Varicose veins are surface veins of the lower limbs that are damaged and gradually become progressively dilated, enlarged and twisted. The dysfunction of this disease occurs in the valves and in the walls of the veins, jeopardising the return blood flow in the upper direction.
Varicose veins are largely hereditary; however there are other precipitant factors. In women, pregnancy and taking contraceptives may cause varicose veins. In the general population, remaining in a standing or sitting position for long periods of time may also cause varicose veins.
A usual complaint is pain in the lower limbs associated with heaviness and fatigue, which worsens in hot weather or when standing for long periods of time. In women, these symptoms tend to get worse in the premenstrual period and during pregnancy.
There are also other associated complaints such as itching, tingling, heat, cramps and oedema (swelling) of the ankles and legs, especially at the end of the day. These symptoms are proportional to the severity and size of the varicose veins.
Prevention of this disease is crucial not only in preventing its appearance but also its progression:
▪ Remaining in a standing or sitting position for long periods of time or sitting cross-legged should be avoided. When it is necessary to remain seated or standing for long periods, it is important to change position and take small walks;
▪ Practising regular exercise causes muscle contraction and promotes return blood flow, especially gymnastics, swimming, cycling and dancing. Sports which demand sudden movements should be avoided, e.g. basketball and tennis, as they cause pressure variations in the veins causing these to dilate, decreasing the return blood flow;
▪ Hot places should also be avoided as they cause the veins to dilate. On the other hand, cold water baths provide pain relief and a decrease in heavy leg sensation;
▪ Constipation and excessive weight gain increases venous blood pressure and should be avoided;
▪ Very tight clothing causes compression of the veins and hampers circulation. Shoes with very high heels or flat shoes have the same effect. Shoes with 3-4cm heels are advised.
▪ Sleeping with the legs raised about 10-15cm provides relief, as well as performing leg movements before falling asleep;
▪ Massaging legs with movements from bottom-up may relieve symptoms.
Minimally invasive techniques have provided very good results, including thermal radiofrequency ablation or laser and sclerotherapy.