Varicose veins

Signs of vein weakness

Varicose veins

What are varicose veins?

Varicose veins are referred to as varices in the medical profession (varicose vein disorder: in the medical field, this is known as “varicosis”). The irregular, tube-shaped, extended and tortuous veins appear directly under the surface of the skin on the legs.

Causes: What causes varicose veins?

Varicose veins are created when the venous valves located in the veins no longer close correctly. Doctors call this valve insufficiency. If the venous valve funtion function decreases, blood collects in the veins. It puts pressure on the venous wall, causing the veins to continually expand. The result: The surface veins become stretched and are visible as the characteristic tortuous varicose veins.

Symptoms of varicose veins

Varicose veins can be easily recognised and identified. Unlike spider veins, which are mostly harmless, varicose veins can cause symptoms and pain in the legs and negatively affect quality of life. They are also often an indication of a more serious venous disorder. Possible signs include:

People with varicose veins suffer from tired and heavy legs, particularly in the evenings, after long periods of standing or sitting but also in warm weather conditions. The ankle area can also be swollen because fluid has collected in the tissue there. The symptoms can be alleviated by lying down or sitting with your legs raised.

First varicose veins during pregnancy

Many women first notice varicose veins during pregnancy. The expectant mother gains weight. Her body produces more blood and the pressure in her veins increases. Tired and swollen legs during the day are a common side effect during the months of pregnancy.

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Risk factors for developing varicose veins

The following factors may increase the development of varicose veins:

Return of blood

Everything that prevents the blood returning from the legs:

  • clothing that is too tight
  • pregnancy
  • exercise involving crunches and heavy lifting
  • chronic coughing or constipation (pushing causes intense backflow into the leg veins)
  • sitting for a long time or crossing your legs
  • being overweight

Venous wall

Everything that relaxes the venous wall:

  • Hormones (contraceptive pill, menopause hormones, pregnancy
  • Alcohol
  • Warmth (for example, saunas, hot baths, underfloor heating)

Muscle pump

Everything that impedes or shuts off the muscle pumpways:

  • standing or sitting for a prolonged time
  • high heels
  • paralysis

Genetic predisposition

Genetic predisposition:

Venous diseases are hereditary to some extent. It is likely that further members of your family may experience similar symptoms. Therefore, always pay attention to the symptoms.

Preventing varicose veins: Tips and options

“Better to walk and lie down than sit and stand.” This is the rule of thumb from the German Venen-Liga e. V. vein association. Exercise supports the vein function by alternating between tensing and relaxing the leg muscles. Do vein exercises several times a day. These easy exercises will get your vein system moving and are quick to do. These tips can support you in everyday life.

  • Exercise: Lying down and walking is better than sitting and standing: Move around as often as you can. Change your position more often; raise your legs.
  • Sport and exercise: Plan ten minutes of vein exercises into your everyday routine to activate your calf muscle pump.
  • Healthy diet: How to eat a healthy, balanced diet.
  • Optimise your weight: Reduce any excess weight.
  • Clothing: Wear comfortable, loose clothing.
  • Shoes: Choose comfortable, flat shoes so that your calf muscle pump is able to work effectively.
  • Showers: Rinse your legs in cold water regularly. This helps the veins contract and improves the blood flow to the heart.

Avoid hot baths, underfloor heating and saunas because warmth makes your veins expand more and the negatively affects the return flow of blood.

Treating varicose veins: Diagnosis and therapy

Diagnosing varicosis: This is how varicose veins are diagnosed

For a precise diagnosis, the doctor examines the characteristics of the vein weakness and checks whether deeper veins are also responsible for the varicose veins. The following medical procedures are used in the diagnosis of varicose veins:

  • Anamnesis (questions about the medical history): Questions about typical leg symptoms and risk factors.
  • Examination (visual analysis): Varicose veins are easily visible when you are standing up, as are the advanced stages of chronic venous disorders, such as swelling or skin changes.
  • Palpation (examination by feel): The doctor feels the hardened tissue and oedema.
  • If necessary, imaging diagnosis methods, such as ultrasound investigations (duplex sonography, doppler sonography).

 The examination methods listed are not painful and do not involve any risk! 

Varicosis therapy: Treatment of varicose veins

Venous disorders are not curable because defective venous valves or dilated veins cannot be restored to their original state. However, there are ways to alleviate the symptoms.

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Conservative therapy for varicose veins with medical compression stockings and exercise

  • Medical compression stockings: The basic therapy for varicose veins is compression stockings in combination with exercise. The overstretched veins are compressed by the stockings. The venous valves close better and the direction of flow of blood to the heart is positively influenced. Medical compression stockings keep existing venous disease under control and help prevent new varicose veins from developing. Compression stockings also have an aesthetic aspect: They hide the varicose veins on the legs. Treatment with compression stockings is essential because non-treated venous disease can worsen continually. Studies prove the effectiveness of medical compression stockings: Your symptoms, such as heaviness or tightness, pain and swelling, are significantly improved, which has a positive effect on your quality of life.1
  • Comfortable venous therapy: Substances such as horse chestnut have a positive effect on the venous wall. Therefore, you should also consider the medi skincare series.

 

 

 

Removing varicose veins: Sclerotherapy, laser or also surgical removal (“vein stripping”) of the affected veins

The general rule: You decide together with your doctor what measures are necessary and advisable. Smaller spider veins can be treated with laser, or example. In sclerotherapy, a substance is injected into the affected vein with a very thin needle. This leads to the vein permanently closing up. Larger varicose veins are usually removed surgically. The surgical methods are so advanced that there are hardly any visible scars and all healthy veins are retained.

Medication for varicose veins: Strengthening the venous walls

There is no medicine to cure varicose veins. However, medicines can be a useful supplement and aid to treatment.

  • Vein tonics are medicines that activate the muscles in the venous wall and improve the return blood flow thanks to the increased elasticity of the veins.
  • Oedema protectors create vascular walls that are less permeable and thereby prevent increased collection of liquid in the tissue. Both medicines reduce the feeling of tightness and heaviness in the legs and support compression therapy. für weniger durchlässige Gefäßwände und verhindern damit eine erhöhte Ansammlung von Flüssigkeit im Gewebe. Beide Medikamente reduzieren das Spannungs- und Schweregefühl in den Beinen und unterstützen die Kompressionstherapie.

What happens if varicose veins remain untreated?

If the condition remains untreated, the increased pressure in the veins means that increased fluid will collect in the leg tissue. Doctors refer to this as an oedema (swelling).

Furthermore, red blood cells, among other things, can enter the tissue. These are visible as typical reddish-brown skin changes on the legs. Owing to the changes in the vascular wall and the reduced speed of the blood flow, the varices can become inflamed (varicophlebitis), with either severe or less severe development of a blood clot (thrombus).

A leg ulcer (ulcus cruris venosum) is the most severe possible consequence of varicose veins. If left untreated, varicose veins can therefore have serious consequences for your health:

  • Skin colour changes (pigmentation)
  • Eczema
  • Leg ulcers (vein-related lower leg ulcer, ulcus cruris venosum)
  • Thrombosis

Which doctors treat varicose veins?

A vein specialist is known as a “phlebologist”. Phlebologists specialise in the diagnosis and treatment of vascular diseases, particularly venous diseases.

They treat venous disease, among other things, including varicose veins (varicosis) in the lower extremities or thrombosis diseases, such as deep vein thrombosis in the legs, as do vascular surgeons. Skin specialists, such as dermatologists, also treat venous conditions.

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Source

1 Rabe E et al. Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology 2018;33(3):163-184.

Der Arzt stellt die Diagnose und entscheidet über die Therapie. Bei Notwendigkeit kann er medizinische Kompressionsstrümpfe verordnen. Im medizinischen Fachhandel wird der Patient von geschultem Personal vermessen. Der Patient erhält anschließend medizinische Kompressionsstrümpfe für seine individuellen Bedürfnisse.

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