Varicose veins are the large "ropelike" veins which are often one quarter inch or larger in diameter.
What causes varicose veins?
Varicose veins occur when veins are not properly returning blood from the lower leg to the heart. Leg veins have valves that open to allow the flow of blood to the heart and close to prevent the backflow of blood to the legs. When valves fail to function properly, blood leaks through and flows down the leg in the wrong direction. This problem is called reflux.
How common are varicose veins?
Chronic venous disease of the legs is one of the most common conditions affecting people of all races. Approximately half of the United States population has venous disease, fifty to fifty-five percent of women and forty to forty-five percent of men. Of these, 20 to 25% of the women and 10 to 15% of men will have visible varicose veins.
Complications of Chronic Venous Disease
- Leg and Ankle edema or swelling.
- Pain or cramps in the calves. Feeling of heaviness in the leg.
- Skin thickening and discoloration.
- Superficial Thrombophlebitis
- Spontaneous bleeding from varicose veins.
- Deep Venous Blood Clots (DVT)
Superficial Thrombophlebitis is encountered frequently and, although it is usually a benign, self-limiting disease, it can be recurrent and persistent, at times causing significant incapacitation. Superficial thrombophlebitis often occurs spontaneously, especially in the lower extremities in the greater saphenous vein or its branches, or as a complication of prolonged sitting such as occurs with plane trips or long car rides, or with medical or surgical interventions. Superficial thrombophlebitis presents as redness and tenderness along the course of a vein, usually accompanied by swelling. Treatment is aimed at the symptoms and is primarily treated with non-steroidal anti-inflammatory drugs such as Aleve or Motrin, elevation and rest. Although the vein may look "infected" antibiotics are not usually needed.
Varicose veins with thin overlying skin may rupture and bleed spontaneously or due to a very minor injury, such as occurs with a bump in the shower or a while shaving. Often, the veins which bleed spontaneously are small veins near the ankle and they do not necessarily cause pain or tenderness. Venous pressures inside some varicose veins near the ankle or foot can be nearly as high as arterial blood pressure due to the effect of gravity. The vein may rupture very suddenly causing bleeding into the tissues causing a bruise or through the surface of the skin. Bleeding from a varicose vein may be very scary with blood squirting across the room, but is easily treated. Emergency treatment for bleeding from a varicose vein is simple: elevate the leg higher than the heart, and apply pressure over the bleeding site. This should be done initially with a finger to control the bleeding followed by a simple dressing once the bleeding has stopped.
Deep venous thrombosis is a blood clot that forms in a vein deep inside a part of the body. It mainly affects the large veins in the lower leg and thigh. DVTs are most common in adults over age 60. However, they can occur at any age. When a clot breaks off and moves through the bloodstream, this is called an embolism, when it goes to the lungs it is called a pulmonary embolism (PE) and can be fatal.
Leg ulcers occur in skin that has become hard and thickened around the ankle and lower leg due to chronic venous insufficiency. The leg ulcers can be very difficult to heal, and often cause significant pain and disability. Treatment focuses on compression, elevation, and correction of underlying causes of venous reflux.