Leg Veins and Your Health- Unsightly or Painful? Help is Available

Leg veins and your health go hand in hand but most people don’t really make that association.

The venous system and muscles of your legs are sometimes referred to as the peripheral heart.  This network of vessels is responsible for getting the blood that flows from the upper body down to your feet to get all the way back to the heart again.  For those individuals who stand a lot every day, it’s a lot of work for your body to be able to accomplish this successfully over and over again.

You probably never give it a second thought that your body is moving one and a half gallons of blood through all of your vessels 24 hours a day every day.

The venous system of the legs actually has 2 components, the deep system and a superficial system. Normally 90% of the return blood flow to the heart is through the higher pressure deeper component and 10% through the superficial venous system which has lower pressure inside of the veins.  Under normal circumstances, blood travels from the superficial system through perforator veins to the deep system.

For a variety of reasons, there can be weakness of venous vessels in the legs combined with the backing up of pressure from the deeper structures that cause the superficial vessels to become noticeable. Depending upon how well the superficial veins can handle this pressure, you might only develop small threadlike spider veins, or large bulging varicose veins can result.

Genetic predisposition is one of the key factors that really determine how mild or severe your experience with leg veins can be.  Prolonged sitting or standing can also have a significant impact on your susceptibility to varicose veins.  Here is an overview of what you might develop.

Spider Veins

These vessels are superficial and visible just under the skin surface and range in color from red to blue or sometimes purple.  You can start to develop these vessels as early as the late teens or during your twenties, but most commonly they start to appear between the ages of 35 and 45.  Increased pressure in the pelvic area during pregnancy can cause females to develop these venous blemishes. For some individuals, they become concerned about the veins because of their appearance, but for others they can be associated with burning, stinging, and discomfort especially with prolonged standing.  Vessels of this type can be treated by injecting sclerosing solutions that cause the vessels to close off and disappear.  Treatment with vascular lasers can be an alternative approach.

Reticular Veins

These are greenish appearing veins that can be flat and only visible through the skin or when more advanced, they start to bulge out and be noticeable.  Like the spider veins, you may or may not have symptoms associated with these vessels, however they usually direct the higher pressure to the spider veins from the deeper system. So, when reticular veins are present in the area of spider veins, they need to be treated first and the spider veins second to make the treatment more successful and the spider veins less likely to return.  Injections with sclerosing medications are the best way to get these vessels to go away.  A series of several treatments can be required to get the desired result.

Varicose Veins

Large, bulging vessels ranging from several inches to several feet can develop on the legs and indicate that the higher pressure from the deep venous system overwhelmed the superficial vessels so that they have stretched beyond their limits. Again, they can be bothersome because of their appearance as well as associated aching discomfort.  At this point, a new problem can develop.  The blood flow is no longer effective at returning all of the blood back to the heart so that fluid begins to leak through the vessel walls into the surrounding tissue which causes swelling of the legs and ankles. For some reason, when men develop leg veins they are usually the larger bulging veins.

At this point compression socks or hose should be worn on a daily basis and the legs elevated above the waist for at least 30 minutes every evening to help redirect the fluid back to the upper body.  To know how to best treat the larger bulging veins requires ultrasound evaluation to find the points at which the highest pressure originates.  Then a choice can be made to use local anesthetic and perform an endovenous procedure by inserting a laser fiber or radiofrequency cannula to heat and close off the abnormal vessel. This is a highly successful technique with quick recovery compared to traditional vein stripping done under general anesthesia.

Deep Vein Thrombosis

A variety of conditions can cause one or more of the vessels in the deep venous system to develop a blood clot.  When this happens, the leg becomes swollen and tender and represents a medical emergency.  Immediate treatment is required with intravenous anticoagulant medication to dissolve the clot and prevent movement to the lungs or other organs.  Hospitalization is usually required for this type of treatment.

So, your leg veins do their work every day without you really thinking about it and if you do not have any visible signs of varicose vein disease consider yourself fortunate. If you have started noticing spider veins it might be a good idea to wear compression hose or socks daily as well as eat a high fiber diet and participate in low impact exercises.  If you have any symptoms of burning, stinging, or irritation associated with the veins, then it would be good to see your physician and get the veins checked out to see if treatment is indicated.