Varicose Veins and Lower Extremity Venous Insufficiency 

Varicose Veins

Varicose Veins and Lower Extremity Venous Insufficiency: Varicose veins are enlarged, swollen, and twisting veins that often appear on the legs and feet which occur when the valves in the veins control the flow of blood are not working properly or are damaged. Varicose veins occur because the valve couldn’t hold blood from flowing backward from the leg. This causes blood to flow back to the leg and pool in the veins of the leg.

Varicose veins are just a cosmetic concern for many people but can also lead to more serious problems for others. People with varicose veins may not need treatment as they may not pose any health issues. However, there are cases where some people experience aching, swelling, discomfort or pain. In such cases, treatment may be required.

Symptoms of Varicose veins

Symptoms of varicose veins include:

• Veins that appear blue or dark purple in color
• Veins that appear twisted and bulging
• An achy pain
• Feeling heavy in your legs
• Burning, throbbing, muscle cramping
• Swelling in your legs
• Itching around the varicose veins
• Skin discoloration around the varicose veins
• Experiencing increased pain after sitting or standing for a long period of time
• Experiencing increased bleeding when injured in the area with varicose veins

Treatment of  Varicose Veins

Treatment of varicose veins includes:

1. Home remedies

Home remedies for varicose veins include:

• Exercising
• Losing weight
• Raising your legs
• Avoid wearing high heels
• Avoid wearing very tight clothes
• Avoid standing or sitting for too long.

2. Compression stockings 

Wearing compression stockings helps to squeeze your legs and allow your veins and leg muscles to move blood more efficiently.

3. Sclerotherapy 

This procedure is done to scar and close up the affected varicose veins. It involves injecting small, medium, and larger varicose veins with a solution that scars and closes the varicose veins.

4. Laser treatment

Laser treatment is used to close off smaller varicose veins. It involves sending strong bursts of light onto the vein.

 5. Catheter-assisted procedures using radiofrequency or laser energy

The procedure involves inserting a catheter into an enlarged vein and then heating the tip of the catheter with either radiofrequency or laser energy to destroy the affected vein.

6. High ligation and vein stripping

This is a surgical procedure used to remove a damaged varicose vein. The procedure involves making small incisions and then removing the affected veins.

7. Ambulatory phlebectomy 

This is a procedure used to remove smaller varicose. It involves removing smaller damaged varicose veins through a series of tiny skin punctures.

Lower Extremity Venous Insufficiency 

Lower extremity venous insufficiency is a condition that occurs when the valves in the leg veins are not functioning properly or damaged, making it difficult for blood to flow back to the heart from the leg. This causes blood to remain and pool in the veins at the lower part of the leg.

What causes lower extremity venous insufficiency?

The veins transfer blood from the other parts of the body, including the legs to the heart while the arteries transfer blood from the heart to the other parts of the body.

Blood needs to flow upward from the veins in the legs to reach the heart. The calf muscles and muscles in the feet need to contract with each step to squeeze the veins and push blood upwards to the heart.

The veins have one-way valves that keep blood flowing upward and ensure that blood doesn’t flow backward. When the valve becomes damaged or starts malfunctioning, it can’t hold blood from flowing backward from the leg, thereby allowing blood to flow back to the leg, causing a pool of blood in the veins at the lower leg region.

Valve can get damaged due to different factors such as aging, blood clot, smoking, pregnancy, obesity, sitting or standing for a long period of time, et al.

Risk factors of developing venous insufficiency

• Lack of exercise
• Obesity
• Standing or sitting in a position for a long period of time
• Pregnancy
• Aging (over 50)
• Smoking
• Family history or hereditary
• A person with a previous leg injury
• Previous leg surgery
• Female gender

Symptoms of Lower Extremity Venous Insufficiency

The symptoms of lower extremity venous insufficiency include:

• Hardened or thickened skin around your lower legs or ankle
• Swelling of your lower legs or ankles
• Feeling of heaviness in your lower legs
• Aching and itching in the leg
• Feeling of pain
• Weakness of the legs
• Leg cramps
• Skin discoloration at the lower legs or ankles
• Varicose veins
• Feeling of tightness around your calves
• Worse case of leg ulcers

Diagnosis of venous insufficiency

During diagnosis for venous insufficiency, your doctor will conduct a physical examination. You will be asked questions about your medical history.

Your doctor may examine the pulse rate of your legs. Imaging scans such as x-ray, MRI or CT scan may also be conducted.

Special tests and ultrasound such as Venogram or Duplex ultrasound may also be conducted.

Treatment of venous insufficiency

As the disease progresses, the complexities of treatment increase. For this reason, it is important that you seek treatment at the early stage of the disease. The earlier you get treated, the better your chances of preventing serious complications.

Lower extremity venous insufficiency can be treated with home remedy or self-care at its early stage.

Medical care and treatment are recommended for worse cases.

1. Self-care treatments

Self-care treatments for early stages include:

Regular exercises

Engaging in regular exercises helps to enhance blood circulation throughout the body. Exercises also prevent blood clots.

Avoid standing or sitting in a position for a long period of time

Sitting or standing in a position for a long period of time hinders the free flow of blood in the body. Take walks and change positions as often as possible.

Practice leg elevation

Try to elevate your legs above your heart as often as possible. Keep your feet at a higher position above your heart level when lying down on the bed.

Reduce your weight

Obesity could cause increased pressure on your legs and veins. To lower the pressure on your legs, you should shed excess weight.

Wear compression stockings

Wearing compression stockings help to contract the muscles of your leg to facilitate the upward flow of blood.

Avoid excess salt intake

Taking excess salt can lead to water retention in the body which can cause swelling in your legs. Avoid intake of excess salt.

2. Medical treatments

Severe cases or latter stages of venous insufficiency require medical treatment.

Medical treatment options include:

Vein repair

This procedure is done to fix the valve or vein. Your doctor will cut open your leg or make small incisions to access the vein or valve and then fix it.

Vein transplant

This procedure involves replacing a damaged vein with a healthy one. A healthy vein will be harvested from other parts of your body. The damaged vein will be replaced with the healthy vein.

Sclerotherapy

This procedure involves injecting a damaged vein with a solution so as to close up the damaged vein.

Varithena

This procedure involves injecting polidocanol foam directly into the damaged vein. It causes the damaged vein to collapse, causing blood to flow out of the leg through healthy veins.

Ligation

This procedure involves cutting off the damaged vein so that blood won’t be able to flow through it anymore.

Endovenous thermal ablation

This uses radiofrequency or laser to heat up or burn up a damaged vein so blood can flow through healthy veins.

Medications

When lower extremity venous insufficiency leads to leg ulcers, antibiotics are used to treat infections.

Vein bypass

This procedure involves harvesting a healthy vein from other parts of your body and rerouting blood around the damaged vein. The blood will then flow through the healthy vein.

Frequently Asked Questions

Is venous insufficiency serious?

Venous insufficiency is not a serious health issue but it can be painful and very uncomfortable. Severe cases can make walking difficult.

Does walking help venous insufficiency?

Walking and other forms of exercise can be an effective treatment for venous insufficiency. When you exercise, your heart pumps more blood. The extra pumping force of your heart makes it easier for blood to push up and out of your lower legs. Walking makes blood flow more freely within your legs.

Can venous insufficiency cause shortness of breath?

Venous insufficiency can cause chest pain and shortness of breath.

Can venous insufficiency lead to amputation?

If left untreated, venous insufficiency can cause serious complications. It can lead to bleeding, venous ulcer, and other fatal conditions. Venous ulcer can get infected, leading to cellulitis or gangrene which may ultimately result in amputation of the affected leg.

Can you live with chronic venous insufficiency?

Venous insufficiency affects millions of people around the world. About 1 in 4 adults in the United States is affected by venous insufficiency. Venous insufficiency is usually not a life-threatening disease but it can degenerate over time, leading to serious complications. Keeping a healthy lifestyle such as exercising, reducing salt intake, shedding excess weight, practicing good skin hygiene, eating healthy foods can help you live a normal life.

What causes varicose veins? 

The most familiar cause of varicose veins is weakening the vein walls over time. Other causes include genetics, aging, pregnancy, obesity, and a family history of varicose veins. 

In addition to genetics, pregnancy is the most likely cause of varicose veins in women. Women who have to proceed with menopause and have not had children are less likely to develop varicose veins.

What are the risk factors for varicose veins?

Risk factors for the different types of varicose veins include the following:

• Spurting varicose veins that are blue or blue-black are more likely to be associated with vein disease.  
• Little spider veins on the legs may indicate underlying vein problems. 
• If you have spontaneous bleeding from a varicose vein, it is likely to sign underlying vein disease. 
• If you have a family history of vein disease, you are more likely to be affected. 
• Being female is a risk factor for varicose veins

How serious is venous insufficiency?

It’s a condition affecting the veins in your body characterized by the reduced ability to pump blood in the veins. The blood pools in the less part of your body when this happens, causing pressure and swelling.