About Vein Disorders

What are varicose veins?
Varicose veins are a very common problem, generally appearing as twisting, bulging rope-like cords on the legs. Spider veins are extremely common, small, red or purple veins closer to the skin surface. While many people have heard about varicose veins, very few truly understand their underlying cause, and the potential they have for developing into a serious medical issue. Fortunately, there are new and effective treatments for varicose veins.

Normally veins return blood from the legs back to the heart. One-way valves in the veins normally prevent blood from traveling in the opposite direction. Varicose veins are veins with poorly functioning valves. If these valves are not working, blood can back-up in the veins, causing the varicose vein to enlarge. Varicose veins can occur anywhere in the body, and are often found in the legs. While they are often unsightly, they can also cause pain, burning, aching, and other symptoms.

What are spider veins?
Spider veins are similar to varicose veins, but they are smaller. They are often red or blue and are closer to the surface of the skin than varicose veins. They can look like tree branches or spider webs with short jagged lines. Spider veins can be found on the legs and face. They can cover a very small or very large area of skin.

Why do people get varicose veins?
Heredity plays a large role in the development of varicose veins. Other factors include obesity, pregnancy, trauma, and occupations requiring standing for long periods of time, among other things.

Facts about varicose veins

Varicose veins affect an estimated 40% of women and 25% of men. There are a number of factors which lead to varicose veins, including:

Heredity – One of the most important factors. If your parents and grandparents had the problem, you are at increased risk.

Gender – Women have a higher incidence of varicose vein disease due in part to female hormones and their effect on the vein walls.

Pregnancy – Blood volume increases during pregnancy and hormonal effects contribute to vein enlargement.

Age – The tissues of our vein walls lose elasticity as we age causing the valve system to fail.

The following additional factors, while not directly causing varicose veins, may speed up the development of this disease and make the veins worse:

Prolonged standing – Occupations that involve standing for long periods of time cause increased volume and pressure of blood in the lower limbs due to the effects of gravity.

Obesity – Increases in weight often increase abdominal pressure which may worsen vein problem.

Hormone levels – Treatments like birth control pills and post-menopausal hormone replacement may cause the same hormonal effect as pregnancy.

Physical Trauma – Injury to the lower limbs can damage underlying blood vessels and valves, and add to the problem.

What are the symptoms? Will they get worse?

Many patients may experience one or more of the following:

  • Pain (an aching or cramping feeling)
  • Heaviness/Tiredness
  • Burning
  • Tingling sensations
  • Swelling
  • Restless legs
  • Itching
  • Tender areas around the veins

If you experience symptoms and delay treatment, your symptoms may progress to more serious complications including:

  • Inflammation (phlebitis)
  • Blood clots (e.g., DVT)
  • Ankle sores or skin ulcers
  • Bleeding

If you are experiencing any of the above, consult your physician, as treatment may be required.

How do varicose veins occur?
Arteries carry blood from your heart out to your extremities (hands, feet, head, skin), delivering oxygen deep into the tissue. Veins then return the ‘de-oxygenated’ blood (now bluish in color) back to your heart to be re-circulated.

To return this blood to the heart, your leg veins must work against gravity. Muscles in the leg squeeze the deep veins to help push blood forward. Small, one-way valves in the veins open to allow blood to flow upward, towards the heart. During muscle relaxation the valves close to prevent blood from flowing backwards. While deep veins are assisted in their efforts by muscles, a second type of leg vein, lying outside the muscle layer and closer to the skin (superficial veins), are not. The largest superficial vein is called the Great Saphenous Vein (GSV), which begins at the ankle and ends at the groin.

Varicose veins occur when the valves in these superficial veins malfunction. When this occurs, the valve may be unable to close, or become leaky allowing blood that should be moving towards the heart to flow backward (called venous reflux). Blood collects in your lower veins causing them to enlarge and become varicose. In this manner, faulty valves high in the leg may cause varicose veins in the mid or lower leg.

Can varicose veins be prevented?
Avoid standing for long periods of time. Avoid sitting for long periods of time by taking short walks every 30 minutes. If possible, try to elevate your legs. Avoid clothing which limits the use of the calf muscles (e.g. high heels) or restricts blood flow in the groin or calf. Wear graduated compression stockings or kneehi’s during pregnancy or when standing for long periods.

Since the above measures do not treat the underlying cause of the disease, varicose veins will usually enlarge and worsen over time.

Legs and feet may begin to swell and sensations of pain, heaviness, burning or tenderness may occur. If and when this happens, consult your physician immediately.