed images of your veins, allowing the doctor to see the blood flow and identify any blockages.
  3. Venogram: In rare cases, a venogram might be done to further assess your veins. During this test, a special dye is injected into your legs and X-rays are taken. The dye appears on the X-rays, giving a visual of blood flow through your veins.

Prognosis and Impact

Prognosis

The prognosis for varicose veins is generally good with appropriate management. Non-invasive treatments like compression stockings, regular exercise, and elevating the legs can often control the condition and prevent complications.

If these measures aren’t sufficient, procedures to seal or remove the veins, such as sclerotherapy, laser therapy, vein stripping, or endovenous ablation therapy, are typically very successful.

Most individuals find their symptoms are improved significantly following treatment and they’re able to return to normal activities. The recurrence rate can vary, and in some cases, new varicose veins can develop, requiring further treatment.

Impact

Varicose veins can significantly impact a person’s quality of life. In terms of physical health, varicose veins can cause pain, discomfort, swelling, and skin changes like darkening or inflammation. Severe cases can lead to complications like venous ulcers, blood clots, or bleeding.

The condition can also have a substantial psychological impact. The appearance of varicose veins can lead to decreased self-confidence and self-esteem, causing people to avoid activities where their legs might be exposed, such as swimming.

Moreover, the chronic nature of varicose veins means that ongoing management is often needed, which can have a financial impact and may also require regular doctor visits and possibly time off work for treatment.

While varicose veins are a common condition, they should not be dismissed as merely cosmetic. The discomfort and potential complications can be serious, and appropriate diagnosis and treatment are key to managing the condition effectively.

Treatment Options

  1. Lifestyle changes: The first line of treatment often involves changes that help manage symptoms and prevent the condition from worsening. This may include:
    • Exercise to improve your leg strength, circulation, and vein strength.
    • Dietary changes, such as a low-salt diet to prevent swelling caused by water retention.
    • Avoiding long periods of sitting or standing.
    • Elevating your legs when resting to improve circulation.
    • Wearing compression stockings to help blood move up your legs.
  2. Sclerotherapy: This is a common treatment where a solution is injected directly into the vein, causing it to scar and close. This procedure is typically used for smaller varicose veins.
  3. Laser surgeries: These procedures use light energy to block off a vein, causing it to fade and disappear. No incisions or needles are used.
  4. Catheter-assisted procedures: These involve inserting a thin tube (catheter) into an enlarged vein and heating the tip of the catheter to cause the vein to collapse and seal shut.
  5. High ligation and vein stripping: This involves tying off a vein before it joins a deep vein and removing the vein through small incisions. This is an outpatient procedure for most people.
  6. Endoscopic vein surgery: In advanced cases, especially if there are ulcers, a thin video camera may be used to visualize and close varicose veins and then remove them through small incisions.

Risks and Side Effects

Lifestyle Changes

These carry minimal risks but may not be effective in all cases or for larger varicose veins.

Sclerotherapy

While generally safe, potential side effects can include:

  • Bruising or discoloration at the injection site.
  • The development of small blood vessels around the treated area.
  • Small air bubbles in your bloodstream, which could cause headaches, nausea, or other issues. However, this is rare.
  • Allergic reactions to the solution used.

Laser Surgeries

Risks and side effects include:

  • Changes in skin color over the treated vein.
  • Burns and scars from the laser.

Catheter-assisted Procedures

Risks and side effects include:

  • Bruising or discoloration.
  • A small chance of burns or nerve damage.

High Ligation and Vein Stripping

Risks and side effects include:

  • Bruising and pain in the treated area.
  • Infection or a reaction to the anesthesia.
  • Risks associated with surgery such as blood clots or deep vein thrombosis.

Endoscopic Vein Surgery

Risks and side effects include:

  • Risks associated with surgery, such as infection, blood clots, and reactions to anesthesia.
  • The possibility of nerve damage.

FAQ Section

Varicose veins are enlarged, twisted veins often seen under the skin in the legs. They occur when the valves in the veins do not work properly, causing blood to collect and pressure to build up.

Anyone can develop varicose veins, but they are more common in women, the elderly, and those with a family history of the condition. Factors like pregnancy, obesity, prolonged standing or sitting, and a lack of exercise can also increase your risk.

Symptoms can include visible, bulging veins that are blue or dark purple, a heavy or aching feeling in your legs, burning or throbbing, muscle cramping, swelling, itching around the veins, or skin discoloration.

While varicose veins are often harmless, they can sometimes lead to complications like ulcers, blood clots, or bleeding if not treated.

Non-invasive treatments include lifestyle changes such as exercising regularly, maintaining a healthy weight, avoiding long periods of standing or sitting, and elevating your legs when resting. Compression stockings can also help manage symptoms.

Medical treatments include sclerotherapy, laser surgeries, catheter-assisted procedures, high ligation and vein stripping, and endoscopic vein surgery.

Yes, potential side effects can include bruising, discoloration, small blood vessels forming around the treated area, changes in skin color, burns, scars, and nerve damage. It’s important to discuss these risks with your healthcare provider before deciding on a course of treatment.

Yes, it is possible for new varicose veins to develop after treatment, so ongoing management may be needed.

Insurance coverage can vary depending on the plan and the severity of the varicose veins. If the treatment is medically necessary, it is often covered. However, treatments for cosmetic purposes are typically not covered.

INDICATION-Varicose veins