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What are Varicose Veins?

Varicose veins are a very common condition in the United States, affecting one out of two people age 50 and older, and 15 to 25 percent of all adults. These dilated blood vessels in the lower extremities are the result of damaged valves which allow blood to pool in veins. This pooling causes the veins to appear dark purple or blue and visibly bulge from the leg’s surface.

The word "varicose" is derived from the Latin root word "varix," which is translated in English as "twisted." Any vein in the body may become varicose, though certain contributing causes of varicose veins make the legs the most susceptible to this condition. Varicose veins occur in the legs and lower extremities because standing and walking increases the pressure in the veins in the lower half of the body, and the higher pressure can compromise the functioning of the valves.

In healthy, normally functioning veins, tiny valves placed throughout the vessel allow appropriate amounts of blood to flow through the vein, in one particular direction. When these valves malfunction, circulation isn’t regulated properly, overfilling the vein and/or allowing blood to flow in the wrong direction. This causes the unsightly, dark coloration and texture that are the visible indicators of varicose veins.

While varicose veins can appear unsightly and be a source of embarrassment for some individuals, the affected veins can also cause uncomfortable medical symptoms. Sensations of heaviness, aching, and tingling can be attributed to the presence of varicose veins. While not life-threatening in themselves, varicose veins may lead to serious problems if left untreated. At a minimum, people with varicose veins should have them evaluated by a specialist because these veins can serve as an indication that the individual is at a higher risk of other, more serious disorders of the circulatory system.


Pregnancy and Varicose Veins

Pregnant women often develop varicose veins during their pregnancies. There are two main reasons for this. Pregnancy increases the volume of blood in a woman’s body, which, if the valves aren’t functioning properly, can increase the likelihood of veins becoming over-filled. As the woman’s abdomen and pelvic area accommodates the growing fetus, the flow of blood from the legs to the pelvis can be compromised. These changes are natural, but they can produce unfortunate side effects such as enlarged veins in the legs. Varicose veins may appear for the first time during pregnancy. It has been observed that the varicose veins may worsen during late pregnancy because the expanding uterus exerts greater pressure on the veins in the legs. Physicians may prescribe compression stockings to pregnant women to help support the legs and improve circulation in the legs during pregnancy, reducing the side-effects varicose veins may cause.


Symptoms

Not all individuals with varicose veins experience discomfort related to them. There are a number of symptoms that are commonly associated with varicose veins in addition to their physical appearance, including:

  • Achiness or a heavy feeling in the legs
  • Pain such as burning, throbbing, muscle cramping and swelling in the lower legs
  • Itching on the skin around the affected veins
  • Skin ulcers near the ankle, which represent a severe form of vascular disease and require immediate attention

Most patients observe that prolonged sitting or standing tends to aggravate the symptoms, due to reduced circulation.


Risk Factors that Increase your Chances of Developing Varicose Veins

  • Standing for long periods of time. Blood doesn't flow as well if the body remains in the same position for long periods of time because the muscles are not contracting to push the blood back to the heart.
  • Obesity. Additional weight increases the pressure on the vascular structures.
  • Age. The normal aging process causes wear and tear on the valves inside the veins, weakening them and possibly causing them to malfunction.
  • Gender. Women are more likely than men to develop varicose veins. This is attributed to hormonal changes during pregnancy, menstruation and menopause. Researchers have found that female hormones may relax vein walls. Moreover, the use of certain hormone replacement therapies or birth control pills may increase the risk of varicose veins.
  • Genetics. Some individuals seem genetically predisposed to developing varicose veins; consult family history to determine if a patient’s older family members have them.

Screening and diagnosis by a Physician

Consulting a vascular specialist is an important first step towards the treatment of varicose veins. Prior to making a diagnosis, the physician will most likely examine the legs while the patient is standing to evaluate the extent and number of the varicose veins. Ultrasound technology may be used to further examine and “map” the veins. A venous reflux exam may be performed to screen for additional vascular conditions that may be present.

Finding a reputable, experienced vascular specialist is important to an effective treatment application, and ultimately, a positive result.


Varicose Vein Treatment Options

While surgical vein removal procedures are still performed in some cases, recent advancements in medical technology have allowed physicians greater variety in the type of procedures available for the treatment of varicose veins. Many modern techniques allow treatment to be administered in an outpatient setting, without the use of general anesthesia, and with a shorter recovery time and fewer side effects than are associated with traditional surgical procedures.

Prior to undergoing treatment for varicose veins, patients should ask a physician about the affects of lifestyle changes such as wearing compression stockings, exercising, losing weight, wearing loose-fitting clothes, elevating the legs, and avoiding long periods of standing or sitting. These simple behavioral changes may help alleviate symptoms on their own or be successfully used in conjunction with medical treatments.

Below are some procedures that a physician may recommend for the treatment of varicose veins:

  • Sclerotherapy
    This form of treatment is a non-surgical procedure in which a solution is injected into the problem varicose veins or spider veins in order to cause its disappearance. More info on Sclerotherapy

  • Endovenous Ablation
    Endovenous ablation works by heating the inside of the vein, which causes it to seal shut and disappear. This treatment requires that a very thin heating element be inserted into the damaged underlying vein. More info on endovenous ablation

  • Varicose Vein Surgery
    These procedures range from traditional vein stripping surgeries to less-invasive techniques that involve making tiny punctures or incisions through which the varicose veins are removed. The incisions are so small no stitches are required. More info on Varicose Vein Surgery

There are many other varicose vein treatments available which include laser surgeries, catheter-assisted procedures and endoscopic vein surgeries. Patients should consult a physician or other medical care provider regarding what type of treatment is best for their particular situation.


Prevention

Because of the variety of causes, there is no way to completely prevent varicose veins from occurring. However, improving circulation and muscle tone can reduce the risk of developing varicose veins or getting additional ones. Lifestyle choices that can positively affect varicose veins include:

  • Exercise. Walking is a great way to encourage healthy levels of blood circulation in the legs. A doctor can recommend an appropriate activity level for any patient’s body type and age.
  • Maintain a Healthy Weight and Diet. Shedding excess pounds takes unnecessary pressure off of veins, especially those in the legs. Following a low-salt, high-fiber diet to prevent the swelling that may result from water retention and constipation is also recommended.
  • Make Healthy Fashion Choices. Wearing low-heeled shoes allows calf muscles to work more, which is better for vein health. Wearing tight clothing around the waist and legs can restrict circulation.
  • Elevate the legs. To improve venous circulation, experts recommend taking several short breaks daily to elevate legs above the level of the heart.
  • Avoid long periods of sitting or standing. Changing the body’s position frequently to encourage blood flow can be beneficial.

Insurance Coverage

In general, insurance providers do not typically cover treatments that are administered for an exclusively cosmetic purpose. Because varicose veins can sometimes cause medical symptoms, if such symptoms are documented medical insurance may cover some or all of the cost of treatment. Individual insurance plans vary greatly, so it is best for patients to discuss this issue with their individual provider.


Related Varicose Vein Conditions:

Variocoele

Varicocele is a condition which causes the enlargement of the veins that are in the testicles, often resulting in discomfort and, in some cases, infertility. Varicocele is caused by malfunctioning valves, the same mechanism that causes varicose veins to form in the legs. In healthy vessels, tiny valves located along the vessel walls maintain the flow of blood in one direction. When these tiny valves weaken or malfunction, blood flow can become deregulated, causing swelling and pain. Valve malfunction can occur as a result of several factors, including trauma or other injury, congenital weakness, or pressure from surrounding organs and structures.

Some varicoceles cause no symptoms and require no treatment. But for those men who suffer from painful or swollen varicoceles, or who experience infertility as a result of the presence of varicocele, treatment becomes necessary.

Today, varicoceles can be treated in one of three ways. The most common treatment is an outpatient surgical procedure called varicocelectomy. Two other procedures, embolization and laparoscopy, are also performed on an outpatient basis and are less invasive than varicocelectomy. However, in some men they may not be as effective. Following an initial physical examination, a specialist can determine which technique will achieve the best results for a patient’s individual condition.


Pelvic Congestion Syndrome

Pelvic congestion syndrome is a painful, sometimes difficult condition to diagnose. It is caused by enlarged veins located in or around the ovaries or the larger pelvic area. Varicose veins located in the thighs, buttocks, or vaginal area are associated with the symptoms of pelvic congestion syndrome.

Some women develop pelvic congestion syndrome during or after pregnancy. This is due to the higher potential for developing vaginal varicose veins during pregnancy, as a result of the pressure the growing fetus puts on the pelvic and vaginal structures.

Women who are experiencing pelvic pain that may be caused by pelvic congestion syndrome should have physical exam with a pap smear to rule out the possibility of other conditions causing the symptoms. Chronic pelvic pain that is caused by pelvic congestion syndrome can be treated using a variety of non-surgical, minimally invasive treatments that a vascular specialist can discuss with patients.


Hemorrhoids

Hemorrhoids are varicose veins located in and around the anus. This condition is very common in the United States; by age 50, about half of adults have experienced the discomfort associated with hemorrhoids.

Hemorrhoids, also known as “piles”, are swollen veins in the anus and rectum. The causes include chronic constipation and the increased pressure on the surrounding areas and structures experienced during pregnancy.

Effective medications and procedures are readily available to treat hemorrhoids. In many cases successful treatment of hemorrhoids may require only lifestyle changes.

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