Varicose veins refer to an abnormal condition of the veins (blood vessels that carry impure blood back to the heart). The affected veins become swollen, twisted and painful following abnormal collection of blood in them. Women are more commonly affected than men.
Varicose veins have been reported to affect about 36% of women and 19% of the men in the US. Although varicose veins are more commonly observed in the legs, they can form anywhere in the body and may vary in severity.
Varicose veins are commonly associated with pain in the affected legs. The legs feel full and heavy with enlarged veins that are visible over the skin. The skin over the veins may be itchy. The ankle of the affected leg may have a mild amount of swelling with ulcers present occasionally.
The diagnosis of varicose veins is based on the symptoms noticed. The physician may advise additional tests in order to rule out the presence of other disorders of the legs.
In healthy individuals, the blood within the veins is easily pumped back to the heart. In case of a varicose vein, this mechanism is affected which results in pooling of blood within them. Numerous causes have been identified to be associated with the incidence of varicose veins. Heredity has been put forth as the main cause of varicose veins. In some cases, certain birth defects may be the possible cause.
In other cases as those listed below, varicose veins may occur owing to increased stress on the veins. Pregnant women may suffer from a transient type of varicose veins. Increased incidence of varicose veins is also noted in individuals who stand for prolonged periods (such as working at a counter). Individuals who are obese are more prone to suffer from varicose veins than normal individuals. As the age progresses the incidence of varicose veins is also noted to increase owing to poor responses of the leg muscles.
A wide variety of options are available for the treatment of varicose veins. These options are individualised for each case and are selected based on the factors such as size of the varicose veins, their location and the severity of the disorder. Your physician may offer you a combination of one or more treatment options in some cases.
Mild to moderate variants of varicose veins respond well to self care measures. This involves minor modifications in the way you perform your day to day activities at home or at work. The self care options offer good results especially in case of transient type (those observed in pregnant women). Some of the self care measures that are helpful have been listed below.
Take a break: standing at work continuously for prolonged periods can reduce the amount of blood being circulated from your legs. It is advisable to take a break at regular intervals.
Lift them up: while you are sleeping or resting remember to keep your leg raised with a pillow kept below your legs. This improves the blood circulation in the legs and prevents varicose veins.
Shed the weight: losing weight has been found to be beneficial especially if you are overweight or obese. This also helps you to ward off other problems associated with obesity.
Stock up: certain specialised stockings are available that are useful for individuals suffering from varicose veins. These stockings improve the blood supply and reduce pain associated with varicose veins by preventing pooling of blood in the affected veins. Take your physician’s advice if you are planning to wear them for longer durations.
Stay fit: if you are living a sedentary life, it is time that you become active. Indulging in some physical activities and staying active with regular walks or exercise has many advantages among which better blood circulation is one.
This option is considered either as a separate therapy or in combination with the conservative self care measures. Non-surgical as the name suggests is a minimally invasive treatment procedure which does not involve any major surgical correction and does not require the individual undergoing the procedure to be admitted at the hospital. Some of the non-surgical treatment options include:
- Laser therapy or Radiofrequency ablation
- Ambulatory phlebectomy
- Vein ligation
Sclerotherapy procedure is aimed at closing the affected veins permanently by scarring them. A chemical solution is injected into the affected veins which gradually induces the formation of scars within these veins. The affected vein closes once dense scar tissues are formed within them and blood flow continues through the other healthy veins in the vicinity. Sclerotherapy is a simple procedure and does not require the administration of general anaesthesia.
Laser Therapy or Radiofrequency Ablation
Laser therapy involves the use of amplified light to cause closure of the affected veins. Radio waves can also be used to cause a similar result. During this procedure which is performed under local anaesthesia, a small tube is passed into the affected vein and through which the laser or radiofrequency apparatus is passed to generate heat within the vein thereby resulting in its closure. The blood flow in this region is taken over by the other healthier veins.
This procedure is used in the treatment of small varicose veins. The affected sections of the veins are removed through a series of incisions placed over the skin. The ambulatory phlebectomy is done under local anaesthesia.
Vein ligation procedure is employed to treat larger varicose veins. The aim of this procedure is to prevent the blood from entering the affected vein by blocking it at the point of entry. This procedure requires the administration of local anaesthesia following which an incision is placed on the skin to identify the affected vein. The affected vein is then tied with certain specialised material to block the blood flow through it. The blood flow from the legs continues through other healthy veins.
Severe cases of varicose veins that may or may not be associated with constant pain require to be treated surgically. Hospital admission may be required in certain affected individuals. The surgical treatments are more extensive procedures which may require the administration of general anaesthesia. No major complications have been associated with the surgical treatment other than the requirement of rest for some period before resuming work. The surgical treatment options for varicose veins include:
- Vein stripping
Vein stripping is advised when the whole length of the vein is affected. Following the administration of general anaesthesia, the affected vein is completely removed. This procedure does not have any major complication and treated individual can resume regular activities after a period of about two weeks.
This is a new procedure that is being considered as viable treatment option with minimal complications. CHIVA stands for Conservative and Haemodynamic cure of Incompetent Varicose veins in Ambulatory patients. The procedure performed under local anaesthesia involves the placement of 1 to 4 small incisions on the varicose veins to prevent the abnormal flow of blood into them. More research is required to prove its safety and efficacy in the treatment of varicose veins.