What are varicose veins?
Varicose veins, also known as varicoses or varicosities, occur when your veins become enlarged, dilated, and overfilled with blood. Varicose veins typically appear swollen and raised, and have a bluish-purple or red color. They are often painful.
The condition is very common, especially in women. Around 25 percent of all adults have varicose veins. In most cases, varicose veins appear on the lower legs.
Causes of varicose veins.
Varicose veins occur when veins aren’t functioning properly. Veins have one-way valves that prevent blood from flowing backward. When these valves fail, blood begins to collect in the veins rather than continuing toward your heart. The veins then enlarge.
Varicose veins often affect the legs. The veins there are the farthest from your heart, and gravity makes it harder for the blood to flow upward.
Risk factors.
These factors increase your risk of developing varicose veins:
️ Age: The risk of varicose veins increases with age. Aging causes wear and tear on the valves in your veins that help regulate blood flow. Eventually, that wear causes the valves to allow some blood to flow back into your veins where it collects instead of flowing up to your heart.
️ Sex: Women are more likely to develop the condition. Hormonal changes before your period or during pregnancy or menopause might be a factor because female hormones tend to relax vein walls. Hormone treatments, such as birth control pills, might increase your risk of varicose veins.
️ Pregnancy: During pregnancy, the volume of blood in your body increases. This change supports the growing fetus, but also can produce an unfortunate side effect — enlarged veins in your legs. Hormonal changes during pregnancy may also play a role.
️ Family history: If other family members had varicose veins, there's a greater chance you will too.
️ Obesity: Being overweight puts added pressure on your veins.
️ Standing or sitting for long periods of time: Your blood doesn't flow as well if you're in the same position for long periods.
Symptoms of varicose veins.
The primary symptoms of varicose veins are highly visible, misshapen veins, usually on your legs.
You may also have pain, swelling, heaviness, and achiness over or around the enlarged veins.
In some cases, you can develop swelling and discoloration.
In severe cases, the veins can bleed significantly, and ulcers can form.
Complications.
Ulcers: ulcers may form on the skin near varicose veins, particularly near the ankles. A discolored spot on the skin usually begins before an ulcer forms. See your doctor immediately if you suspect you've developed an ulcer.
Blood clots: Occasionally, veins deep within the legs become enlarged. In such cases, the affected leg may become painful and swell. Any persistent leg pain or swelling warrants medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.
Bleeding: Occasionally, veins very close to the skin may burst. This usually causes only minor bleeding. But any bleeding requires medical attention.
Prevention.
There's no way to completely prevent varicose veins. But improving your circulation and muscle tone may reduce your risk of developing varicose veins or getting additional ones.
The same measures you can take to treat the discomfort from varicose veins at home can help prevent varicose veins, including:
Exercising.
Watching your weight.
Eating a high-fiber, low-salt diet.
Avoiding high heels and tight hosiery.
Elevating your legs.
Changing your sitting or standing position regularly.
Physiotherapy treatments for varicose veins.
️ The most important step includes patient education to obtain better outcomes after treatment. Training the patient about the changes in lifestyle is important. The control of weight, care of the limbs and optimum exercises to keep the calf muscles and ankle joint supple are among the strategies.
Treatment includes:
Compression stocking (CS):
Relies on the use of compression therapy, which is considered the “gold standard,” provided by means of elastic stockings, bandages and pneumatic compression devices. Patient education is essential. CVI is a chronic disease that needs a life-long care. So patients with CVI should encourage to maintain a normal body weight, exercise daily (a walking program is especially good) and wear compression garment throughout the day
Most patients obtain adequate symptom relief by using long-term graduated compression stockings, and through leg elevation and oral pain medications. For compression rates the recommended graduation is 20-30 mmHg and in more severe cases can be elevated to 30-40 mmHg. Stockings when worn daily are the ideal treatment for patients who do not want surgery. They do work but the heat and hot weather can reduce compliance.
️ Structured exercise program:
CVI causes ankle immobility due to storage of fibrotic tissue. Because of immobility, the calf muscle pump cannot be activated and venous blood does not return to the heart. Presence of any abnormality in pump functions of calf muscle plays a significant role in the development of CVI. In patients with CVI, progressive exercise program have been used to rehabilitate the muscle pump function and improve symptoms.
A normal walking motion is required for activation of the calf muscular pump. It has been found that exercise program twice a week increased the angle of dorsiflexion and plantar flexion in those with CVI.
References.
https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643
https://www.healthline.com/health/varicose-veins
Jayani Randima.
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