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What are varicose veins?
Veins are vessels which are designed to carry de-oxygenated blood back to the heart from
the tissues of the body. Varicose veins, however, are abnormally dilated veins that cannot perform their function.
Varicose veins are larger veins that bulge above the skin surface which are commonly found
in association with larger and deeper vein problems.
If there is a deeper vein problem can be detected at an initial examination. Dilated blood vessels often cause aching especially after prolonged standing. Although dilated blood
vessels do carry blood they are not very efficient and are often not necessary to the
circulatory system. The body has an already established alternative route for the blood
to travel back more efficiently to the heart (deep venous system). They can be treated
without damaging the circulation. In fact, treatment actually improves venous circulation.
The probability of a greatly improved appearance following treatment is about 80 per cent depending on the severity of the problem.
Treatment will also usually relieve any symptoms caused by the veins.
What causes varicose veins?
Since our ancestors decided to stand upright, our leg veins have been faced with the
difficult task of taking the blood up to the heart against the pulling force of gravity. To do
this, leg veins depend on the contraction of the calf and thigh muscles to pump the blood.
This is why walking is good for your circulation.
When you walk, the contraction of your leg muscles pumps the blood up. However, as
the saying goes "what goes up must come down" which is what happens to blood in the
leg veins. Therefore, to prevent the blood from falling back down, nature has designed
valves in the leg veins which open in only one direction: upwards. So the valves allow the
blood to get through but when it comes back down, the valves shut and stop the blood
going all the way down. The next contraction sends the blood even higher until it eventually reaches the heart.
In venous disease, the underlying problem appears to be damage to the valves. The
abnormal reticular veins, for instance, act as "feeders" of the spider veins. The blood flow
in these feeder veins can compared to a "two-way" street. In other words, blood in the
feeder veins can go back and forth. This backward flow through the incompetent valves
dilates up the smaller veins (medically called "post-capillary venules"). These dilated
post-capillary venules are commonly referred to as "spider veins".The same principle
applies to varicose veins. The abnormal valve cannot stop the blood from rushing back
down.
The blood in these veins is oxygen low and in fact carries a lot of toxins. In the case of
varicose veins, this "toxic" blood pools in the legs and cannot be returned to the
circulation.
This is why patients with varicose veins suffer from night cramps and their legs feel
heavy at the end of the day.
Varicose veins occur in both men and women. A definitive cause is not known, however
a strong family history suggests that some people inherit veins that are more likely to deteriorate. In women, oestrogen may play a role as the onset of puberty, pregnancy
and taking oral contraceptives can give rise to vein abnormalities.
In pregnancy, the enlarged uterus can restrict blood flow from the legs and promote the development of varicose veins.
Spider veins and varicose veins are also associated with obesity.
Occupations involving prolonged standing and sitting in cramped areas
tend to increase the likelihood of veins to develop.
Bone fractures and soft tissue trauma can cause localized vein abnormalities
Can we do without varicose veins?
Varicose veins serve no useful function to the body's circulation. They do not return
blood to the heart and our body has already established alternative pathways to bypass
the abnormal varicose veins. When varicose veins are closed down, the circulatory
system improves, as do many of the symptoms.
It is important to understand that varicose veins can be a progressive condition and
that new veins can develop with time. Ongoing maintenance treatment is likely
for most patients by wearing compression stockings.
Can vein problems be prevented?
Wearing specialised venous support stockings may prevent some dilated blood
vessels from developing in some people. Maintaining a normal weight, regular exercise, avoiding constipation and avoiding wearing high heeled shoes may also be helpful.
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