Aches and veins: Should you be concerned about varicose veins?Veins don’t get the attention they deserve. The network responsible for delivering blood back to the heart doesn’t usually get much thought. Unless, of course, one of them becomes a squiggly blue nuisance.
By: Meredith Holt, INFORUM
Veins don’t get the attention they deserve.
The network responsible for delivering blood back to the heart doesn’t usually get much thought.
Unless, of course, one of them becomes a squiggly blue nuisance.
Varicose veins may be unsightly, but they can also be a medical issue.
Veins become “varicose” when their valves stop functioning properly and allow blood to flow backward, says Dr. Brian Dees, a general and vascular surgeon with Essentia Health.
Though they do appear elsewhere, the gnarled, enlarged veins generally occur in the legs and feet.
“Whenever you bear down, you’re forcing blood down your leg,” says Brandi Rostad, nurse and vascular technician at Hogue Vein Institute in Fargo.
Symptoms include tingling, throbbing and swelling, and they can worsen.
“Maybe they have symptoms and don’t realize it and chalk it up to being on their feet all day or other activities,” Rostad says.
So when should you talk to your doctor about a problematic vein?
Generally, if a vein is causing discomfort or distress, it should be checked out.
“If you have large, bulging veins, they cause problems, period,” Dolores Carson says.
The 81-year-old Fargo woman says she’s had trouble with veins most of her life.
But if they aren’t bothering you, you probably don’t need to treat them, says Dees.
An ultrasound examination can determine whether a vein poses a health risk. The imaging reveals the distribution of the veins and whether they’re working properly.
Rostad says varicose veins have the potential to become dangerous.
In some cases, they can lead to more serious problems like tissue edema, leg ulcers and blood clots, though Dees says that’s uncommon.
“Occasionally, the large varicose veins can erode very close to the skin’s surface. I’ve had a few patients who started bleeding in their own bathrooms when they popped,” he says.
Who gets them
Though varicose veins are hereditary, pregnancy and work that requires long periods of standing can bring them on.
However, Dees says some people who have no family history of varicose veins show symptoms.
Pregnant women are prone to varicose veins because of increased blood flow and added pressure from an enlarged uterus.
“Pregnancy can make the problem progress, and progress more quickly,” Rostad says.
Dees says he sees three times more women for the problem than men.
“Men and women can both have the condition. Women just tend to pay more attention to it,” Rostad says.
Varicose veins are also more likely to appear as you get older because veins lose elasticity with age.
Dees says exercising and weight-lifting can cause pre-existing varicose veins to swell up, but he hasn’t seen anyone develop them from training alone.
However, they can become more noticeable with weight loss because they’re surrounded by less tissue.
“All of sudden these things are bulging all over the place just because they lost 20 pounds, but the veins themselves probably haven’t changed,” Dees says.
How they’re treated
Treating veins can be, well, tricky.
“There isn’t a once-and-done treatment for a varicose vein,” Rostad says.
There are a few ways to treat veins, and patients often use a combination.
Endovenous laser ablation (EVLA) shrinks and collapses varicose veins. Sclerotherapy uses a chemical agent to destroy them. Sclerotherapy is often required after EVLA, Rostad says.
Very large varicose veins can also be surgically removed.
A vein’s size, “twistiness” and existence of backward flow help determine which course of action to take.
“If there’s a big vein and it’s a twisty mess, there’s no way to laser it. You need a semi-straight vein to laser it,” Rostad says.
Dees reserves sclerotherapy for small varicose veins or spider veins.
Patients are advised to resume their normal activities as soon as possible after treatment.
“If you sit on the couch and try to baby it, it seems like it just hurts more,” Dees says.
Follow-up scans are typically scheduled for six months to a year afterward.
Dees says varicose veins can return, but it usually takes a couple years. “I don’t see very many people back with recurrences,” he says.
Carson, who had both EVLA and sclerotherapy, says she hasn’t had any swelling in her ankles since her first EVLA treatment.
The Hogue Vein Institute takes a comprehensive approach to treatment.
“It’s important to take care of the entire problem and not just the problem vein,” Rostad says.
Readers can reach Forum reporter Meredith Holt at (701) 241-5590