Causes and risk factors:
People engage in certain occupations which includes prolonged standing like traffic police, teaching, nurses etc are more susceptible for varicose veins. Varicose veins are caused due to weakness of the walls of the veins or due to weakness of valves which causes poor circulation of blood or retrograde blood flow respectively. Congenital defects in the veins, or inflammation of the veins (phlebitis) or obstruction in blood flow due to thrombus are certain conditions which can lead to varicose veins. Varicose veins are also more commonly seen in obese people. Increase in the blood volume along with all the hormonal changes that occurs during pregnancy predispose to varicose vein. During pregnancy it is more commonly seen in first trimester. Apart from pregnancy all the hormonal changes that takes place during puberty and menopause, use of hormonal replacement therapy and birth control pills contribute to varicose veins.
Clinical presentations:
The veins of the lower extremities (lower leg and thighs) are more commonly affected. The complaints can be unilateral or bilateral. Most of the times the patient is asymptomatic. The patient has no complaints expect that certain enlargement or distention along the course of the vein is seen. Cosmetically the appearance can make the patient feel embarrassed. Pain in extremities is the most common complaint with which the patient comes up with. Dull aching pain which is aggravated on walking, prolonged standing or on sitting is experienced. Changes in the skin are seen. There is reddish blue discoloration seen. Itching can be felt at times. The patient feels heaviness in the limbs. Varicose veins can also cause swelling of the ankle joint. Varicose vein can also lead to certain complications like varicose ulcers, cellulitis and deep vein thrombosis in the lower extremities.
Diagnosis and investigations:
Symptoms narrated by the patient along with examination carried out by the doctor will help in confirming the diagnosis. Certain physical tests are carried out. Reviewing of the history is necessary to evaluate the cause. Doppler ultrasound and duplex ultrasound visualization are the diagnostic investigations.
Treatment:
Elevation of the lower extremity (by using pillow) while sleeping or sitting is effective in relief. Use of compression bandages ,compression varicose stocking which are readily available at the counter are recommended. Varicose veins are treated by sclerotherapy. Use of radiofrequency, Laser ablation to destroy the abnormal veins is done. In severe cases vein stripping (it is a procedure which now outdates), phlebectomy is advised. Weight loss in cases of obese is essential. Regular exercising is must.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up the disease. Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms .Some herbs are also available.
