Varicose veins refer broadly to dilated, tortuous superficial veins. Commonly there are spider-web-like fine threads or raised bulging veins on the skin of the legs, which affect appearance; more marked cases cause leg swelling, aching and numbness or cramps. The clinical picture is similar to symptoms of nerve or muscle disorders. Although most cases seldom cause immediate danger to life, they affect patients’ quality of life.
Causes of varicose veins
Blood in the lower limbs is pushed back to the heart by the contraction of the leg muscles squeezing the leg veins. The upward flow of blood (from legs to heart) tends to flow back down because of gravity. The normal venous valves inside the veins act like one-way valves; when they close properly they hold back the downward flow and let blood return normally to the heart.
If a person sits or stands for long periods, the leg muscles do not contract and move, and blood cannot be pushed back from the legs to the heart smoothly. Blood then pools in the leg veins and the veins dilate. Over time, the structure of the veins is affected and the normal closing of the valves is damaged, so backward flow increases and blood easily pools in the legs, causing swelling, and dilated, tortuous, protruding vessels like earthworms, among other symptoms.
Normal vein
Varicose Veins
People more prone to varicose veins
- Heredity (family history)
- Older age
- Overweight
- Work that involves long periods of sitting or standing (sedentary office workers, medical staff, hairdressers, teachers, cooks and so on)
- Pregnancy
- Smokers
- Sex (female)
Common symptoms
- Swelling of the lower legs
- Blue-purple spider-web-like fine vessels
- Raised, bulging veins
- Heaviness, swelling, aching or numbness of the legs
- Calf cramps (at night)
- Pigmentation of the lower legs and ankles
- Itchy skin
- Wounds that do not heal for a long time
Clinical classification of varicose veins
For the different degrees of varicose veins, the medical community generally uses the international CEAP classification as the standard.
CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classification
Link from Dr Elena Conde’s website (click)
