Varicose veins are frequently misunderstood - even by health care providers
What Are Varicose Veins?
Varicose veins are dilated ropey veins generally occurring in the legs and feet, appearing bluish-purple in color. They are easily identifiable due to their twisted and discolored appearance and frequently protrude above the skin surface, although not always visible.
What Causes Varicose Veins?
Healthy veins transport “used” blood back to the heart using one-way valves, which prevent blood from flowing backwards towards the feet due to gravity.
Our veins may occasionally fail, allowing blood to back up and pool in the veins. The congestion stretches and dilates them over time, eventually bulging to the skin’s surface as swollen, ropey varicose veins.
Due to slow progression of vein disease, signs and symptoms such as achy, tired legs are frequently overlooked as just part of normal aging. This is certainly not the case and if left untreated, may continue to dangerous blood clots, deep vein thrombosis and even severe leg ulcers.
From the embarrassment of unsightly bulging veins to the distressing symptoms impacting lifestyle, this extremely common condition can truly cause needless suffering. Fortunately, the state-of-the-art treatment options we offer can get you back to loving your legs!
Varicose Veins Risk Factors
Anyone can get varicose veins. In fact, it is extremely common, affecting up to 60% of the US population. It is a highly complex disease process with multiple risk factors:
Vein disease is inheritable and accounts for approximately 80% of cases. If one parent has varicose veins, your likelihood of developing vein disease is 50%. If both parents have them, your likelihood climbs to 90%.
With age, veins lose elasticity and the valves gradually weaken and fail. Due to gradual malfunction and slow progression, associated symptoms are typically brushed off as part of normal aging, leading to unnecessary suffering. It is important to understand that vein disease is not merely a function of age; it does occur in young people.
Pregnancy is one of the main reasons vein damage and symptoms are noticed earlier in women. In fact, around 40% of women will experience varicose veins during pregnancy. For many, pregnancy-related varicose veins tend to minimize after pregnancy. However, successive pregnancies will certainly worsen vein disease. It is a misconception to wait until after all pregnancies to pursue treatment.
Varicose veins are treated more commonly in women than men, mainly due to effects of pregnancy and the greater concern about their appearance. However, men are frequently troubled with varicose veins and their symptoms as well. Strong data shows up to 40% of men will suffer from vein disease at some point in their lifetime.
While walking, calf muscle contractions assist in pumping blood back to the heart. Prolonged sitting or standing puts significant pressure on veins, forcing them to work harder against gravity and promoting early failure.
Being overweight puts extra strain on your veins, again contributing to early failure. Being moderately overweight has a 50% increased risk of developing varicose veins.
Previous vein blood clots (deep vein thrombosis) or extensive surgery can damage veins leading to early vein disease, typically severe and debilitating, termed chronic venous insufficiency.
Signs and Symptoms of Varicose Veins
Varicose veins are not merely a cosmetic concern, and have many associated clinical problems, even with small veins. These may include:
Classically vague annoying pain worse towards end of day and exacerbated with prolonged sitting or standing.
Progressively worsening through the day, especially with prolonged sitting and standing.
Particularly at night. Described as constant uncomfortable feeling regardless of position, oftentimes disturbing sleep.
Predominantly around the bulging veins.
Typically at the ankle area and progressive as the day proceeds. Swelling often improves when feet are raised or upon awakening, as the damaged veins do not have to work against gravity while laying flat.
Skin changes of chronic progressive vein disease particularly in the lower leg around the shin and calf region. This is termed ‘varicose eczema’ or ‘stasis dermatitis’.
Result of long standing, severe venous disease and one of the worst complications. There is strong evidence that treating the underlying vein disease will significantly improve ulcer healing and prevent ulcer recurrence.
Can varicose veins be prevented?
Unfortunately, there is very little you can do to prevent varicose veins entirely. Below are a few steps to help relieve discomfort from existing varicose veins and slow down progression.
- Wear compression stockings/socks. These help your veins function well and support healthy blood circulation.
- Exercise regularly to improve circulation, and vein strength. We always recommend walking or running.
- Avoid prolonged standing or sitting. If you must, take a short walk every 30 minutes to help your calf muscles move blood through your veins.
- Elevate your legs when resting as much as possible, especially towards the end of day.
- Keep your weight in a healthy range to avoid excess pressure on your legs.
People with vein disease may present with:
- Prominent veins alone
- Prominent veins plus symptoms
- Symptoms alone
Unsure about your vein health? Check your symptoms with our free vein assessment.
At The Vein Clinic of Dallas, we take the time to get to know you and your veins first.
Step 1
Diagnosis starts with an in-depth review of your vein related history and physical exam. We aim to understand how your vein problems limit you and what your goals for treatment are.
Step 2
Next, a comprehensive venous duplex ultrasound mapping is performed. This critical step determines if the veins are functioning normally or if blood flow is moving in the opposite direction – known as venous reflux. Additionally, this study evaluates for hidden varicose veins deeper below, any existing blood clots (deep vein thrombosis), or chronic damage from previous blood clots; all of which may alter treatment.
Finally
All of the above findings in combination will allow your vein specialist to accurately assess your vein health and formulate a treatment plan that will yield the best results.
As a board certified vascular and interventional radiologist, Dr. Husein Poonawala has towering standards for ultrasound quality and scanning technique. He has put in considerable effort in selecting brand new machines based on extensive review and personal testing, and also frequently performs the entire study himself. Despite being highly experienced, our ultrasound techs undergo additional training to align with Dr. Poonawala’s meticulous scanning techniques and high level of expectations, resulting in flawless synchrony. This is the most critical step in your journey to healthy veins and Dr. Poonawala accepts nothing but perfection.
What is the treatment for varicose veins?
Conservative management – This typically involves lifestyle modification and wearing appropriately sized compression stockings. Self-care options will typically help with pain and symptom management but will not halt disease progression.
Highly effective, minimally invasive procedures – Previously, surgical varicose vein stripping was the only option; invasive and painful with long recovery periods and many complications. Today, this is largely replaced by walk-in-walk-out treatments with near zero recovery time, rare complications, and significantly improved results in experienced hands. Successful treatment relieves symptoms, prevents long-term complications, and improves appearance of the legs.
