You and Your Legs
Have you ever thought about varicose veins or those little pesky, unattractive spider veins? Did you know that over 25 million Americans suffer from these conditions? That’s more than coronary artery disease and peripheral vascular disease combined! The sad truth is that many people don’t seek treatment in large part because they think it’s only a cosmetic problem.
The symptoms of varicose veins vary widely. There could be burning, itching, aching or cramping leg pain, or leg and ankle swelling and a heavy feeling in the legs. Advanced stages include skin discoloration, texture changes of the skin on the leg and potentially leading to open ulcers or sores. It’s no wonder that these things can take a toll on a person’s ability to maintain their normal daily activities!
Varicose veins come in all sizes, from the tiny spider veins to large, rope-like bulging veins. Why does this happen? The primary cause of varicose veins is due to damage to the valves in the vein that results in a backward flow and pooling of the blood. This in turn increases pressure and causes the the superficial veins to dilate. Sometimes the pressure of the blood in dilated veins causes fluid to leak from the vein which causes swelling. That could be quite uncomfortable or even painful! If not addressed, this could lead to thickening and discoloration of the skin and soft tissue and ultimately to skin ulcers around the ankles.
What are the risk factors for varicose veins? They include female gender, age, heredity, pregnancy, a standing occupation or sedentary lifestyle, obesity, prior injury, blood clot or surgery. Crossing your legs is not a cause but wearing high heels is associated with Varicose Veins.
Evaluation of varicose veins begins with a careful history and physical exam to identify any medical cause of the varicose veins. The mainstay of evaluation is a sophisticated painless and non-invasive ultrasound study that pinpoints the exact cause and location of the problem. This is usually done by an ultrasound technologist who is dedicated to vascular evaluations.
Now what can be done about this? Traditionally the treatment for varicose veins has been very conservative, with most physicians prescribing compression stockings and telling their patients that they had to live with it. For the most severe cases, a vein stripping was done. Fortunately, as in all areas of medicine, technology has come to the rescue. Now there are several minimally invasive modalities to treat varicose veins including laser, radio frequency ablation and sclerotherapy with a variety of chemicals. Sclerotherapy is used to treat small spider veins in which a tiny needle is used. Several sessions are typically required for best results. An exciting option that is still on the horizon uses a modified “superglue” to close the vein. These procedures can be done under local anesthesia in the doctor’s office. Depending on the case there are even more options available which can also be performed in the office. Compression stockings are prescribed after all of these procedures for one to two weeks, but resumption of normal activities is generally within a day or two.
Remember that varicose veins are no longer considered to be just a cosmetic issue. They can result in serious lifestyle and health consequences. The good news is that the evaluation and treatment of symptomatic varicose veins is covered by most insurance plans. Talk to your doctor if you think this may apply to you. It’s never too late to Love Your Legs!