It’s Wednesday afternoon and you were planning to go to the gym after work. But after standing and running around almost all day you feel cramping, pain and itching down at your feet and lower legs. Why did I wear those heels, you think to yourself? And how am I going to workout with this pain?

DEFINITION:
Varicose veins are veins that have become enlarged and tortuous, typically occurring on the leg.

PREVALENCE AND CAUSES:
At least 25 million Americas experience symptoms caused by varicose veins. Common professions like nursing or teaching require prolonged sitting or standing, which increases chances of developing varicose veins. Not to mention pregnancy, where the amount of blood in the body increases and may enlarge veins. Obesity, hormonal changes, increasing age, family history, sun exposure, and leg injury may do the same.

Veins have small leaflet valves to prevent blood from flowing backwards. When they enlarge, the leaflets don’t work properly allowing blood to flow backwards. This backward flow causes more pressure and enlarges the veins even more. Varicose veins are located more commonly in the legs due to gravity causing increased pressure in the lower part of our bodies during standing or sitting.

SYMPTOMS:
Some common symptoms include aching pain, easily tired legs, leg heaviness or swelling, darkening of the skin, numbness in the legs, itching or irritated rash in the legs.

PREVENTION:
1. Do not cross your legs when sitting
2. Elevate your legs when resting as often as possible
3. Avoid standing or sitting for prolonged periods of time
4. Exercise regularly
5. Watch your weight
6. Eat high-fiber foods, decrease salt
7. Avoid becoming constipated as this may put pressure on the veins
8. Wear sunscreen
9. Consider compression stockings

COMPLICATIONS:
Severe varicosities can lead to poor circulation throughout the legs, skin conditions (dermatitis) , skin ulcers leading to development of carcinoma or sarcoma (cancers), blood clotting causing thrombophebitis , and fat decomposition.

More than you can handle… time to talk to your doctor about OTHER TREATMENTS:
You find yourself doing all the preventative methods mentioned above and still the symptoms continue or you developed an ulcer now or you simply hate their appearance. First, talk with your doctor about your varicose veins and what you have done. He/she may order some lab work, ultrasound to rule out possible clots and/or refer you to a specialist such as a vascular surgeon who specializes in vein diseases. You doctor may also perform certain procedures in his office such as sclerotherapy.

SPECIFIC PROCEDURES:
1. Sclerotherapy - performed in a doctor’s office without anesthesia. It is the most common and very effective treatment with 50-90% improvement. A solution is injected into the vein causing it to swell, stick together and seal shut. Blood flow is stopped, the vein turns to scar tissue and is absorbed by the body. Side effects: temporary bruising, red raised patches of skin at injection site, temporary stinging at injection site, brown lines around area that usually disappear, etc.

2. Laser surgery – no needles yet you may feel a heat sensation that can be quite painful although cooling reduces the pain. Most skin types and colors can be treated. Used mostly on small veins. Two to five treatments are needed lasting 15 to 20 minutes per session. Side effects include bruising, redness, swelling of skin, discoloration that eventually disappears.

3. Endovenous Technique/radiofrequency and laser – can be performed at doctor’s office. Used to treat deeper varicose veins. A tube, catheter, is put into a vein. It sends radiofrequency/laser energy that shrinks and seals the vein wall. Side effects include bruising.

4. Surgery – Used to treat large varicose veins. Types of surgeries include surgical ligation and stripping, ambulatory phlebectomy or endoscopic vein surgery. They may include general anesthesia and increased side effects and/or risk factors.

Whatever your decision, be knowledgeable about your own conditions/diseases/problems.