Varicose veins: causes, symptoms, and management

Posted by: Ramesh Venkatraman

Introduction: Veins are blood vessels that carry/return deoxygenated (impure blood or blood lacking in oxygen) blood from the various parts of the body to the heart and then the lungs. Veins have valves that help in propelling the blood forward towards the heart and prevent backflow.
Varicose veins appear swollen, twisted, bluish-purple in color, and slightly raised above the surface of the skin. Generally, the following are true of varicose veins: (a) more common in women than in men (b) can form anywhere in the body, but most commonly located in the legs, particularly visible on the calves (c) Usually painless and harmless but can sometimes become painful (d) tend to be inherited and become more prominent as one ages (e) statistics show that 1 in 2 people above the age of 50 develop varicose veins (f) typically it is the superficial veins present closer to the skin that usually become varicosed.

Causes: Although several theories exist, the commonest and most accepted cause is “defective valves” These defective valves do not perform their function of ensuring that the blood keeps moving forward. Veins with defective valves allow backflow of blood causing the blood to pool and stagnate - this causes the veins to enlarge and lose their characteristic shape causing “varicosities” in the vein. Some other causes of varicose veins include heredity and congenital (born with) abnormalities of the vein-wall which can cause the valves to malfunction.

Hemorrhoids (piles) is a very common type of varicosity that occurs in the anal/rectal region usually due to chronic constipation

Conditions and factors that can trigger or aggravate varicose veins:

1. Pregnancy: Increased blood volume and increased weight are the primary reasons along with the effects of the hormones estrogen and progesterone which cause relaxation of the vein walls
2. Prolonged standing
3. Obesity, particularly people with a distended belly
4. Chronic constipation, chronic cough, urinary retention due to an enlarged prostate and any other condition that causes you to strain and exert yourself over prolonged periods of time
5. Surgery and/or trauma to the leg

When varicose veins become serious and when to seek medical care: Varicose veins in general are harmless and the only problem that you may face is the occasional itching besides the unsightly appearance. However go to a doctor when you experience the following:

1. Unexplained pain, discoloration, swelling, and/or ulceration on or around the region of the varicosity - this could signify the beginning of a clot and warrants a thorough medical examination. Individuals who have been diagnosed with DVT (deep vein thrombosis) should exercise greater caution.
2. Constant ache in the legs, centered on or around the varicosity that is preventing you from getting a good night’s sleep.

Your doctor may advise a Doppler scan to determine how serious your problem is and if you need treatment/medication. A Doppler scan is essentially an ultrasound scan that is painless and uses high frequency sound waves to provide an image of the affected part. The Doppler scan can provide information on the direction of blood flow inside the veins, how well your veins are functioning, and the presence of clots (if any).

Treatment and management of varicose veins:

1. Compression stockings: Compression stockings are specially designed to steadily squeeze your legs and encourage blood flow towards your heart (i.e. normalize blood flow in your affected veins). Compression stockings are usually tightest at the ankle and get gradually looser as they go further up your leg and may help to relieve the pain, discomfort and swelling in your legs.
2. Surgery: Surgery may be required if the varicosity is spread over a large surface area or if the affected veins are particularly large, or if the diagnosis shows a possibility of increased risk of developing complications. Some individuals may also choose to go in for surgery for cosmetic reasons.
3. Simple interventions that can provide relief include: exercising, losing weight, avoiding prolonged periods of standing, avoiding tight-fitting clothes, elevating your legs when resting, and not crossing them when sitting.
4. Yoga: Yogasanas such as UTTHAN-PADASANA, CHAKRA PADASANA, PADA SANCHALANASANA, and PAWANMUKTASANA can be extremely beneficial in people with varicose veins. These are simple asanas that you can learn on your own. Check out these sites to read about these asanas:
   http://yogadeep.blogspot.com/2010_06_01_archive.html
   http://shilpamoreshwar.weebly.com/yogasanas.html