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VARICOSE VEINS

Updated: Jul 6, 2020

Varicose veins are congested blood vessels caused by reduced blood flow in the lower limb vasculature.


This leads to an enlargement of the veins, which turn into a purple-like color and cause diverse signs and symptoms.


To understand varicose veins, we first have to tackle a short anatomy lecture.


Don’t panic just yet! It will be worth it.



THE NORMAL STRUCTURE OF THE VEIN


There is one major difference between the arteries and veins, and that’s the pressure inside these vessels.

Arteries are part of the high-pressure system of the body, which includes the heart and the arteries. The low-pressure system, on the other hand, is comprised of the pulmonary vessels and the rest of the veins.

Due to the high pressure in arteries, blood circulation is usually smooth even if it’s coming from the lower parts of the body (e.g. lower extremities). However, veins do not function in the same way.

You see, because veins are part of the low-pressure system, there isn’t enough power to push the blood from the lower extremities to the heart; as a result, it will just flow backward every time it’s pushed.

To counter this effect, the veins are composed of what’s known as valves, which are soft tissue material that prevents the blood from flowing in the opposite direction (see figure 01).



Figure 1

When these venous valves fail to do their job, patients start to experience varicose veins that manifest with visible veins on the legs and pain.


PREVALANCE OF VARICOSE VEINS


Current statistics state that 23% of US adults have varicose veins, adding up to more than 75 million people diagnosed with this disease.

It usually affects women more than men with a considerable portion of these patients developing chronic signs and symptoms that need prompt medical attention.

Varicose veins and their chronic complications cost the healthcare economy more than 3 billion dollars every year in the United States alone!

As you can see, varicose veins are quite a hassle to deal with and involve crazy numbers in terms of incidence and prevalence of the general population.


CAUSES OF VARICOSE VEINS


Many conditions increase the risk of developing varicose veins; however, the exact pathophysiology of each cause is not clearly understood.

Nevertheless, here are three common causes of varicose veins:

  • Pregnancy

  • Prolonged standing

  • Obesity


Figure 02 shows how failing venous valves lead to blood flow in both directions.

Figure 2

SIGNS AND SYMPTOMS OF VARICOSE VEINS


PAIN


While not all patients experience pain, it is still a common symptom in varicose veins. Patients might present with a vague chief complaint of feeling achy, cramping-like pain in one or both of their legs.

Your physician will evaluate the situation by performing a physical exam to determine whether the pain is muscular, venous, or arterial in origin.

This step is crucial to eliminate other potential diagnoses, such as deep vein thrombosis and peripheral arterial disease.


BULGED-OUT VEINS


Physicians often look for visible veins in the leg to confirm the diagnosis of varicose veins.

The veins look twisted and discolored, forming a web-like appearance, which is the result of blood accumulation.


ITCHING


This symptom could be seen around the bulged-out veins, and patients might scratch the affected area for long periods of time, exacerbating the situation even further.

Swelling of the lower extremities

Due to the floppy venous valves, blood flow to the heart is disrupted, which leads to the stagnation of fluids in the lower veins, causing the feet and legs to swell.

This swelling could lead to many symptoms, including pain, itching, and feeling like your legs are carrying extra weight.


TREATMENT OF VARICOSE VEINS

  • Lifestyle changes

  • Compression stockings

  • Surgery

CONCLUSION


Varicose veins are commonly seen in medical practice, affecting a large portion of the general population. Moreover, it is often a challenging disease to manage since there is a high risk of recurrence and chronicity.

If you have ever experienced varicose veins before, feel free to share your story in the comment section below.


We would be thrilled to read it!

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