What is varicose veins on the legs?
Varicosis is a venous disorder in which the veins become enlarged and the venous valves become weak. A common cause is a congenital weakness of the vein walls in the sense of a weakness of the connective tissue. The disturbed blood flow in the affected veins results in visibly bluish, dilated and later also tortuous veins. Varicosis usually affects the legs, but it can also develop in other areas, such as the pelvic and genital area.
Forms of varicose veins in the legs
Depending on which veins are affected by varicose veins, three forms can be distinguished:
- Truncal varicosis, which occurs in larger, superficial (trunk) veins
- Lateral branch varicosis, which affects smaller branches of the main veins
- Spider veins and reticular varicose veins, which affect very small veins in the skin that are arranged in a reticular pattern
Frequency and age: varicosis of the legs is common
Varicose veins in the legs are relatively common: around a third of all women and almost 20 percent of men are diagnosed with varicose veins. However, experts estimate that varicose veins on the legs are much more common and go undetected.
The incidence of varicose veins increases with age. This is because the skin and subcutaneous tissue slowly lose their elasticity. As life expectancy increases in the western world, we expect a corresponding increase in varicose veins.
Around 5 to 15 percent of those affected require special treatment.
Causes and risk factors
In most cases, the cause of varicose veins cannot be specifically determined. Veins have the task of pumping deoxygenated blood upwards towards the heart. They achieve this with the help of the venous valves, which prevent the blood from returning and with the so-called “muscle pump”. The muscle pump works by contracting the muscles and thereby compressing the neighboring veins. This is how they pump the blood upwards towards the heart. If the venous valves do not function properly, the blood “sinks” into the veins as a result of gravity and the affected veins dilate.
Risk factors that lead to varicosis are:
- standing for long periods, sitting a lot and lack of exercise
- Tight, oppressive clothing
- Obesity
- Pregnancies
In around five percent of all patients with varicose veins, the cause is a pre-existing condition such as thrombosis or tumors. In this case, medical professionals speak of secondary varicosis.
Symptoms: Visible bluish tortuous veins
Varicose veins on the legs are characterized by increasingly visible, bluish, nodular, tortuous and dilated veins. Those affected experience pain, a feeling of heaviness, pressure and tension in their legs. Swelling of the ankles and lower legs is also typical. The symptoms worsen after prolonged standing or in warm weather, as well as in the evening.
In advanced cases, itching, skin changes with brownish discoloration of the skin or open skin wounds (ulcers) may also occur. Nocturnal calf cramps, sensory disturbances, a feeling of heat and restless legs can also be caused by varicose veins.
Typically, the symptoms improve when patients elevate their legs or walk. Often the symptoms are not too bothersome and those affected see their varicose veins more as a cosmetic problem. In these cases, the disease is mild and usually harmless.
In more severe cases, varicose veins can also cause complications, such as superficial vein thrombosis, thrombosis of the deep vein system or bleeding. It therefore makes sense to seek advice from us in good time.
Diagnosis: Special vein tests
If you are referred to us for an examination of your varicose veins, we will first ask you a few specific questions (anamnesis) and examine your legs for varicose veins and signs of venous insufficiency. This is followed by an ultrasound examination. The deep leg veins and then the superficial leg veins are examined. A thrombosis (blood clot in the vein) is ruled out, and the course, diameter and direction of the blood flow are documented.
Prevention, early detection, prognosis
The following measures can help to prevent varicose veins in the legs:
- Regular exercise, especially running and swimming
- Avoiding or reducing excess weight
- Put your legs up
- take cold foot baths
If you already notice slight changes in your veins, you can do something yourself to prevent further deterioration:
- Regular exercise and elevation of the legs
- Occasional cold showers or treading water according to Kneipp
- Symtomatic wearing of compression stockings, especially in stressful situations, can also help (unless you suffer from a severe circulatory disorder (PAD))
Course and prognosis
Varicose veins usually have a good prognosis if they are detected early and treated if necessary. After surgical treatment or sclerotherapy, you can expect to be 80 to 90 percent symptom-free after ten years.
Possible complications of varicose veins on the legs
- Bleeding due to burst varicose veins
- Thrombosis (blockage) of the superficial veins due to blood clots
- Thrombosis of the deep veins and pulmonary embolism
- Inflammation and dark discoloration of the skin, as well as itching and swelling, due to the increased pressure and blood retention in the affected veins
- Open leg: In severe cases, wounds (ulcers) form and the tissue can die because it is not properly supplied with oxygen and nutrients.
Varicose veins on the legs: Treatment
There are various ways to treat varicose veins in the legs. We will be happy to advise you on the individual methods:
- Compression stockings (always recommended as a basic treatment)
- Endovenous laser ablation and radiofrequency ablation
- Ultrasound-guided foam sclerotherapy
- Phlebectomy (miniphlebectomy)
- Crossectomy/stripping (referral to surgical specialists required, not offered at our clinic)