(Vein Disease, Varicose Veins, Venous Reflux)
Venous insufficiency occurs when the veins in your legs do not allow blood to flow back to your heart.
Normally, the valves in your veins make sure the blood flows in one direction. Sometimes the valves do not work properly, causing the blood to flow backward. This backward flow can cause blood to collect or pool in your legs causing edema (swelling).
With Venous Insufficiency, you may experience ANY or all of the following symptoms:
- End of the day achiness
- Night cramps
- Restless legs
- Skin color changes
- Slow healing wounds
- Bulging varicose veins
Many people have symptoms without visible varicose veins, brown skin or poor healing wounds. You may notice difficulty standing on your feet all day, aching in your legs that may interrupt sleep, leading to feeling tired and sluggish during the day. You may experience an uncomfortable feeling in your legs with an urge to move them (restless leg syndrome) particularly at night. Painful cramping (Charley Horse) may also occur, also significant swelling in the ankles/feet, requiring larger shoes in the afternoon. In any case, signs can range from mild to severe and negatively affect the quality of your day to day life.
- Causes of venous insufficiency include any of the following:
- Family History of vein problems
- Previous pregnancy
- Being overweight
- Sedentary job/lifestyle
- Previous damage/injury/surgery to your legs
- Previous blood clots
UNDERSTANDING OUR ANATOMY-CIRCULATION
Circulation is the process by which blood flows away from the heart to the rest of the body, and returns back to the heart again. We have 2 types of blood vessels: Arteries which carry blood away from the heart, and Veins which return blood to the heart. Superficial veins lie just beneath the skin, and deep veins lie within the muscle of the legs. Veins and arteries vary greatly; Arteries are under pressure (our blood pressure 120 mmHg) while vein pressure is very low at 11-15 mmHg. Because veins have such low pressure, they compensate by having one-way valves that help the blood flow constantly move back toward the heart. Veins also greatly rely on the movement of our leg muscles squeezing the veins and pushing the blood along. In a damaged vein, the valves no longer work, and the vein walls become weak and dilated, which allows the blood to leak backwards through the valves and pool. Left untreated, symptoms tend to become worse and develop visible signs as well.
Initial treatments include conservative measures, things we can do on our own. This includes more exercise, increased walking, avoiding prolonged sitting or standing (sewing, computer games, puzzles, computer browsing, woodworking, extending reading, etc.) also leg elevation when sitting, and compression hose use. If symptoms persist, office-based procedures are highly effective in relieving symptoms and improving visual signs. Treatments may include endovenous laser or radiofrequency ablation. These procedures, performed in the office, use a device to apply heat to the affected vein, causing it to close down and stop the pooling. With these procedures, you walk in and walk out of the office (usually within one hour’s time), no IV is needed. Post treatment, blood flow and circulation are greatly improved. Another common treatment is sclerotherapy where we use an FDA approved medicine injected directly into the vein causing it to close. After treatments, your body reabsorbs these veins, and blood flow is rerouted to better functioning veins.
Venous insufficiency was once treated with vein stripping which could be painful and required a long recovery period. Patients who undergo endovenous ablation are most often back to work and normal activities within 1-2 days. There are no restrictions after I week. During recovery, it is important to stay active with frequent walks and exercise.
HOW TO MAKE AN APPOINTMENT
You do not need a referral from your primary care provider to be evaluated for venous insufficiency. Just contact our office, we will discuss your symptoms, and if appropriate, schedule you for evaluation.