VARICOSE VEINS ARE A MEDICAL PROBLEM

THERE’S A SURPRISING REASON FOR LEG PAIN, DISCOMFORT, OR SWELLING THAT CAN BE TREATED EASILY

Advertorial by Ashish Pal, M.D.; F.A.C.C

One of my patients had been experiencing significant pain in her knees and legs and it was radiating to her back. She found that this pain increased if she stood for long periods of time at the office, or at home doing housework or cooking. The pain lessened if she sat or lay down or exercised, but it never completely went away and always hurt when she was standing. She thought she might be developing a problem with her knees or joints, because she didn’t have any obvious vein issues.

You might be surprised to know that she had developed Chronic Venous Insufficiency. CVI is a result of dysfunctional valves caused by aging, pregnancy, obesity, blood clots in the deep veins of the legs (deep vein thrombosis) or pelvic tumors. When the valves become damaged, pressure in the veins is elevated as blood is unable to flow upward from the veins in the legs to the heart and leaks backwards and collects in these veins resulting in swollen, painful legs. Valve damage may occur as a result of aging and/or extended sitting or standing.

CVI is often associated with varicose veins, which are ropey, twisted and enlarged veins close to the surface of the skin, most common in the legs. Like my patient, you may not have these bulging veins, but may be experiencing pain, aching, muscle cramps or tiredness in your legs. People who stand for many hours– teachers, service workers, doctors, nurses, chefs – are more prone to get CVI. In fact, by age 60, 70% of women and 40% of men will be affected.

Symptoms: Symptoms of CVI in the earliest stages can include swelling in the lower legs and ankles, visible spider or varicose veins, aching or tiredness in legs, restless legs, muscle cramps, pigmentation and ulceration of the skin. Over time, the skin may become dry and scaly and become a light pink to a reddish-brown color if left untreated. This is due to pressure and swelling increasing until the blood vessels in the legs (capillaries) burst, making the skin very sensitive to being broken if bumped or scratched. Ulcers can also result from tissue damage due to CVI. These symptoms are more prevalent with people who are overweight, inactive, genetically predisposed or who are pregnant, smoke or have professions that require extended periods of standing or sitting.

Prevention: CVI is most treatable in the early stages. Try to avoid long periods of sitting and standing and exercise regularly. Wear tight fitting support hose/compression stockings and practice good skin hygiene.

Treatment Options: Non-surgical treatments include Sclerotherapy and Endovenous Thermal Ablation (Venefit procedure), a newer technique that uses laser or radiofrequency treatment as an alternative to surgical “vein stripping” or ligation. Heat is directed through a catheter to close up the targeted veins, but leaves them in place so there is minimal bleeding or bruising. It results in less pain and fosters a return to normal activity. Laser and RF ablations can treat superficial veins and can cure about 70% of the symptoms. Those who have persistent symptoms have obstruction of the deep veins, which is treated with stents to relieve the obstruction.

The seriousness of CVI increases as the disease progresses so it is important to see a doctor immediately if you have symptoms proper diagnosis and treatment plan. to get a