Varicose Veins

What are varicose veins?


            Veins are part of the circulation of your body.  Arteries carry oxygen rich blood away from your heart to the body’s tissues.  Veins return the blood back to the heart after the body has used the oxygen.  Varicose veins are distended, gnarled veins that are close to the skin’s surface.  They often are blue in appearance. Within the veins, valves open and close, moving the blood toward the heart, and keeping it from flowing backwards.  When the valves begin to malfunction, blood flows backwards in the vein, causing blood to pool, or collect within the veins.  Pooling of blood in the veins in the leg leads to ankle and calf swelling, a feeling of leg heaviness and fatigue, and leg pain. These symptoms seem to worsen with prolonged standing, in warmer weather, and with menstrual cycle.


As the blood continues to pool in the veins, the pressure within that vein increases.  This pressure causes the veins to enlarge, and even twist.  When the veins are enlarged, the already malfunctioning valves are unable to close properly.  These veins are called varicose veins.


What causes varicose veins?

            Many things can cause varicose veins.  The most common causes include:

  • Heredity—a family history of varicose veins.
  • Prolonged standing—especially in jobs that require you to be on your feet for long periods of time with no breaks for walking or sitting.  In this case, gravity is working against you, increasing the difficulty for blood to return to the heart.
  • Pregnancy—estrogen causes smooth muscles to dilate, causing the veins to dilate.  Increased blood volume during pregnancy can also cause varicose veins, as well as the enlarged uterus causing pressure on the lower extremity veins.  While these veins should decrease in size within three months after pregnancy, they will worsen with each successive pregnancy.
  • Obesity—the added weight causes pressure on the veins.
  • Past history of a deep vein thrombosis (DVT)—past obstruction within the vein can cause increased back flow and pressure, and damage to the valves.
  • Lack of exercise—sitting around causes the blood to pool in the veins, which can damage the valves by causing increased pressure.

What can you do to minimize varicose veins?

The key is to minimize the appearance of varicose veins and prevent progression of the disease.  Some steps that you can do to improve your vein circulation include:


  • Compression therapy—Prescription compression stockings help the veins return blood toward the heart by gently squeezing the leg.  They also support the varicose veins.  Some stockings squeeze more at the ankles than at the calves or thighs.  These are called graduated compression stockings and they help reduce swelling, leg heaviness, fatigue, and pain.  They also help reduce the pooling of blood.  Individuals with varicose veins should wear graduated compression stockings as much as possible, especially when they are going to be up on their feet or sitting for long periods of time.  With the wide variety of stockings available today on the market, patients have the ability to choose from different attractive colors, patterns and styles to suite their lifestyle.  The days of thick, hot, flesh-colored stockings are gone!
  • Elevate your legs—elevating your legs helps gravity return the blood to the heart.  This will decrease swelling and the feeling of leg fatigue and heaviness.  Whenever you can, elevate your legs, keeping your heels higher than your heart.  While at work, prop your legs on a footstool.  If your job requires that you be on your feet for long periods of time, as soon as you get home, elevate your legs for 20 minutes.  Putting blocks under the bottom of your bed (4-6 inches) if possible can also reduce swelling.
  • Exercise everyday—not only does exercise help you lose weight, it also improves your circulation.  Try walking, swimming or other aerobic activity.  Of course, check with your physician before starting any exercise program.  Even when you are sitting, you can tighten your calf muscles, flex your feet, and wiggle your toes.  These all help with lower extremity circulation.
  • Avoid standing or sitting for long periods of time—if your job requires that you be on your feet for long periods of time, take breaks and walk around or sit and elevate your feet for as long as you can.  When you are at work, wear your compression stockings faithfully!
  • Control swelling of your legs from other causes—if you have congestive heart failure (CHF) make sure you see your doctor and stay on the appropriate medications, as a CHF exacerbation can cause leg swelling.  Decrease your salt intake, since sodium causes fluid retention, which can lead to feet and leg swelling.