Varicose veins are caused by weakened valves and veins in your legs.  Normally, one-way valves in your veins keep blood flowing from your legs up toward your heart.  When these valves do not work as they should, blood collects in your legs, and pressure builds up.  High blood pressure inside your superficial leg veins causes varicose veins.  The veins become weak, large and twisted.  Varicose veins often run in families.  Aging also increases your risk.  Being overweight or having a job where you must stand for long periods of time (nurses, teachers, flight attendants) increases pressure on leg veins.  This can lead to varicose veins.  Pregnant women have an increased risk of developing varicose veins, but the veins often return to normal within 1 year after childbirth.  Women who have multiple pregnancies may develop permanent varicose veins.  Other factors that can increase your risk for varicose veins include not exercising enough, smoking or having DVT.  Women are more likely than men to develop varicose veins.  Varicose veins usually affect people between the ages of 30 and 70.

          Varicose veins look dark blue, swollen and twisted under the skin.  Some people do not have any symptoms.  Mild symptoms may include heaviness, burning, aching, tiredness or pain in your legs.  Symptoms may be worse after you stand or sit for long periods of time.  You may notice clusters of veins in a winding pattern on your leg, or soft, slightly tender knots of veins.  You may also experience night cramps.  Swelling in your feet and ankles may be another sign and itching over the vein is common is some people.  More serious signs include leg swelling and calf pain after you sit or stand for long periods of time, skin changes (color changes, dry skin, thinned skin, inflammation and swelling) and open sores or bleeding after a minor surgery.  If you have severe varicose veins, you have slightly increased chances of developing deep vein thrombosis (DVT).  DVT may cause sudden, severe leg swelling.  DVT is a serious condition that requires immediate medical attention.

          In order to diagnose the condition, your healthcare professional will ask you questions about your general health, medical history and symptoms.  In addition, your doctor will conduct a physical exam.  Your physician will examine the texture and color of any prominent veins.  He or she may apply a tourniquet or direct hand pressure to observe how your veins fill with blood.  To confirm a diagnosis of varicose veins, your health care professional may order a duplex ultrasound test.  Duplex ultrasound uses painless, high-frequency waves higher than human hearing can detect.  Your physician uses duplex ultrasound to measure the speed of blood flow and to see the structure of your leg veins.  The test will take approximately 20 minutes for each leg.  Besides showing varicose veins, duplex ultrasound may help your doctor decide whether your varicose veins could be related to some other condition rather than the veins themselves.

          Varicose veins may sometimes worsen without treatment.  Your physician will first try methods that don’t require surgery to relieve your symptoms.  If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and relieve other symptoms.  Your doctor may instruct you to prop your feet up above the level of your heart 3 or 4 times a day for about 15 minutes at a time.  When you need to stand for a long period of time, you can flex your legs occasionally to allow the venous pump to keep blood moving toward your heart.  For more severe varicose veins, your physician may prescribe compression stockings.  Compression stockings are elastic stockings that squeeze your veins and stop excess blood from flowing backward.  In this way, compression stockings also can help heal skin sores and prevent them from returning.  You may be required to wear compression stockings daily for the rest of your life.  For many patients, compression stockings effectively treat varicose veins and may be all that are needed to relieve pain and swelling and prevent future problems. 

          When these kinds of treatments alone do not relieve varicose veins, you may require a surgical or minimally invasive treatment, depending upon the extent and severity of the varicose veins.  These treatments include sclerotherapy, ablation, laser treatment and vein stripping or TIPP procedure.

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