Although not generally life-threatening, varicose veins can be compared to a difficult life: long, tortuous, painful and sometimes ugly.
Varicose veins are basically twisted, widened veins with incompetent valves, and although they are a long-term problem, symptoms can come and go.
COMMON SIGNS AND SYMPTOMS
Common signs and symptoms may include throbbing, aching, cramping, swelling or a general heavy feeling or restlessness in the lower legs, especially after prolonged standing or sitting. Another common sign is itching or burning around the congested veins. However, if they are particularly bothersome it may be as well to have them checked out, since they could signal a risk of other circulatory system disorders. Skin ulcers near the ankle can represent a severe form of vascular disease that requires immediate medical attention. The most common complications of varicose veins are venous insufficiency (which can cause thrombosis), phlebitis, rupture, and venous stasis ulcers. These blue-purple ‘road maps’ occur most commonly in the legs, ankles and feet, but can also occur in the vagina during pregnancy, or around the anus as haemorrhoids, or as varicose veins of the scrotum (varicoceles). They appear blue because they contain deoxygenated blood, which is in the process of being recirculated. Basically they develop when veins just below the surface of the skin are damaged: either due to a genetic weakness in the walls of the veins, or an inherited weakness of venous valves, or simply through the ageing process and lifestyle-related behaviours. Gravity doesn’t help the situation either since blood is naturally pulled down into the lower extremities, whether one is standing or sitting. Anatomically, veins have one-way valves to ensure that blood is kept moving in the right direction and to prevent it fl owing backward. However, when they become faulty the veins tend to fill with too much blood and they get swollen or congested; consequently legs can feel very heavy and painful. However, in some people varicose veins do not produce symptoms.
WHY ARE THEY MORE PREVALENT IN WOMEN?
Although anyone can develop varicose veins, women are two to three times more prone to developing them than men, and there are several reasons for this. For example, women are often in occupations that require prolonged or uninterrupted standing, such as nursing or waitressing, which can cause pressure-related damage to veins or valves. Fatigue makes existing varicosities worse as well. Female hormones are additional predisposing factors, so during times of hormonal flux, such as menstruation, pregnancy or the menopause they may be worse. Pregnancy and obesity are possibly the higher- risk culprits, since increased pressure within the abdomen may increase or aggravate susceptibility towards developing varicosities. Pregnancy also increases the volume of blood in the body, but decreases the flow of blood from the legs to the pelvis. Both pregnancy and obesity cause changes in blood pressure that can have negative effects on venous fl ow. When blood does not flow back towards the heart in the normal manner, the tendency for it to pool in the veins is increased, and with it comes the risk of developing varicose veins. Drugs such as birth control pills and hormone replacement therapy (HRT) may also increase the risk of developing varicose veins, so women of childbearing age, mothers with young children, and older women, especially those with sedentary lifestyles, join those in the high-risk ranks. Unfortunately, varicosities tend to increase with age, so the condition embodies an element of ‘built-in obsolescence’. From the time that humans started standing and walking upright, pressure in the veins of the lower body naturally increased as part of our evolution.
ONCE YOU’VE GOT THEM, WHAT CAN BE DONE?
Conventional medical treatment A common conventional medical treatment for small varicose veins and spider veins is sclerotherapy. This procedure involves injecting a high concentration of an irritant solution into the veins. This causes thrombophlebitis, which encourages obliteration of the varicosity by thrombosis and subsequent scarring, eventually leading to disappearance of the vein. Significant varicose veins are often due to great saphenous vein (GSV) reflux, and they may require more radical treatment such as surgical removal or ‘stripping’, which involves removing and ligating the offending veins. This procedure carries the usual general anaesthetic risk and is not always 100% successful, as recurrence rates are high. Another surgical procedure, ambulatory phlebectomy, also removes veins through small skin incisions, and is less invasive than classic stripping and ligation. An even less invasive medical technique, with a lower risk of complications, is endovenous laser therapy. This procedure is performed under local anaesthetic and involves placing a laser into the vein, under ultrasound guidance, which causes thermal injury to the lining of the vein and allows it to collapse and seal.
Other than regular exercise, raising the legs, rest, or the use of appropriate support stockings or specialised elastic compression stockings may be sufficient in simple cases. In about 50% of cases the condition is familial, so it’s important to practise preventive health care if it runs in the family. The most important self-help activity is regular exercise, and avoiding prolonged pressure on the veins, so that blood flow is not impeded. Tight elastic, such as in garters, socks, panties or any other over restrictive garments, as well as sitting with crossed legs, or wearing highheeled shoes (this diminishes calf muscle activity) should be avoided. Constipation contributes to varicose veins so eating high-fibre foods, whole grains, and lots of fresh fruits and vegetables to promote good bowel function is important. Smoking is another serious risk factor. Natural medicine treatments Natural medicine treatments include careful massage, aromatherapy, homeopathy, herbal remedies, a healthy diet with additional nutritional supplements such as bioflavanoids, and exercise therapy including swimming and yoga, among others. Herbal remedies Horse chestnut (Aesculus hippocastanum) is possibly the best known herbal remedy for treating some of the symptoms of chronic venous insufficiency, including varicose veins. However, horse chestnut should be avoided by anyone with liver or kidney disease, and its internal use is also contraindicated during pregnancy and lactation. Bilberries (Vaccinium myrtillus) support normal formation of connective tissue and strengthen capillaries in the body, and in this way help prevent varicosities, while butcher’s broom (Ruscus aculeatus) is a venous tonic and anti-inflammatory agent. Herbs that strengthen blood vessels and improve peripheral circulation include gotu kola (Centella asiatica), ginkgo (Ginkgo biloba), and hawthorn (Crataegus laevigata). Spider veins may benefit from the astringent properties of witch hazel and coltsfoot, applied topically. Research by Kiesewetter et al ¹ concurs that standardised red vine leaf extract is rich in polyphenols, including anthocyanins, oligomeric proanthocyanidins (OPCs) and the important flavonoids – quercetin and isoquercitrin – which are superb natural venotonics.
Essential oils such as cypress (Cupressus sempervirens), lemon (Citrus limon), and geranium (Pelargonium graveolens) are excellent venous tonics. Add five drops of each to 20 ml of grapeseed oil and apply gently in the direction of the heart. An alternative blend is three drops of rose otto (Rosa damascena), five drops o frankincense (Boswellia carterii) and seven drops of juniper berry (Juniperus communis) in 20 ml of apricot oil. These essential oils can also be used in compresses. Care needs to be taken not to massage heavily beneath a varicose vein, especially if there is any history of thrombosis.
There is no simple cure for varicose veins, but prevention and the application of healthy selfcare treatments, or consulting qualified natural health specialists, can play a significant role in managing the condition.