Varicose Vein

Veins are the tube like structures that carry deoxygenated blood from the body to heart. The force of bloodflow in the veins is usually not very high. Hence there are high chances that the blood may flow back. To prevent the blood from flowing back, nature has kept leaf like structures. These structures are called valves. When a vein enlarges and loses its elasticity, the valves are not able to close properly and stop the blood from flowing back. This flow back further, enlarges the vein, making it even worse. Hence there is flowing back of blood thereby enlarging it more. These veins look large and zigzag in pattern, these enlarged veins are known as varicose veins.

Though varicose vein can occur anywhere in the body, the most commonly seen area is the legs. This is because gravity tends to pull blood downwards. It commonly affects the Saphenous vein, the longest vein of the leg.

varicose vein of the leg

Causes of Varicose Veins

Veins from all parts of the body must carry blood from the respective organs to the heart, for purification. This is a tough task for the leg veins since they have to pump the blood up against gravity. So, a  minor defect in the vein or its valves results in blood stagnating in the veins. The conditions predisposing to this are:

Standing for a long Period of time

The blood has to flow in a direction opposite to gravity. Hence standing causes pressure and stasis of blood, leading to varicose veins.

  • Pregnancy and Obesity

    In pregnancy, the presence of foetus in the uterus puts pressure on the vena cava (one of the main veins that carries blood to the heart). So, there is improper flow of blood to the heart. This causes blood to accumulate in the lower veins of the leg. They enlarge, making the valves non functional, hence leading to varicose veins.

  • Alcohol

    Alcohol has dilating effect on the veins. So, long term consumption of alcohol results in widening of veins. This makes the valves defective, leading to pooling of blood and varicosities.

Symptoms of Varicose veins

Varicose veins usually do not give much trouble in the initial stages. Thats why it goes neglected until it gets complicated. Following are symptoms one has to be aware of :

  • Veins become enlarged and a zigzag pattern is noted.
  • The skin above the ankle starts thickening.
  • The skin around the veins becomes bluish in colour.
  • Swelling of legs
  • If the blood supply gets altered because of the problem the patient may have burning pain in the affected area.
  • Long standing dilated veins can also cause bleeding.
  • Sudden movement may cause pain.

Diagnosing Varicose Veins

Physical Examination

The dilated and zigzag pattern of the veins are very typical of varicose veins.

Duplex Ultrasound

Confirmed diagnosis can be made only when images of the veins with an ultrasound is taken. There is a special type of ultrasound which helps in judge the direction of blood flow. This is known as duplex ultrasound. With the help of this, the problematic valves are visualized, and the direction of blood flow is observed. Back flow or stagnant blood indicates presence of varicose veins.

Treatments for Varicose Veins

Non Surgical Treatments

Elevating leg while lying down after a long day will give great relief.

  • Likewise, even, not standing for a long time will reduce the severity.
  • Tight socks called compression stockings, helps in pushing the blood towards heart.
  • If there is bleeding or wound near the area of the dilated veins, then proper and regular dressings might be needed.

Medical Treatments

There are none.

Surgical Treatments

Varicose veins are usually observed on the surface of lower legs. These veins carry only about 10% of the venous blood from the legs. Hence, the treatment usually consists of removing the faulty veins.

In the olden days, techniques like vein stripping, multiple ligation, and sclerotherapy were used. However the standard treatment these days is to insert a probe inside the veins and heat the veins in such a fashion as to make them close. To know more read about Endovascular Radiofrequency Ablation of varicose veins.

Prevention of varicose veins

There are no known ways of reliably preventing varicose veins. However, steps can be taken to avoid the existing condition from becoming worse.

  • Avoid sitting or standing for long periods of time without taking a break.
  • Avoid sitting cross legged.
  • As much as possible, when sitting or resting, keep your legs at a higher level.
  • Avoid wearing high heels. Low heels keep the muscle toned and improve circulation.
  • Wear compression stockings. This helps pushing the blood up into the heart and hence avoids strain on the veins.

Radiofrequency Ablation Specialists

Dr. C.M.K. Reddy

Consultant General & Vascular Surgeon
M.B.B.S., DSc., F.R.C.S. (GLAS), F.R.C.S., F.R.S.H (Eng), F.I.C.S, F.I.C.A (USA)

Dr. P. Ilayakumar

Consulting Vascular Surgeon