Patient Education

Varicose Veins

Description

We’ve all seen those disaster movies. You know, the ones where failing valves seem to be a major plot points (at least those involving overly complex machines that blow up when they encounter some unsolvable problem, like “What is love?”). Pressure builds, steam screams from fissures in the machinery, and valves fail to hold back the flood of destruction.

Did you know that there are valves in your veins, too? They’re there to prevent backflow and keep your blood moving in the proper direction: to the heart and lungs. Basically, they’re these flaps that are only supposed to open up in the direction the blood is supposed to flow. What’s tricky is when your blood is trying to move against the pull of gravity. Think of a waterfall that’s trying to flow up rather than down (except, maybe, a little less dramatic). Fortunately, the muscles in your legs help squeeze the blood back up the veins, but even still, the veins that carry your blood from your feet and legs back up to your heart have to fight against gravity all the way, which means they’re more likely to have valve problems than other veins in your body. And some people may have valves that are weaker than normal.

When your venous valves start to fail, blood leaks back through them and pools in the veins. This backed-up blood can eventually make the veins bigger and misshapen: varicose veins. (Spider veins, by the way, are like varicose veins, but on a smaller scale.) This valve failure happens quite often in the great saphenous vein that runs through the thigh, leading to varicose vein formation in the leg down below.

Over half of those 50 and older have varicose veins, so if you find yourself in this group, you’re certainly not alone. There are a few risk factors for developing varicose veins, though, including a family history of the condition, obesity, pregnancy, age, lack of movement, hormonal changes (such as during puberty and menopause), exposure to sunlight, and being female. Varicose veins aren’t usually dangerous, although you may find them painful or embarrassing. Occasionally, there are serious complications from the condition, such as ulcers or blood clots. (When clots form in veins deep in the leg, the condition is known as deep vein thrombosis. If the clot moves to the lungs, it can be life-threatening.)

Symptoms

If you get varicose veins, you probably won’t start spitting steam or flashing red lights, shouting, “Danger! Danger!” Instead, (if the affected veins are near the skin) you’re likely to notice that the veins in your leg look prominent, bulging, twisted, or cord-like. Or, you may find what looks like bunches of grapes beneath the skin. Your legs may feel achy, tired, or heavy. Varicose veins that are closer to your bones may not be as obvious visually, but you may have chronic swelling in your legs, ankles and feet, as well as aching, tiredness and heaviness in the legs. Sometimes people with varicose veins develop an itchy rash on the leg. More serious cases may involve discoloration of the skin and the development of ulcers.

Diagnosis

It’s a good idea to see your podiatrist if your vein is swollen, painful or warm to the touch. You’ll also want to check in with a doctor if you develop a rash or sores, if the skin over your ankle or calf becomes thickened, if your varicose veins begin to bleed, or if your varicose veins are keeping you from doing things you would normally do.

Your podiatrist knows what to look for to discover if the valves in your veins are failing. He or she will probably perform a physical examination of your legs while you’re standing up, or possibly while you sit and dangle your legs. A history of your symptoms should also help your podiatrist pinpoint your troubles. Be sure to mention a family history of varicose veins if you have one. Additional tests such as an ultrasound or (less commonly) a venogram may help your podiatrist make the diagnosis.

Treatment

Your foot doctor may opt to treat your varicose veins conservatively at first. He or she may suggest compression stockings as a way to give a bit of assistance to your veins. Compression stockings put pressure on the veins and help the blood to continue to flow upward to the heart. Support pantyhose provide a little assistance, and over-the-counter and prescription compression stockings are also available.

Exercise, keeping your legs elevated when sitting down, and losing weight can all help relieve problems from varicose veins. You’ll also want to avoid crossing your legs, wearing tight clothing, and standing for long periods of time.

If conservative treatments don’t adequately improve your symptoms, there are procedures available to treat the condition. Minimally invasive procedures may involve threading a catheter into the vein, then closing the vein using heat or chemicals. (Your blood will still flow through other veins, so don’t stress about getting the problematic vein closed up.) Ultrasound may be used to guide such procedures on veins deep below the skin. Varicose veins can also be dealt with by getting lasers treatments on the skin surface. Or, your doctor may feel it’s best to remove the varicose vein surgically.

So, as you can see, failing valves in the veins don’t have to be the disaster that movies sometimes portray. With treatment (and with treating your veins kindly) you should be able to feel much better.