Varicose veins are dilated, tortuous veins, engorged with blood, which result from improper venous valve function. They can be either primary or secondary. Primary varicose veins originate in the superficial veins-the saphenous veins and their branches; secondary varicose veins occur in the deep and perforating veins.

Primary varicose veins tend to run in families, affect both legs, and are twice as common in women as in men. Usually, secondary varicose veins only occur in one leg. Both types are more common in middle adulthood.

Causes of Varicose Veins

Primary varicose veins can result from congenital weakness of the valves or venous wall; from conditions that produce prolonged venous stasis, such as pregnancy or wearing tight clothing; or from occupations that necessitate standing for an extended period. Secondary varicose veins result from disorders of the venous system, such as deep vein thrombophlebitis, trauma, and occlusion.

Signs & Symptoms of Varicose Veins

Mild swelling of ankles
Skin at the ankle discolored brown
Skin ulcers near the ankle
Pain in the legs: fullness, heaviness, aching
Visible, enlarged veins

Diagnostic Tests

Photoplethysmography, a noninvasive test, characterizes venous blood flow by noting changes in the skin's circulation.

Doppler ultrasonography quickly and accurately detects the presence or absence of venous back flow in deep or superficial veins.

Venous outflow and reflux plethysmography can be used to detect deep venous occlusion.

Ascending and descending venography can demonstrate venous occlusion and patterns of collateral flow. It's an invasive test and not routinely used.

Treatment

In mild varicose veins, treatment involves wearing elastic stockings, avoiding tight clothing and prolonged standing, exercising, and elevating the legs. Treatment of moderate varicose veins consists of wearing antiembolism stockings or elastic bandages. Severe varicose veins may require custom-fitted, surgical-weight stocking with graduated pressure (highest at the ankle, lowest at the top). An exercise program such as walking, promotes muscle contraction and forces blood through the veins, thereby minimizing venous pooling.

Severe varicose veins may require stripping and ligation or, in patients who are poor surgical risks, injection of a sclerosing agent into small segments of affected veins.

Prevention Tips

There's no way to completely prevent varicose veins. But improving your circulation and muscle tone can reduce the risk of developing varicose veins or getting additional ones. To improve circulation and muscle tone, follow these tips:

Avoid high heels
Control your weight
Don't sit with your legs crossed
Exercise Walking is great exercise

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