Varicose veins – symptoms, causes, diagnosis, treatment, and prevention

Varicose veins, also known as varicoses or varicosities, is a condition of the veins where they become enlarged, dilated, twisted and overfilled with blood, causing them to appear blue or dark purple. Varicose veins appear swollen and raised, and can cause pain. Any superficial vein can be affected and become varicosed, though the most commonly affected veins include the ones in the legs because standing and walking straight increases the pressure on the veins of the lower body.

Women are more susceptible to varicose veins, especially pregnant women. Also, people who are obese or have excess body fat are more likely to have varicose veins.

Causes of Varicose Veins

Varicose veins tend to mostly appear on the legs and feet, due to increased pressure causing the valves in the veins to dysfunction, thereby restricting blood flow. This is basically because the veins are weak or damaged.

Generally, the arteries carry the blood from the heart to the rest of the body and veins; on the other hand, bring back the blood from the rest of the body for recirculation. So, to ensure the blood from the legs is returned to the heart, the veins work against the force of gravity, which is supported by the muscle contractions in the lower legs that functions as pumps to push back the blood to the heart. During this procedure, the valves in the veins open to allow the blood to flow up and close immediately to restrict the flow backwards. However, if the valves are weakened or damaged, the process will not function properly, causing the blood to flow back into the veins through the valves, causing them to stretch and twist.

Symptoms of Varicose Veins

In many cases, varicose veins may not cause any pain and can go unnoticed, unless they start to produce symptoms such as:

  • Pain or heaviness in the legs or feet
  • Burning, swelling, muscle cramping, etc. in the lower legs
  • Intense pain especially upon sitting or standing for a length of time
  • Uncontrollable itching around the veins
  • Discolouration of skin around the veins
  • Swelling in the ankles
  • Easy bleeding or bruising in the area
  • Spider veins
  • Redness and dryness of the skin surrounding the veins
  • Restless leg syndrome
  • White patches on the ankles 

Diagnosis of Varicose Veins

The primary method to diagnose varicose veins is to study the appearance of the veins and related symptoms. Varicose veins are:

  • Dark purple or blue in colour
  • Twisted, bulging, swollen, lumpy and appear like cords

However, varicose veins are different from spider veins that can affect any veins of the body, including the face.

The doctor will study the veins in the legs through some movement and then order some diagnostic tests to confirm the findings and assess the condition internally. These tests include:

Doppler test: The test enables the doctor to determine the direction of the flow of the blood in the veins. This also checks for any blood clots or blockages in the veins.

Colour Duplex Ultrasound: The test helps determine the speed of blood flow, as well as any abnormalities by providing clear and colourful pictures of structure the veins.  

Treatment of Varicose Veins

In cases where the varicose veins do not produce any troubling symptoms, treatment is a choice. But in cases, where the condition produces painful symptoms and discomfort, treatment is necessary to avoid further complications, including leg ulcers, swelling, etc. Some people might also want cosmetic surgery to hide the appearance of the varicose veins.

A few treatment options for varicose veins include:

Surgery: In case the varicose veins are too large, they might require surgery to be removed. The surgical procedure is short, simple and has shorter hospital stay – patients can go home the same day; in case of treatment of both legs – one night of hospital stay might be needed.

Laser: Laser treatment can also be used to close smaller veins by applying strong energy light waves to the veins, making them fade and disappear.

Ligation and Stripping: A treatment option in which an incision is made at the top of the affected vein on the groin and another incision is made at the bottom end of the vein on the ankle or knee. The top of the vein is sealed, while a thin, flexible wire is inserted from the bottom and pulled out while pulling the vein with it. The procedure is easy, quick and often requires no hospital stay; though patients might experience weakness, pain, bruising and bleeding. 

Sclerotherapy: This method involves injecting a chemical in the varicose veins that cause them to scar and eventually close on their own; the veins should fade away in a few weeks. The procedure might need to be done more than once to ensure complete success.

Radiofrequency Ablation: This procedure is highly effective in closing large varicose veins. It involves making an incision on the knee, inserting a catheter into the vein and directing it based on the ultrasound scans. The catheter is then injected with a probe that emits radiofrequency energy causing the vein to heat up and its walls to collapse, creating an effective closure. During the procedure, the patient is under the influence of anaesthesia.

Endovenous Laser Treatment: This treatment involves inserting a catheter into the vein and threading a small laser to direct short energy bursts from the top of the vein, causing the vein to heat up, collapse and seal. The procedure is done by placing the patient under local anaesthesia and can also minor nerve injury, which is brief and recovers on its own.

Transilluminated Powered Phlebectomy: In this procedure, the doctor makes an incision to insert an endoscope mounted with a special light to check the affected vein and cut it out to remove it via suction through the incision made. The procedure is performed under anaesthesia and can cause bleeding and bruising, which is temporary. 

Prevention of Varicose Veins

Varicose veins can be easily prevented by reducing risk through steps such as:

  • Physical exercise such as walking
  • Healthy weight
  • Healthy diet
  • Avoiding standing or sitting for too long (mover around every 30 minutes)
  • Do not sit cross-legged
  • Sit and sleep with feet raised higher on a pillow

In all, varicose veins can be easily prevented, simply managed and effectively treated, if needed to ensure minimum complications.