Varicose Veins: Causes and Symptoms

Varicose veins and spider veins represent a common medical condition.  It is estimated that 15% of males and 25% of females are affected in the United States.  Varicose veins are triggered by heredity, and influences related to circulating hormones and the effects of pregnancy.  Obesity, sedentary lifestyle, and jobs requiring prolonged standing or sitting also play a role.  Despite the prevalence of venous disease, much is poorly understood about symptoms attributed to varicose and spider veins.   

The venous system acts as a collecting system throughout the body.  A series of one way check valves coupled with the contraction and relaxation calf muscles (calf pump), moves blood from the legs back to the heart.  The venous system is an extensive network of vessels found in three distinct layers.  The deep system lies deep or within muscle, while the saphenous layer and surface vessels sit deep to the surface of the skin or at the skin respectfully, yet above the muscular layer.  When a vein becomes dilated, one way check valves no longer work properly and blood begins to flow backwards, away from the heart.  Backwards flow (reflux) leads to elevated pressure in the veins that in turn allow them to become engorged and progressively more dilated.  As dilated veins are permitted to flow in reverse and build pressure, the network of diseased veins begins to grow, commonly leading to symptoms of pain and swelling.  Complicating matters involves progressive skin changes with pigmentation, swelling, and inflammation.  In severe cases of prolonged venous pressure, open sores or blood clots may develop.

Do varicose veins cause pain?  Patients routinely share they were told that ‘varicose veins do not cause symptoms.’  Some medical professionals still profess that varicose veins do not cause symptoms, based purely on opinion, not medical facts. In 1999, a study was published titled, “What are the symptoms of varicose veins?” This study looked at more than 1500 patients with physical inspection of vein disease, and questionnaire about leg symptoms.  No relationship was found between visual/physical presence of veins and symptoms of leg pain, etc.  Sadly the study did not hold water.  In 2003, a subsequent study of over 40,000 patients in Poland, demonstrated a high degree of correlation between physical findings and symptoms in patients with varicose veins. The most common symptoms were found to be leg pain (82%), leg heaviness (79%), intensification of symptoms with standing or warm environments (71%) and leg cramping (63%).   Conclusion Varicose veins can and often do cause symptoms.  Other symptoms may include itching and burning, leg swelling that worsens as the day progresses, and restlessness sensations.

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