Varicose veins: Implications and treatments
Varicose veins: All you need to know!
Varicose veins are a common medical condition, especially in women, and are easily visible. The typical characteristics of varicose veins are enlarged, raised, and twisted veins in the legs’ subcutaneous tissue. These veins are of a purplish or bluish color. Often painful, varicose veins affect approximately one-fourth of adults. Varicose veins are usually a result of weakened walls or damaged valves, resulting in blood reflux. Blood reflux occurs when one-sided valves of the weakened veins cannot push blood towards the heart, and the blood flows backward. Furthermore, gravity plays a substantial role in making the blood flow towards the heart difficult. All this resulted in blood pooling and increased pressure in the veins. Consequently, the veins become distorted and enlarged.
Widely varicose veins are not considered medically necessary, and these snaky veins harm not many persons. Symptoms of varicose veins can include one or more of the following: bluish veins, heaviness feeling in lower legs, skin color change, itching, leg cramps at night, and aching pain.
The risk factors/ red flags for varicose veins include:
· Inactive lifestyle
· Sitting or standing for long durations
· Pregnancy or childbirth or Menopause
· Age >50 years
· Obesity or overweight
· Family history of varicose veins or Deep vein thrombosis
Diagnosis typically includes a physical examination followed by evaluating symptoms, family history, lifestyle, and other medical conditions. The physician could recommend imaging tests, including an ultrasound scan, X-ray, or a computed tomography (CT) scan to evaluate the leg veins’ situation.
Although varicose veins are usually harmless, the appearance of the legs is a common cosmetic concern for women. Apart from the cosmetic problems, there could be other implications as well: ·
Discomfort: Varicose veins can cause heaviness, itching, swelling, or pain. These symptoms worsen during extended sitting or standing and are relieved by lying down or elevating the feet. ·
Thrombophlebitis: Varicose veins can be complicated by phlebitis (superficial thrombophlebitis). There is a possibility of deep vein thrombosis if veins are occluded permanently. Differential diagnosis is crucial during the examination.
Ulcers and bleeding: Skin changes in varicose veins can include discoloration, eczema, florid lipodermatosclerosis, or inflammatory liposclerosis. Lipodermatosclerosis, if untreated, can lead to ulcer formation. Bleeding is rare but can occur in prominent veins.
Treatment of varicose veins is usually conservative, with a primary focus on lifestyle changes. Various approaches for varicose veins include:
Lifestyle changes: First and foremost measure is changing the lifestyle and adapting to an active life. Most persons require explanation and reassurance to incorporate these lifestyle changes. Lifestyle changes can include maintaining a healthy weight, exercising for improved blood circulation, and avoiding sitting and standing for long durations. Increased physical activity is very important in today’s lifestyle that promotes a sedentary culture. People who have computer jobs or travel on long flights should get up after every hour—elevating legs while sitting and sleeping is recommended for easing the symptoms of varicose veins. ·
Compression therapy: Compression therapy is usually recommended alone or along with other treatment approaches. Compression therapy may also be recommended after surgery. Specialized compression stockings or bandages with varying levels of compression are available. The objective is to put pressure on the veins to help blood flow to the heart and reduce/ prevent swelling.
Compression stockings relieve the symptoms of heaviness in the legs, pain, and swelling. Usually, it is recommended to wear stockings at least once a week, but depending upon the severity of the condition, the physician might recommend the patient to wear stockings continuously. Some patients have reported itching, discomfort, or skin irritation while wearing these stockings, but the physician has to weigh the benefit-risk in such conditions.
Compression stocking applicators are another useful invention that helps the patient easily put up and remove these stockings. These applicators have been found to increase patient compliance as the patient can independently use them without physically straining the leg. Applicators are lightweight and portable; they are instrumental in persons with arthritis, pregnant women, and the elderly.
Surgical measures: In case varicose veins are painful and affect your overall quality of life despite lifestyle changes, the physicians might consider surgical interventions. Surgical treatment usually involves saphenofemoral ligation and stripping under anesthesia. The technique of surgery varies, but the aim is to reduce post-operative bruising. Postoperative bruising can occur in obese patients with big varicose veins. Studies have shown that surgical treatment has clinical benefits along with being cost-effective. ·
Holistic approach: Another approach is the use of supplements to strengthen the blood vessels. Coenzyme Q10, Omega-3 fatty acids, Vitamin K, and Ginkgo Biloba are being promoted as nutrients to help veins become more elastic and have adequate circulation; however, clinical studies are needed to prove the clinical significance of these supplements.
Advanced techniques: With the advancement in technology, various minimally invasive techniques are available. These treatment options include:
Laser technique: Light energy is used to unblock the occluded veins.
Sclerotherapy: In this method, a chemical is injected into the large veins to unblock the occlusion.
Microsclerotherapy: In this method, a chemical is injected into the smaller veins to unblock the occlusion.
Endovenous ablation therapy: In this technique, radiofrequency waves and heat are used to unblock the veins.
Endoscopic vein surgery: In this method, a tiny incision is made on the occluded vein, and a small lighted scope is inserted to unblock the veins.
To conclude, varicose veins are common worldwide, attributable to a specific lifestyle or work priorities. Usually, these are harmless to most persons, but chronic conditions can lead to blood pooling and increased blood pressure in veins leading to discomfort, swelling, pain, and irritation. Also, untreated chronic conditions can lead to severe implications involving thrombophlebitis, skin changes, ulceration, and bleeding. Therefore, lifestyle changes are necessary to manage the situation and relieve the symptoms. Compression stockings are highly effective in reducing varicose veins’ symptoms, and the use of applicators has further made donning and removing the stocking easier and hassle-free.
Applicators have also improved compliance with the use of compression stockings. There are additional approaches for treatment involving surgical interventions and minimally invasive techniques. Overall, management is essential, and awareness of the condition is the key to managing varicose veins.