What are varicose veins?

Varicose veins are veins close to the skin that are swollen, twisted, or stretched. Veins in the legs and pelvic area are most often affected. Varicose veins are more common in women. They often first appear before age 40 and get worse with age.

How do they occur?

Unlike the arteries, which pump blood from the heart, the veins, which return blood to the heart, have no muscle tissue. Veins use the muscles in our feet and legs to return the blood, against gravity, to the heart. To help this process, the veins have a series of valves in them that prevent blood from flowing backward. When these valves stop working, the blood has difficulty moving upward. Consequently, blood backs up in the veins where the valves no longer are functioning. These swollen veins are varicose veins.

Factors that may contribute to this condition are pregnancy, excess weight, and standing on your feet for long periods of time. Constipation may contribute to the development of varicose veins in the rectal area (hemorrhoids). Varicose veins tend to run in families.

What are the symptoms?

Varicose veins in your legs often look blue, twisted, and enlarged. You may have no other symptoms, or you may have:

• swelling in the legs

• generalized leg aching

• aching in the area where the veins are swollen

• feeling of heaviness in legs

• leg muscles that tire easily

• itching around the veins

• leg cramps

• sores on your skin, especially near the ankle.

How is it diagnosed?

Your health care provider will give you a physical exam and check your legs while you are standing. Your provider may also order tests such as an ultrasound exam to check blood flow if there is any evidence of a blood clot.

How is it treated?

The main treatment is wearing elastic stockings for support during daily activities. If you have leg swelling along with varicose veins, these stockings are especially important for preventing skin sores. Regular walking, avoiding prolonged standing, and elevating your feet as often as possible may keep your varicose veins from getting worse.

One treatment available, called sclerotherapy, involves injecting an irritating liquid into the veins. This causes the varicose veins to close and forces the blood to flow through healthier veins. While this procedure makes your legs look better, it may cause worse problems later.

A surgeon may need to remove varicose veins in some cases.

How long will the symptoms last?

The symptoms will last as long as the varicose veins are present and may get worse without treatment.

How long will the effects of injection or surgical repair last?

Usually sclerotherapy or surgical treatment gives permanent results in the treated veins. However, if there are underlying causes of severe varicose veins, such as obesity, new varicose veins are likely to appear.

How can I take care of myself?

• Elevate your legs at a level higher than your heart as often as you can.

• Rest frequently.

• Elevate your feet when you sleep by propping them on a pillow.

• Wear support hose.

• Exercise regularly to increase circulation.

• Maintain a normal weight.

• Avoid constipation.

What can be done to help prevent varicose veins?

• Avoid sitting or standing in one position for a long time.

• When you are sitting, exercise your calf muscles (for example, by raising your heels up and down) to promote normal blood flow.

• Exercise regularly to maintain good muscle tone, good circulation, and normal weight.