Varicose Veins :: Dr. Jayesh Kakar's Clinic :: Diabetic Foot Hyderabad :: Revival Clinic for Diabetic Foot, Varicose Veins, Gangrene Peripheral Vascular Problems

What are Varicose Veins?

Varicose Veins The veins are the means by which blood is returned from the legs to the heart. Muscles in the foot, calf and thigh act as pumps to push blood from the foot to the heart and from the superficial veins (long saphenous and short saphenous veins) to the deep veins via perforator veins. When muscles relax, blood is prevented from running back to the feet and from the deep to the superficial veins, by valves in the veins, which close like gates, once blood tries to run in the wrong direction.
Varicose veins occur when these valves or gates no longer work properly, allowing blood to bank up in the veins. The varicose veins you see in your legs are due to blood damming up in superficial veins and their branches. Why these veins fail is not completely understood. It may be due to a weakness in the valve itself or in the vein wall.

Interesting Facts: Varicose veins affect about 20% of the population. They are more common in women (20 - 25%), than men (10 - 15%). Pregnancy is often an initiating event in women. They tend to get worse with age. There is a genetic element. Being overweight and having an occupation that involves standing a lot aggravates varicose veins. Walking or running do not have an adverse effect.

Types of varicose veins

1.	Thread or Spider Veins: These occur mainly in women, and are more common in the thigh. There may be no other varicose veins.
2.	Primary Varicose Veins: These are the most common type and occur in the long and short saphenous veins and their branches.
3.	Secondary Varicose Veins: These act as bypass veins when the deep veins have been damaged or occluded. They should not be removed.
4.	Vulval Varices: They occur in women as a complication of pregnancy or infection

Facts

1.	30% of adults suffer from varicose veins.
2.	Varicose veins are big, blue, swollen and twisted veins underneath the skin.
3.	Varicose and spider veins can happen to any vein, but are more commonly found in the leg veins.
4.	Ulcers can form if this condition worsens. In some cases there may be sudden bleeding from the vein, which can be alarming.
5.	Like most medical conditions, varicose veins should be treated as early as possible- they will not get better by themselves but are likely to get worse.
6.	Eczema & Skin Changes - A form of eczema can occur in the calf, sometimes over an area of varicosity. The skin is red and itchy. Areas of the calf and around the ankle may develop a brown stain in the skin. Sometimes the entire lower leg feels tight and hard, and may look red and inflamed.
7.	Long standing skin darkening or blackening or wounds on the legs which do not heal may be an indication of varicose veins even if the blue twisted veins cannot be seen.

Common Symptoms

1.	Heaviness or tension in the legs.
2.	Swelling or Feeling of swelling the legs- especially around the ankles.
3.	Itching or tingling.
4.	Cramps.
5.	Restless legs
All symptoms tend to increase in the evenings or after periods of long standing.

Self Care

1.	Avoid sitting or standing in the same position for more that one hour at a time. Make it a point of changing your position regularly.
2.	Exercise regularly (walking, biking, swimming...) any kind of exercise that gets your legs moving will greatly improve the blood circulation in the legs. A doctor may even recommend some sort of activity that is just right for you.
3.	Take a load off. Put your feet up and rest them. Keep off your feet as much as possible. You should take at least three 10 minute breaks with your feet elevated above the level of the heart.
4.	Avoid wearing tight clothing, especially around the calves.
5.	Avoid wearing high heels. Low heeled shoes will work your calf muscles more.
6.	Wear support tights or stockings whenever possible.
7.	Avoid scratching the itchy area.
8.	Control your weight. Removing some of the extra weight you have been carrying will take away the extra unnecessary pressure off your legs and veins.
9.	Avoid crossing your legs when sitting.
10.	Constipation also contributes to varicose veins. Try to eat high-fiber foods like cereals and whole grains and get enough fresh fruits and vegetables. Also reduce your salt intake.
11.	Avoid SMOKING.

Varicose veins can affect men and women of all ages particularly women during pregnancy. It is common for sufferers to have relatives with the problem. People who stand at work for prolonged periods develop varicose veins earlier and suffer worse symptoms.

Special tests

Hand Held Doppler Examination: this is a small instrument used in the clinic by a vascular surgeon to listen to the direction of blood flow in the main superficial veins in the leg and so determine if the blood is running back in the leg (reflux).

Duplex Ultrasonography: this is the most common laboratory test for varicose veins. It enables the veins and blood flow to be visualized as well as listened to. With this test, back-flow (reflux) in the main superficial veins and their tributaries can be mapped out. The junctions of the superficial veins with their deep veins can be localized (especially important behind the knee) and incompetent perforators can be located ( and marked before surgery). The duplex ultrasound can also visualize whether there is reflux or obstruction of the deep veins. This test is performed by putting an ultrasound probe in the skin over the vein. It is completely painless. No injections are required.

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