Varicose veins affect nearly 10% to 20% of all adults. They are easily recognizable on legs -blue veins that appear swollen and twisted close to the surface of the skin. Because the valves in the veins are damaged, they hold more blood at a higher pressure than normal. The pressure in the veins forces fluid into the surrounding tissue, which can make the affected leg swell and feel heavy. In addition to being unappealing and uncomfortable, varicose veins can also cause swelling in the ankles and feet and itching of the skin. Varicose veins may occur in almost any part of the leg but are most commonly seen on the inside of the leg between the groin and the ankle or in the back of the calf. If varicose veins are left untreated, patient symptoms are likely to worsen with some possibly leading to venous ulceration (leg ulcers).
What causes varicose veins?
The normal function of the leg veins, including both the deep veins in the leg and the superficial veins – is to transport blood back to the heart. For example, during walking, the calf muscle acts as a pump, contracting veins and pushing blood back to the heart. To prevent blood from flowing in the wrong direction, veins have many valves inside. If the vein valves fail (a cause of venous reflux), blood flows back into superficial veins and back down the leg. This backflow of blood results in veins expanding and becoming varicose. The process is similar to blowing air into a balloon without letting the air flow out again- the balloon swells.
In order for varicose vein treatment to be successful, the treatment must stop this reverse flow of blood at the highest site or sites of valve failure. In the legs, veins closer to the surface of the skin drain into bigger veins, such as the saphenous vein, which run up to the groin. Damaged valves in the saphenous vein are often the cause of reversed blood flow back down into the surface veins.
Why do varicose veins occur more in the legs?
Gravity is the main culprit of varicose veins in the legs. The distance from the feet to the heart is the longest distance blood has to travel in the body. Consequently, those vessels undergo a tremendous amount of pressure. If vein valves can’t handle the pressure, the backflow of blood can cause the surface veins to become swollen and disfigured.
Who is at risk for varicose veins?
Several conditions contribute to varicose veins including genetics, obesity, pregnancy, hormonal changes at menopause, work or activities requiring extended standing, and past vein diseases such as thrombophlebitis(i.e. inflammation of a vein as a blood clot forms.) In addition, women are more likely to suffer from varicose veins and the incidence of varicose veins increases to 50% for people over the age of 50.