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Varicose Veins

Intro

If a person has varicose veins, any of the following warrant a visit to a health care provider:

  • Inflammation, discoloration, or ulceration of the skin or swelling of the calf or leg is more typical of problems related to the deeper veins, especially a blood clot.
  • Unexplained pain or swelling in a leg particularly suggests a blood clot. Varicose veins by themselves do not usually cause a leg to swell.

Varicose veins alone are relatively harmless, but every now and then they can cause minor problems.

  • If the skin overlying the vein is thin or irritated, minor trauma from a bump or even shaving can tear the vein and cause bleeding. In this case, elevating the leg and applying pressure for several minutes should be enough to stop the bleeding. If it does not, you may need to visit your hospital emergency department.
  • If, at any time, you feel chest pain  or have trouble breathing, this may indicate the presence of a blood clot in the blood vessels of the heart or lungs. You should go to a hospital emergency department immediately.

Having varicose veins does not necessarily mean you will eventually have a blood clot or that a blood clot somehow caused them.

  • In rare instances, however, a clot increases pressure in the veins by blocking blood flow.
  • This elevated pressure will cause backward flow of blood through weakened valves, creating varicose veins.
  • For this reason, you should see your health care provider if your leg is swollen or if you experience worsening pain in the leg, or if you should suddenly develop varicose veins and you do not have any of the common risk factors such as pregnancy.

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Self-Care at Home

Treatments are available for varicose veins. 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 (such as Ted Hose or Jobst 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 health care provider. You may have problems with the blood supply to your legs (the arterial supply, which provides oxygen).
  • If you are overweight, try to lose weight. A healthy diet high in fiber and low in fat and salt can help.
  • Avoid alcohol, which can cause the veins in your legs to dilate.
  • See your health care provider 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.
Follow-up

Follow-up after a diagnosis of varicose veins is generally necessary only if a person is considering surgery or sclerotherapy. Otherwise, follow up with a health care provider only if severe or worsening symptoms occur.

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Prevention

You cannot change your genes, but you can keep your weight  under control, exercise, eat a healthy diet high in fiber, and try to stick to loose comfortable clothing when possible. If you are genetically destined to develop varicose veins, they may appear despite all your best efforts.

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.

Outlook

Varicose veins that you have now will not go away unless you have treatment, such as sclerotherapy or ligation and stripping. At times the veins may seem more prominent, such as in warm weather. However, once they appear, they will not go away on their own.

Prevention is the key. The earlier you start the lifestyle modifications outlined in Self-Care at Home, the better your chances of preventing new varicose veins from forming. In some cases, varicose veins may be one stage in the continuum of chronic poor vein functioning.

Some people may progress from having no symptoms, to the development of varicose veins, and then on to problems with leg swelling, and finally to ulcers caused by stagnant blood flow.

A small number of these people will have deep vein clots as a cause for their signs and symptoms, but most will not.

The more severe problems, such as skin ulcers, tend to be very difficult to prevent completely. Once these ulcers occur, they are very difficult to cure.

Even when they are eliminated, these ulcers tend to recur.

A deep vein blood clot has the potential to travel through the bloodstream and lodge in the lung. This is called a Pulmonary embolism. Pulmonary embolism  does not occur from varicose veins.

Pulmonary embolism  can be life threatening, because the blood clot can interrupt the circulation of blood.

Common symptoms of Pulmonary embolism  are chest pain and shortness of breath.

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