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Looks aren’t everything
Learning what causes varicose veins can be the first step to curing the problem
By Manuel E. Garcia, MD
Looks aren’t everything and this is certainly true with regards to symptomatic varicose veins. In fact, the majority of individuals suffering from varicose veins do not demonstrate the stereotypical features of varicosities such as large, bulging leg veins. Many people may have normal appearing legs but experience intermittent or persistent discomfort, and don’t know why. So, how can you tell if you may be one of these individuals with unrecognized varicose veins? Read on…
Symptoms resulting from underlying varicosities vary depending on how varicose veins lie underneath the skin. Varicosities pressing against the skin’s surface may cause burning, itching, tingling, and stinging due to stimulation of superficial nerve endings. Engorgement of varicosities adjacent to thigh and calf muscles may result in cramping, throbbing, aching, and restlessness. If varicosities are cushioned in subcutaneous fatty tissue, neither pressing against the skin or muscles, they may cause heaviness, engorgement, and leg fatigue.
Veins in the legs have the responsibility of carrying blood back towards your heart. Since we do not have a heart in our feet to pump blood upstream, we have to depend on our calf and thigh muscles to aid in squeezing veins to accomplish this task. Venous blood normally goes in one direction aided by one-way valves stationed every several centimeters apart. If these valves are non-functioning, then venous blood pools back downstream due to the effects of gravity.
This is the reason individuals with varicose veins have more discomfort during prolonged periods of standing or sitting. This is also the reason why symptoms are alleviated with walking (due to the squeezing action of the calf and thigh muscles), leg elevation, and the use of support hose (to help squeeze blood into healthy deeper veins as well as upstream). There are several causes of poor valve function resulting in varicose veins. The most common of these causes is heredity. Patients with varicose veins are likely to have a father, mother, or grandparents with varicose veins. Women are more susceptible to developing varicose veins because of hormones (estrogen relaxes vein walls) allowing them to distend, and because of pregnancy (increased blood volume in veins; weight of the gravid uterus pressing down on pelvic veins; and the increase in estriol hormone produced by the placenta).
Conservative management utilizing prescription compression hose is always recommended in anyone who has varicose veins to help alleviate symptoms and to slow the progression. In the event that conservative management provides limited resolution of symptoms, varicose veins can now be effectively treated without surgery utilizing state-of-the art technology such as laser, radiofrequency, or foam sclerotherapy.
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