Varicose vein

Hello students and friends, today we are going to discuss what is the varicose vein, its main cause, types, etiology, risk factors, symptoms, and treatment.

So let us first discuss varicose vein.

Varicose veins= term commonly refers to the veins of the legs.

• Varicose veins are veins that have enlarged and become twisted.
• Varicose veins can occur anywhere in the body but it commonly refers to the veins of the legs.
• When there is a condition of varicose veins, the leaflets of the valves are no longer properly meet and doesn't work properly.
• Veins have a pair of leaflet valves, which prevent blood from flowing backward means it prevent retrograde flow of the blood.
• There is valvular incompetence when these leaflets are unable to meet properly.
• When a person remains in a standing position for a long period of time, pressure in the veins is high, varicose veins may occur.
• This mainly affects the superficial veins of the legs.
• A varicose vein is painful(especially in a standing position) and it is also considered a cosmetic problem because of its appearance.
• Leg swelling, venous edema, lipodermatosclerosis, and ulceration are seen.

Is varicose vein is life-threatening?

• Mostly uncommon, but it may be confused with deep vein thrombosis(DVT), which may be considered a life-threatening condition.

Signs and symptoms

1. Heavy legs
2. Aching
3. The appearance of spider veins(telangiectasis)
4. Swelling of ankle(especially in the evening)
5. Venous eczema
6. Brownish-yellow shiny skin discoloration near the affected veinous area
7. When a person stands up or moves suddenly then there are chances of developing cramps.
8. Atrophile Blanche(whitened and irregular sac-like patches can appear at the ankles).
9. Lipodermatosclerosis(shrinking of skin above the ankle)
10. Clotting time increases.

Types of varicose veins

1. Trunk varicose veins
2. Reticular varicose veins
3. Telangiectasis varicose veins(spider or thread veins).

Trunk varicose veins- Thick and long; near to the skin surface.

Reticular varicose vein- They from network and red in color.

Telangiectasis varicose veins(spider veins)- Usually harmless, the appearance of red/blue clusters of veins on the legs or anywhere in the body where varicose vein occurs.

Etiology

• There is the failure of venous veins in the saphenous veins, this results in retrograde flow of venous blood in the branches of saphenous veins.
• Ambulatory venous pressure elevates and symptoms of varicose veins occur.
• Ambulatory venous pressure(AVP) is the ankle venous pressure when a person is walking.
• It is the gold standard test for testing the efficiency of the calf musculovenous pump.

Epidemiology

• Early stage- women-25% & men-15%.
• Venous ulceration- 5% of the population.
• More common in women than in men.

Complications

Poor circulation of blood through the affected limb may lead to complications but most of the varicose veins are reasonably benign.

Some complications are-

1. Skin ulcers or venous ulcer(especially near the ankles)
2. Pain, tenderness, heaviness in the affected limb
3. Long-standing for many hours may lead to pain and may hinder work
4. Dermatitis
5. In long-standing venous ulcers, there may be a development of carcinoma or sarcoma
6. In overweight patients, acute fat necrosis can occur at the ankle
7. Venous eczema
8. Superficial thrombophlebitis
9. Minor trauma may lead to heavy blood loss.

Causes

1. Menopause
2. Elevation of venous pressure
3. Defective venous valves
4. Infection or trauma
5. Incompetent venous valves.

Risk factors

1. As age increases, risk factor increases
2. Genetics
3. Pregnancy
4. Obesity
5. Men<women

Diagnosis

• When you visit your doctor, firstly he will examine your legs and if there is a condition of varicose veins and the veins are visible on the calf itself and he may ask you about pain or symptoms you are having.
• Doppler test is done to diagnose it and it is painless(non-invasive).
• Ultrasound can also be done to check the blood flow through the veins.
• A venogram may be done for the assessment of veins. This is done to ensure that any blood clot or blockage is not present in the veins which causes pain and swelling in the legs.
• An X-ray may be done by injecting a special dye into the legs, this will give a better view of the flow of blood.

Clinical tests

1. Trendelenburg test
2. Multiple tourniquet tests
3. Lower limb venous ultrasonography
4. Fegans test

Treatment

• Non-surgical treatment includes sclerotherapy, exercise, physiotherapy, elevating the legs, and elastic stockings.
• The traditional surgical treatment includes vein stripping to remove the affected veins.
• Alternative techniques- radiofrequency ablation, endovenous laser treatment, and US-guided foam sclerotherapy.
• Microsclerotherapy(block off smaller veins using a liquid chemical injection)
• Endovenous ablation therapy.

What is the physiotherapy management for a varicose vein?

Varicose vein mainly caused due to inactivity of the legs or body for a long period of time(as in standing posture).

Exercises increase the blood flow in the body and increase the flow of blood to the heart.

We can also relieve its symptoms by-

• Walking and running
• Bicycling
• Lunges
• Leg lifts.

Hope you all find this helpful for you, if you have any query related to this topic or any other topic then you all are free to contact me via contact us or you can also ask your doubts on the comment box. Thank you! 

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