What are Varicose Veins?
In healthy veins, one way valves direct the flow of venous blood in the leg upward toward the heart. When one or more of these valves fails to function, the blood in the malfunctioning vein flows in the reverse direction, causing the veins under the skin to engorge and distend. The “back up” of blood flow increases the pressure in the veins to a level that is three to four times the normal amount. This high pressure then causes the veins to bulge and stretch and usually results in inflammation and pain.
Varicose veins do not occur suddenly. It can take years for signs and symptoms to develop. While genetics and inheritance play a big role in their occurrence, anyone can develop them even without a family history. They commonly occur during pregnancy and in people that have had certain types of leg injuries or deep vein blood clots. People that work in jobs that require prolonged standing or sitting are also at higher risk. A physical exam, along with an ultrasound, is necessary to determine the extent and severity of the varicose veins and if the varicose veins are caused by broken valves in the veins underlying the skin. Although less common, it is possible to have varicose veins and not experience painful symptoms.
Varicose veins are a common cause of leg pain. Most patients with varicose veins experience generalized aching and throbbing in their legs. This type of discomfort is usually more pronounced when there is venous insufficiency in underlying veins. Painful symptoms caused by varicose veins are aggravated with prolonged standing and are often relieved once the legs are elevated. Wearing medical grade compression stockings can also provide temporary relief. A physical exam along with diagnostic ultrasound is necessary to determine if leg pain is caused by venous insufficiency in underlying veins. Other causes of leg pain include arthritis, poor arterial circulation, an injury to muscles or joints, foot problems and nerve pain, just to name a few.
Swelling in the legs can be caused by a number of medical conditions, some more serious than others. Varicose veins with underlying venous insufficiency are a common cause, but they are not generally associated with more severe health problems. If swelling exists due to venous disease, most patients experience painful symptoms like throbbing and cramping and have visible varicose veins. A physical exam along with diagnostic ultrasound is necessary to determine if swelling is caused from venous insufficiency. Although pain and swelling caused by varicose veins often go hand in hand, it is possible to have one without the other.
Meet with an experienced physician and receive a diagnostic ultrasound on your first visit!
Possible Long-term Complications:
Varicose veins are common and are not generally associated with more severe health problems. However, they can be painful, unattractive and can worsen over time. Varicose veins can cause legs and feet to swell, create a sense of fatigue in leg muscles and cause throbbing and cramping at night. The skin surrounding the veins may also itch and burn. In some severe cases, venous insufficiency may develop, preventing normal blood return to the heart. Patients with venous insufficiency often benefit from medical treatment. Left untreated, varicose veins can lead to swelling, increased pain, skin discoloration, and ulcerations of the lower legs. These ulcerations are difficult to treat and can become easily infected and painful. Many of these symptoms and complications can be prevented by early treatment of varicose veins.
Skin Changes and Non-Healing Leg Ulcers
If varicose veins are left untreated, the skin surrounding them may begin to itch or burn. Over time, the skin may become dry, flaky and darker in color. These skin changes are caused by high pressure in the veins from a reverse flow of blood and result in poor nutrition to the skin. Eventually, these skin changes can lead to a venous leg ulcer which is very painful and difficult to heal. The inside (medial) or outside (lateral) aspect of the calf or ankle are common locations for a venous leg ulcer to occur. A diagnostic ultrasound is essential to determine if the ulcer is caused by underlying venous insufficiency, and if it exists, an Endovenous Laser procedure and/or Sclerotherapy may be the answer. Once treatment of the underlying problem is completed, the wound often heals very quickly.
Ulcerations to the lower extremities may also occur as a complication of poor arterial blood flow. This often manifests itself as an open sore on the toe and is a common complication of uncontrolled Diabetes. The cause of this type of ulcer is very different from a venous leg ulcer; therefore, treatment is best directed by a primary care physician.
Varicose Veins and Pregnancy
Pregnancy is, without a doubt, one of the greatest risk factors for the development of varicose veins. The hormonal changes and increased blood volume experienced during pregnancy can cause veins to become enlarged resulting in painful symptoms. Early signs of swelling and pain in the legs during pregnancy can also be signs of future venous complications. Women experiencing these symptoms should be fitted for medical grade compression stockings to minimize the risk of DVT (Deep Venous Thrombosis) or SVT (Superficial Venous Thrombosis), as well as to alleviate discomfort. At Midwest Vein Center, we keep a supply of special maternity compression stockings on hand for patients needing to be fitted for compression stockings during their pregnancy.
The majority of our female patients tell us their varicose veins appeared during their first pregnancy and worsened with each subsequent pregnancy. Treatment of venous disease between pregnancies is now safe, effective and can provide long term benefits, especially for patients who experienced a significant problem during pregnancy.
Superficial Thrombophlebitis and Deep Vein Thrombosis (DVT)
Occasionally, varicose veins can become swollen and irritated enough that a blood clot spontaneously develops, prohibiting blood flow through the vein. This is referred to as Superficial Thrombophlebitis. It is not life-threatening, but it generally requires anti-inflammatory medications. Many patients who experience a superficial thrombophlebitis have underlying venous insufficiency.
In contrast to a Superficial Thrombophlebitis, a Deep Vein Thrombosis can be life-threatening. A Deep Vein Thrombosis almost always originates in the deep vein of the calf or thigh and is characterized by pain and sometimes swelling. An ultrasound study will confirm the diagnosis. Treatment with blood thinners is needed for Deep Vein Thrombosis, and long term follow up is recommended.
Bleeding Leg Veins
Hemorrhaging (bleeding) from a vein can be a frightening experience, but it is more common than you may think. When veins are close to the skin’s surface and under high pressure, even a simple trauma may bring about a bleeding episode. Stopping the bleeding can be difficult and may result in a trip to the emergency room. Following immediate care to stop the bleeding, treatment with Sclerotherapy (injections of medicine) is often required to close the vein and prevent further bleeding episodes.
At Midwest Vein Center, we are passionately committed to providing you with the least invasive, scientifically tested, medically approved treatment options for achieving long-term relief from your vein problems.
Our vein treatments include:
Request an appointment to meet with a specialist and determine which treatment options are right for you.