You Don't Have To Live With Varicose Veins

As many as 40 million Americans have varicose veins, and many who have them think it is something they have to live with.

They don’t have to.

Minimally invasive treatments have made treating varicose veins a quick, easy and relatively painless process. Plus, the majority of insurance companies and Medicare will cover the procedure if patients meet certain criteria.

Varicose veins are veins that have become enlarged and twisted due to increased venous pressure that results from leaky valves. 

 Ashish Raju, MD, is a vascular surgeon with Carilion Clinic. He explained that in order to move your blood back to your heart, your veins rely on a network of valves that alternately open to allow blood through, then close to prevent backflow.

"In varicose veins, the valves do not work properly," he said. "This allows blood to pool in the vein—usually in your legs and feet—making it difficult for the muscles to push the blood back up. As blood continues to pool in the vein, the increasing pressure causes the vein branches to bulge and twist, becoming varicose."

Symptoms of varicose veins include:

• Veins that are visibly enlarged and bulging
• Throbbing, aching or burning pain
• Brown skin pigment
• Skin ulcers

Other symptoms can include unexplained leg swelling or bleeding episodes from the vein itself.

Causes

Genetics are thought to play a role in contributing to varicose veins, but several factors can increase your risk.

Unfortunately ladies, being female is one of them.

Other risk factors for both men and women include:

• Being overweight
• Standing or sitting for long periods of time
• Having a deep vein thrombosis (DVT)

Treatments

Before determining a treatment plan, your doctor will want to take a closer look at your varicose veins by performing a duplex ultrasound test. The painless test uses sound waves to visualize the vein structure and the blood flow in the veins.

“It is important to do an ultrasound first to see what is going on underneath the skin,” noted Dr. Raju. “Even though you can usually easily see the varicose veins on a patient’s legs, you have to make sure that there is nothing more serious going on underneath the skin, such as a blood clot or deep vein reflux.” 

Once Dr. Raju has completed the ultrasound test, he will begin by prescribing a conservative treatment regimen.

“I usually have patients wear compression stockings, exercise and keep their legs elevated when possible for about a 3-month period,” he said. “If they are still having pain despite this management and meet certain criteria, we can offer the endovenous ablation procedure to treat the leaky vein.”

Ablation therapy, which uses either laser or radiofrequency energy as a heat source, is an outpatient procedure that usually takes less than 30 minutes. There is very little downtime or pain for the patient.

“The incision is so small that we usually only put a thin Band-aid on,” explained Dr. Raju. “We do ask patients to wear a compression wrap for about 48 hours, but they can still move around. After 48 hours, they can take the dressing off and go right back to their normal activities without restrictions.”

Dr. Raju also noted that most of his patients generally have no pain issues. When they do, they usually only need to take acetaminophen (Tylenol).

“All of my patients walk right out of the procedure center on their own after the treatment,” he said.

Prevention

Some people are genetically predisposed to varicose veins, but there are some things you can do to help decrease your risk. Try the following: 

• Maintain a proper weight
• Elevate your legs when resting
• Avoid sitting or standing for long periods of time
• Wear compression (elastic support) stockings if you are going to be standing or sitting for long periods of time

If you have varicose veins, don’t think that you have to live with them. Talk to your doctor about treatment.