If you notice deep red, blue or purple veins on your legs; do not take them lightly. They are the visible surface manifestation of an underlying problem with ‘reverse venous flow’ in your body, called venous insufficiency syndrome in the medical terminology; more commonly known as varicose veins.
Inside our veins are tiny one-way valves that open to let the blood through, and then close to prevent it from flowing backward. This mechanism helps in keeping a unidirectional blood flow from all over the body back to our heart. These valves have small leaflets. When these leaflets lose their elasticity, their capacity to push the blood upwards against gravity (esp. in the dependent parts) also reduces. Hence there is backpressure resulting in leakage and retention of blood in the veins, which leads to their stretching and elongation. This combined with reduced elasticity of the veins results in them getting ‘tortuous’ or twisted and hard. The veins, thus become visible as zigzag vascular tubes.
They are most commonly found in thighs, legs particularly calves and feet but can also form in other parts of the body. Hemorrhoids (piles) are a type of varicose vein(s).
Mild forms of venous insufficiency are merely uncomfortable, annoying, or cosmetically disfiguring causing psychological disturbances, but severe venous disease can produce serious systemic consequences and can lead to loss of life or limb.
Symptoms of Varicose veins
- Visible tortuous, bulging or stretched superficial leg veins
- Aching, throbbing, burning or night cramps in legs
- Severely tired, heavy, itchy or restless legs
- Leaky veins allowing blood to pool near the skin’s surface causing discoloration/blackening from iron deposits due to the breaking down of blood.
- For some people, there may be swelling of the ankles and feet
- The skin may become taut and easily punctured causing excessive bleeding even from a minor injury
- Should a wound occur, it may become a poorly healing, unsightly, potentially painful ulcer due to bad circulation.
What causes Varicose veins
Varicose veins affect especially the dependent parts of the body i.e. the lower limbs, which gets even worse when one occupationally tends to stand for longer durations such as people in sales, traffic policemen, teachers, doctors esp. plastic surgeons who tend to stand for hours during surgery, etc. Other contributory factors influencing their onset could be:
- Aging causing your veins to lose elasticity.
- Being a woman. Female hormones tend to relax the walls of veins, making the valves more prone to leaking. In addition, frequent hormonal changes – pregnancy, pre-menstruation, and menopause also influence varicose veins. They are found in as many as 40% pregnant women.
- Varicose veins could be inherited from your parents.
- Being overweight puts extra pressure on your veins, which means they have to work harder to send the blood back to your heart. This makes them more prone to leaking.
- Limited physical activity.
- Other conditions like – a previous blood clot, a swelling or tumor in the pelvis or abnormal blood vessels.
A major problem is that many people are not aware that they suffer from varicose veins. Awareness is lacking not only in patients but also in the medical fraternity. It is an undertreated disease; more than 40% of the Indian population suffers from it.
How is it diagnosed
Varicose veins are easily diagnosed by their appearance. Your Physician will carry out a physical examination and ask you a few questions to confirm the signs/symptoms of varicose veins and prescribe medicines accordingly.
In a few instances, he might refer you to a vascular specialist for a diagnostic test called Color duplex ultrasound scan or vein mapping. The test uses high-frequency sound waves to produce colored images of the veins in your legs. The picture shows the blood flow and helps the doctor locate any damaged valves that might be causing you varicose veins. This test can also measure blood-flow speed to access the level of sluggishness.
Complications of Varicose veins
Untreated and undiagnosed varicose veins result in pooling of the blood in the lower limbs due to chronic venous insufficiency, which may further cause:
b. Severe itching and burning leading to eczema on the affected parts
c. Superimposed infection may lead to wounds which may take a long time to heal – varicose ulcer
d. Systemic hypertension or high blood pressure
f. Thrombophlebitis or inflammation of veins causing a painful swelling along the course of the veins close to the surface of the skin.
g. Deep vein thrombosis, a dangerous condition in which blood clots form in veins deep inside the leg. The sluggish blood flow associated with venous insufficiency creates an environment conducive to their formation. These clots have the potential to break off of the vein wall and travel through the bloodstream. If this occurs the clot is known as an embolism. It can cause a number of serious (and potentially fatal) complications, including strokes, heart attacks, and pulmonary embolism.
Treatment of Varicose veins
If you have no symptoms or discomfort and are not bothered by the sight of the varicose veins, treatment might not be necessary. However, if there are symptoms, treatment may be required to reduce pain and/or discomfort, address complications, such as leg ulcers, skin discoloration or swelling. Some may also want treatment for cosmetic reasons – they want to get rid of the “ugly” varicose veins.
a. Non-medical treatment
Postural correction and changes form an important part of treatment for varicose veins:
- Always keep your legs elevated on a pillow during sleep (in case of varicosity of leg veins).
- Avoid standing for long. Form a habit of sitting down or keep moving your legs every now and then if it can’t be avoided.
- Use compression stockings especially meant for varicose veins to squeeze the legs and improve circulation.
- Avoid wearing tight clothing.
- Exercising/massaging helps improve blood circulation.
Conventional surgical treatment and modern non-surgical treatment of varicose veins can be done.
b. Non-surgical medical treatment
A Vein specialist – phlebologist will treat your veins with either a laser, a salt-solution called a sclerosant, or a combination thereof. You’ll be walking home the same day with relatively little pain or discomfort.
- Laser Therapy – used on smaller varicose veins, performed in an outpatient setting, with fast recovery time and positive mid-term results.
- Sclerotherapy – a minimally invasive procedure involving injecting salt water or a chemical solution into the vein. The varicosed vein should then collapse, harden and disappear.
- Endovenous Laser Ablation – a minimally invasive procedure using heat to treat the vein through either radiofrequency energy or laser energy. The varicose vein should disappear over time.
b. Surgical treatment
Surgical procedures might be indicated if varicosity is very severe but are much less preferable. These are more invasive, complicated, have many more potential side-effects, and longer recovery time. These include:
- Ambulatory Phlebectomy – involves removing varicose veins with small hooks through tiny skin incisions. It is performed under general or local anesthesia and can cause bruising, hemorrhage, hematomas, or a bothering sensation of ‘pins and needles’.
- Vein Stripping – in which a damaged vein is removed through small surgical cuts. It takes 1 – 2 hours and is done either under general or spinal anesthesia. You are required to spend some time in the hospital following the procedure and have to avoid physical activity for weeks.
c. Homoeopathic treatment
Homoeopathy works very well for mild to moderate cases of varicose veins. The natural remedies – Lachesis, Hamamelis, Arnica montana, Calcarea carbonica, Calcarea flour, Carbo vegetabilis, Graphites, Pulsatilla, Vipera, Zincum metallicum and many more… (I can give a list of roughly 140-150 remedies), work to root out the underlying cause – be it pregnancy, injury, standing for longer durations, your genetics or aging – in the safest and gentlest way without any side effects. They help reduce the discomfort, pain, swelling or discoloration and control further varicosity by strengthening the vein valves. Over time, there is an improvement in the vein elasticity too. Homoeopathy also helps significantly in cases of varicose ulcers.
If taken at the right time, homoeopathic treatment can help avoid painful surgical interventions.
Varicose veins cannot be completely prevented, but there are many ways to improve vein health.
As part of an anti-inflammatory diet, the best foods to eat to treat varicose veins include high-fiber, high-antioxidant foods (rich in vitamin C and E), natural diuretics, magnesium-rich foods, spicy foods (cayenne pepper) and wild-caught fish (rich in omega-3 fatty acids). Add apple cider vinegar and witch hazel to the list as local applicants. They help to ease off constipation, prevent swelling caused by water retention, are natural blood thinners tied to heart health and are in general beneficial for skin health.
Physical activities such as yoga, walking, cycling, jogging and swimming not only help you maintain a healthy weight; they are also a great way to improve circulation, by pumping blood up the leg against gravity.
Note:: Homoeopathic treatment is strongly recommended for all cases of varicose veins except for those which are truly surgical in nature.