Varicose Veins - Causes, Risk Factors, Symptoms & Treatment
What are Varicose Veins?
There are series of valves in the body that ensure that the blood flows from the legs to the heart properly. There are certain conditions these valves become weak and start leaking and blood starts flowing in the reverse direction towards the feet which leads to gradual dilation of the veins which we see as blue veins in the legs. These blue veins are called Varicose Veins. These veins are twisted, enlarged, and swollen. This is a mild variation of common veins and does not create problems in many people but some people might experience severe pain and discomfort and require medical intervention. It is estimated that 6-7 % of the total population face this issue. If we translate that to India about 84 million people suffer from Varicose veins.
Cause of Varicose Veins:-
There are tiny valves in our veins that open during blood flow towards our heart then close to stop blood flow towards the backward direction, but when these valves become weak or get damaged, blood starts flowing backward direction and accumulates in the veins causing veins to twist, stretch and swollen.
Risk factors of Varicose Veins:-
The study is underway to understand the exact cause of Varicose veins but the following are the potential risk factors that can increase the risk of Varicose Veins.
- • Gender/Sex – Varicose veins are more likely to develop in women than men. Hormonal changes during pregnancy, periods, or post-menopause might be a factor because the women's hormones relax the veins. Adopting hormonal treatment or taking birth control pills might be the contributing factors.
- • Age- The valves in the veins which regulate blood flow become weak or get damaged with the increase in age. The damaged valves cause the backward blood to blow towards the legs instead of flowing to the heart.
• Genetics-People who have a family history of Varicose veins are more likely to develop this problem.
- • Obesity – Being overweight or obese can put added stress on veins and increase the risk of Varicose veins
- • Pregnancy – Pregnant women are more likely to develop the risk of Varicose veins as the volume of blood increases in the mother’s body to support the growing fetus but this change in the body can also put extra pressure on the circulatory system. Apart from this, there are a lot of hormonal changes during pregnancy which can relax the veins and increase the risk of Varicose veins.
- • Nature of job – A person who has got a standing /sitting job for a long time develops Varicose veins.
Symptoms of Varicose Veins: -
People who do not experience pain, the symptoms include dark purple or blue color, and twisted and swollen veins. Symptoms in people who experience the discomfort of pain include: -
- • Heavy feeling in legs
- • Burning, Swelling, and cramping in lower legs
- • Worsening the pain while sitting or standing.
- • Itching around your veins
- • Discoloration of skin around the affected veins
There are spider veins similar to Varicose veins but are smaller and are found closer to the skin’s surface and are blue or red. Spider veins vary in size and often looks like a spider’s web.
Diagnosis of Varicose Veins- Doctors will examine you physically. You may be advised for an ultrasound to see if the valves in your veins are functioning properly or if there is a blood clot. Your doctor may advise color doppler duplex ultrasound to identify any abnormalities in the veins.
Treatment of Varicose veins:- Varicose veins generally do not require invasive procedures and can be treated on an outpatient basis. It can also be controlled by taking self-care treatments like avoiding long periods of standing or sitting, losing weight, and avoid wearing tight clothes. These steps can help reduce the discomfort and pain and prevent varicose veins from getting worse. A compression stocking is often the first approach before moving on to any other treatments. Stockings can help treat Varicose veins in the early stage. It steadily squeezes the legs and helps veins and legs muscle flow blood smoothly. But the surgical intervention may be required if stockings and medication do not work. Surgical techniques include:-
A thin laser(600 microns in diameter) is introduced in the vein through a tiny needle, once it reaches the targeted area of the leaking vein, laser energy is delivered into the vein and closes the vein within a matter of few minutes. The advantage of this technique is that patient does not require a stay in the hospital. The overall cost of the treatment is very less.
- • Ligation and Stripping – It is a traditional method of open surgery which involves multiple cuts and stitches. You have to stay for 2-3 days in the hospital post-surgery and takes around 2-3 weeks to get complete recovery. This risk of infection is high due to multiple cuts and incision
- • Minimally Invasive surgical procedure - Endovenous laser therapy(EVLT) and Radiofrequency ablation(RFA) are minimally invasive techniques to treat varicose veins. This method does not require multiple cuts or stitches and the whole procedure can be completed in 15-20 minutes. The patients can return to their normal routine work immediately after the procedure. This procedure is performed under ultrasound guidance.
- Dr. Amrish Kumar
Cardio Thoracic & Vascular surgery