There are misconceptions related to varicose veins, explains Charles Rogers, MD, of the Morrison Vein Institute. “People think they have varicose veins because they’ve been sitting too long or they’ve had a leg injury, but it is largely passed down from their parents,” he said. “They’re also not aware that leg fatigue, night cramps, restless legs, ankle veins, and ankle swelling are often symptoms of varicose veins, as is generalized leg aching, even without bulging veins.”
Varicose veins are veins that no longer function correctly because of faulty valves. This is referred to as venous insufficiency. The enlarged veins may or may not bulge above the skin’s surface. They are most commonly found on the backs of the calves or on the inside of the leg, and are more prevalent among women than men.
Varicose veins are formed because veins have valves that act as one-way flaps. These valves stop blood from flowing backward as it moves up the legs. If a one-way valve becomes weak, blood can leak back down the leg, going the wrong direction in the vein. The blood slows down and increases pressure on the vein, causing it to enlarge and become incompetent.
Often the veins don’t even bulge, but they still can cause serious problems, Dr. Morrison cautioned. The problems are on the inside and out of sight. “If bulging doesn’t happen, there are other symptoms to look for,” he said. “The vein area may itch, hurt or ache. Some times there are ‘rings’ around the tops of where your socks hit that may indicate swelling from varicose veins. Varicose veins can even cause restless leg syndrome or ‘ulcers’ on your legs that just won’t heal.”
To diagnose varicose veins, we use a specific venous Doppler duplex ultrasound for diagnosis and vein mapping. This will give us a specific treatment plan unique to each patient. “Again, a lot of times the veins don’t bulge, so an ultrasound is critical to the diagnosis,” Dr. Rogers said.
Although people in their golden years seem to suffer from this malady the most, Morrison’s youngest varicose vein patient was 15 years old and his oldest was 92. “The 92-year-old woman was told she needed to have her leg amputated because the ulcers hadn’t healed for four years,” he recalled. “We did the procedure and her ulcer started to heal within two weeks.”