Ask Your Doctor: Varicose Veins in the leg by Dr. Brett Hodge

By anguillian February 3, 2012 10:42

Ask Your Doctor: Varicose Veins in the leg by Dr. Brett Hodge


Many residents ofAnguillasuffer from varicose veins of the legs, and sometimes the associated symptoms can cause much discomfort if not correctly treated. For some people, the veins can be a cosmetic nuisance, but for others they can cause much psychological distress as well.


What are Varicose Veins?

Veins are blood vessels that return deoxygenated blood from the outer parts of the body back to the heart and lungs. When veins become abnormally thick, full of twists and turns, or enlarged, they are called varicose veins. These can occur in any part of the body, but are more common in the legs. Veins in the leg are either superficial or deep. The superficial veins and their branches are close to the skin. These veins typically become varicosed.


Varicose veins in the legs tend to be more common in females. Varicose veins tend to be inherited and become more prominent as the person ages.

What causes Varicose Veins?

Many theories exist about why varicosities occur in veins, but the consensus is that defective/damaged valves within the veins are to blame.

Valves prevent the backward flow of blood within the vein. They keep blood in the vein moving toward the heart. Why the valves stop working is up for debate.

Some experts think inherited problems cause some people to have too few valves or valves that do not function properly.

Some people may be born with abnormalities of the vein wall. The resulting weakness may predispose the valves to separate and become leaky.

The result is that when a person with poorly functioning valves stands up, the blood flow actually reverses and flows down the superficial veins, when it should be flowing up, toward the heart.

When the muscles surrounding the deep veins contract, emptying the deeper veins, a build-up of pressure occurs.

This causes even more blood to go the wrong way from the deep to the superficial veins through faulty valves in the perforator veins.

This increases pressure in the superficial veins and causes varicosities.


Factors that can aggravate the situation

•    Pregnancy – Pregnancy is associated with an increase in blood volume. Also, added pressure on the veins in the legs by the weight of the growing uterus, and the relaxation effects of the hormones oestrogen and progesterone on the vein walls, contribute to the development of varicose veins during pregnancy.

•    Prolonged standing

•    Obesity or distended belly

•    Straining – Chronic constipation, urinary retention from an enlarged prostate, chronic cough, or any other conditions that cause you to strain for prolonged periods of time, cause an increase in the forces transmitted to the leg veins and may result in varicose veins. These mechanisms also contribute to the formation of haemorrhoids which are varicosities located in the rectaland anal area.

•    Prior surgery or traumato the leg – These conditions interrupt the normal blood flow channels.

•    Age – Generally, most elderly individuals show some degree of varicose vein occurrence.


Varicose Vein Symptoms

Some people may have no symptoms at all. For most people, varicose veins are mainly a cosmetic problem. When symptoms are present they are relatively easy to identify. The veins protrude or bulge from under the skin and feel ropey.

The legs oftenache and feel heavy and itchy.

Symptoms can intensify after a long day of standing on one’s feet.

One may have severe pain upon standing or even have cramps in the legs at night.

Varicose veins can be more prominent on first appear during menstruation or pregnancy, and they may be more bothersome during these times.

Varicose veins are prone to developing superficial thrombophlebitis, which is a blood clot, along with inflammationof a segment of vein.

Blood clots in the superficial veins are easy to detect, and troublesome, but are usually harmless. These are different from clots associated with deep vein thrombosis.

You may feel an area of tenderness and pain in the varicose vein, along with redness and swelling.

The area may also feel hard or firm.

Sometimes such areas can represent infection within the vein, so it is a good idea to visit your doctor if you should develop any of these symptoms.

This condition is not to be confused with a deep vein thrombophlebitis which is a blood clot in a deep vein. Deep vein thrombophlebitis is more serious because of the clot’s potential to travel toward the heart and lodge in the lung. This condition requires emergent admission to the hospital for treatment with blood thinning medications.



You cannot change your genes, but you can keep your weight under control, exercise, eat a healthy diet high in fibre, and try to stick to loose comfortable clothing when possible.


Ted stockings are the best nonsurgical treatment of varicose veins. They prevent skin breakdown and worsening of the varicosities. Most people have decreased swelling in their feet, and less tiredness at the end of the day, when using Ted stockings.



Treatments are available inAnguillafor varicose veins of the feet. Many of them are simple things you can start right now.

Elevate your legs as much as possible. If you can take half-hour breaks during the day to rest, do it. It is important to raise your legs up above the level of your heart to get the maximum effect, and to do this for about a half-hour each time.


Wear compression stockings. The key is to put them on in the morning before you start walking around, and before your veins become more swollen. If you try them and experience worsening pain, especially after you have been walking, remove them and see your doctor. You may have problems with the blood supply to your legs (the arterial supply, which providesoxygen).

If you are overweight, try to lose weight. A healthy diet high in fibre and low in fat and salt can help.

Avoid excessive alcohol which can cause the veins in your legs to dilate.

See your health doctor if you have problems such as chronic constipation, urinary retention or chronic cough. Relieving conditions that are causing you to strain may help with the varicose veins.

Avoid wearing tight clothing such as girdles or belts.

Do not cross your legs when sitting.

Walking is good exercise. It can help the muscles force the blood out of the deeper vein system.

If you are driving on a trip, or working at a desk all day, try to get up and walk around every hour or so to allow the muscles to pump the blood out of the veins.

Other treatment options for varicose veins of the feet include the following:

•    Sclerotherapy to close off the vein.

•    Laser treatment to destroy the vein.

•    Radiofrequency treatment to close off the vein.

•    Surgery to tie off or remove the vein.

You should see your doctor to discuss these treatment options and then decide which is the best option. In some cases no treatment might be needed.



Many individuals, especially females, suffer from varicose veins of the legs. In some cases there are no symptoms but for others the symptoms can be very severe and require treatment. There are several ways to help prevent varicose veins from developing, but if you have them and they are bothersome, you should see your doctor and there are several ways available for treating them.


Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in theJohnsonBuildingin The Valley.



By anguillian February 3, 2012 10:42


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