Varicose Veins (Swollen Leg Veins)

Definition

Varicose veins are defined as enlarged, superficial veins in the legs and feet. Varicose veins may be asymptomatic in some cases or may cause pain in the legs in others. The legs may feel full, and may become more sensitive to touch. For many people, varicose veins are just cosmetic concerns. However, in some people, varicose veins can cause discomfort and an aching pain.

Symptoms

Varicose veins are often painless and present with the following and symptoms:

  • Dark purplish or bluish veins
  • Twisted and bulged veins appearing close to the skin
  • Ache in the legs
  • Feeling of fullness or pressure
  • Burning or throbbing pain
  • Muscle cramps and swelling
  • Worsening of symptoms after sitting or standing for long
  • Itching around the veins
  • Skin ulcers near the ankles

Causes

The heart is situated above most of the organs. Veins carry the blood back from the organs to the heart and work under added pressure of gravity. The walls of veins are elastic and help in blood flow. Muscles of the lower legs contract and thus help in pumping blood through the veins. Also, tiny unidirectional valves in the veins prevent blood from flowing backward. A problem in any of these systems can lead to the development of varicose veins.

Causes of varicose veins can include:

  • Age: Upon aging, veins lose elasticity and become stretched. The valves in the veins also may become weak and cannot prevent backward flow of blood. This leads to pooling of blood in the veins.
  • Pregnancy: During pregnancy, the volume of blood in the body increases to support the growing fetus. Varicose veins may appear during pregnancy or worsen during third trimester as the uterus puts more pressure on the veins in the legs. Hormonal changes may also play a role.

Factors like increasing age, female gender, family history, obesity, hormonal changes (especially during pregnancy, before menstruation or menopause), and sitting or standing for long may increase the risk of varicose veins.

Treatment

Varicose veins developing during pregnancy improve on their own within 3 to 12 months after delivery.

Treatment options can be grouped as:

Lifestyle measures

Simple steps that can ease and prevent complications of varicose veins include:

  • Maintaining proper body weight
  • Exercising
  • Avoiding tight clothes that hamper blood circulation
  • Elevating the legs
  • Avoiding long periods of standing or sitting

Compression stockings

Compression stockings are recommended to most people with varicose veins. These stockings assist the pumps and valves in the legs by applying pressure around the veins.

Medical procedures

  • In sclerotherapy, injections of an irritant scar and close varicose veins and veins fade in a few weeks.
  • Laser surgeries are invasive procedures to close off smaller varicose veins.
  • Larger varicose veins can be collapsed and sealed shut by inserting a thin tube (catheter). The tip of the catheter is heated and the heat destroys the vein.
  • In vein stripping, a long vein is removed making small incisions in the skin.
  • In ambulatory phlebectomy, smaller varicose veins are removed from the skin using tiny skin punctures.
  • Endoscopic vein surgery is recommended to severe cases with leg ulcers.

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