Varicose Veins Explained

 

What are they and why do they occur?

Varicose veins are dilated, tortuous, visible superficial veins in the legs, nearly always caused by poorly functioning valves, which normally control the direction of flow in leg veins. If these flap type valves fail, then blood which should be travelling back towards the heart, flows in the wrong direction, causing distension of the surface veins, which gradually become more and more prominent.

The most common sites for such problems to start are where the main surface veins connect to deeper veins, at the groin (long saphenous vein) or behind the knee (short saphenous vein).

In many cases, varicose veins run in the family, where there is likely to be an inherited weakness in the vein wall or valves within the veins. Other factors which exacerbate the development of varicose veins include pregnancy and being overweight. Although occupations involving long hours of standing may aggravate the symptoms from varicose veins, this probably is not the cause in the first place.


What problems can they cause?

Varicose veins are usually easily visible and cause some people concern, purely because of their unsightly appearance. They may also cause considerable aching, heaviness or cramps in the legs. Sometimes swelling at the ankles is seen. The veins may become very tender and inflamed (phlebitis). Skin changes can occur, especially around the ankle, with brown discolouration or staining of the skin and sometimes flaking and itching (varicose eczema). In later stages the skin changes can progress to breakdown of the skin and the development of venous ulcers.


Reasons for treatment

Not all patients with varicose veins need treatment. Simple measures, such as weight reduction or wearing support tights, or elastic stockings and trying to avoid long spells of standing, may be sufficient to alleviate aching symptoms, although these will not cure the underlying problems. Various reasons for more definitive treatment may be considered:

1. To improve the appearance.
2. To alleviate symptoms e.g aching, heaviness, cramps.
3. To treat the developing skin changes e.g varicose eczema
4. To avoid recurring episodes of phlebitis
5. Ultimately to prevent, or aid in treatment of venous ulcers.