Varicose veins are large, swollen veins that often appear on the legs and feet. They happen when the valves in the veins do not work properly, so the blood does not flow effectively. The veins rarely need treatment for health reasons, but if swelling, aching, and painful legs result, in severe cases, a varicose vein may rupture, or develop into varicose ulcers on the skin. 

Diagnosis: A physical examination, mainly visual, by a doctor will decide whether or not a patient has varicose veins. The patient will be asked to stand while the doctor checks for signs of swelling. 

Doppler test:  An ultrasound scan to check the direction of blood flow in the veins. This test also checks for blood clots or obstructions in the veins. 

Color duplex ultrasound scan: This provides color images of the structure of veins, which helps the doctor identify any abnormalities. It can also measure the speed of blood flow.

Causes of varicose veins: Varicose veins occur when veins are not functioning properly. Veins have one-way valves that prevent blood from flowing backward. When these valves fail, blood begins to collect in the veins rather than continuing toward your heart. The veins then enlarge. Varicose veins often affect the legs. The veins there are the farthest from your heart, and gravity makes it harder for the blood to flow upward.

Some potential causes for varicose veins include:

  • Pregnancy
  • Menopause
  • Age over 50
  • Standing for long periods of time
  • Obesity
  • Family history of varicose veins

Symptoms:

1. Veins look twisted, swollen, and lumpy (bulging).

2. The veins are blue or dark purple.

3. Aching legs.

4. Legs feel heavy, especially after exercise or at night.

5. A minor injury to the affected area may result in longer bleeding than normal.

6. Lipodermatosclerosis - fat under the skin just above the ankle can become hard, resulting in the skin shrinking.

7. Swollen ankles.

8. Telangiectasia in the affected leg (spider veins).

9. There may be a shiny skin discoloration near the varicose veins, usually brownish or blue in color.

10. Dermatitis - skin in the affected area is red, dry, and itchy.

11. When suddenly standing up, some individuals experience leg cramps.

12. A high percentage of people with varicose veins also have restless legs syndrome.

13. Atrophie blanche - irregular whitish patches that look like scars appear at the ankles. 

Treatment:

If the patient has no symptoms or discomfort and is not bothered by the sight of the varicose veins, treatment might not be necessary. However, if there are symptoms, treatment may be required to reduce pain or discomfort, address complications, such as leg ulcers, skin discoloration, or swelling. 

Complications:

Any condition in which proper blood flow is undermined has a risk of complications. However, in the majority of cases, varicose veins have no complications. If complications do occur, they may include:

1. Bleeding. 

2. Thrombophlebitis: Blood clots in the vein of the leg cause inflammation of the vein. 

3. Chronic venous insufficiency: the skin does not exchange oxygen, nutrients, and waste products with the blood properly because the blood flow is weak. Chronic venous insufficiency is not caused by varicose veins, but the two entities are closely related. 

Prevention:

To reduce the risk of developing varicose veins:

1. Get plenty of exercise, for example, walking.

2. Maintain a healthy weight.

3. Avoid standing still for too long.

4. Do not sit with the legs crossed.

5. Sit or sleep with your feet raised on a pillow.

Exercises:

If you already have varicose veins, exercise can keep them from getting worse and also help alleviate pain and discomfort. Generally, low-impact exercises are best, and include the following: 

1. Walking or Running

Walking just 30 minutes a day for five days a week can yield good benefits. If you run, try to find a grassy surface or synthetic track to minimize the stress on your joints. 

2. Leg Lifts 

Sit or lie on your back while sticking your feet straight out. Lift one leg at a time up, holding it in the air. Slowly lower it down and repeat with the other leg.

3. Bicycling or Bicycle Legs

Ridinge or stationary bike is also helpful. If you don’t have access to any kind of bike, you can try this bicycle legs exercise. While lying on your back, put your legs in the air, bending them at the knee. Pedal them slowly as if you are bicycling. Try both legs at once, or alternate one at a time. 

4. Lunges

Stand with your legs apart. Step forward slowly, bending your knee and making sure to keep your knee directly above your ankle. Hold it, then slowly straighten your leg and step back to your original position. Repeat with the other leg. While standing with your legs straight, rise up on your tiptoes and then lower back down. 

5. Rocking Your Feet

While you are sitting or standing, rock your feet back and forth from heel to toe. This can be done at any time and is also helpful if health conditions prevent you from trying other forms of exercise.