Health & Medicine

Getting your legs back: The causes behind varicose veins

Dr. Steve Lin
Dr. Steve Lin

As you reach middle age, you may experience bulging veins in your calves, ankle swelling, or a feeling of heaviness in your legs with prolonged standing. Many people mistakenly assume that these symptoms are simply an inconvenience, but in fact they can represent a common underlying circulatory problem known as chronic venous disease.

The risk of varicose veins increases with age, because aging causes wear and tear on the valves in your veins that regulate blood flow. Women are four times more likely to be affected than men, due to hormonal differences. Women who have had multiple pregnancies are particularly at higher risk. The obese are also at greater risk, as well as those who either stand or sit regularly for long periods of time. Those with a family history of varicose veins also are more likely to experience chronic venous disease.

Varicose veins are usually dark purple or blue and may look like cords or ropes. But damaged veins may be deep under the skin’s surface and not visible to the naked eye. If you experience symptoms like heaviness, burning, throbbing, swelling, cramping or itching in your legs, you may have venous disease and not know it.

The discomfort associated with varicose veins and chronic venous disease is often caused by venous hypertension, or high blood pressure inside the vein. All veins have one-way valves that allow blood to travel toward the heart. Venous high blood pressure occurs when the valves inside veins break down, usually starting in the legs. Any vein can become weakened, but the most commonly affected areas are the lower extremities.

If left untreated, those suffering from venous disease may continue to experience pain, fatigue and swelling. Further complications may include discoloration of the skin, visible ulcers, bleeding or weeping of the veins or infections.

Symptoms may be relieved by self-care through exercise, compression stockings or elevating the legs. In more severe cases, minimally invasive procedures inside the blood vessels, called endovascular treatment, may be needed.

Vein ablation is one such option. Vein ablation is a minimally invasive surgical procedure where radiofrequency or laser energy is sent into diseased veins through a thin tube. The heat from the laser seals the vein, and the procedure generally takes less than an hour. Blood that would normally return toward the heart through these veins will travel through other veins instead. Over time, the sealed veins shrink and are absorbed by the body.

Following the procedure, patients are fitted with compression stockings and encouraged to walk around almost immediately. Most patients experience relief from painful symptoms within 48 hours, with the results lasting for many years. The procedure is both safe and highly effective.

If you’re experiencing any symptoms of venous hypertension, including varicose veins without discomfort, ask your physician for a referral to a vein specialist who can work with you to develop a treatment plan.

By Steve S. Lin is with KentuckyOne Health Cardiology Associates - Lexington