Tired legs, varicose veins Everything you need to know
What are varicose veins? Varicose veins are swollen, enlarged and twisted veins in the deep or superficial venous system of the legs, due to loss of vein elasticity, atrophy or weakened and malfunctioning valves.
Frequency Varicose veins are a common disorder that affects many people, regardless of age and sex. It is estimated that 50% of the population suffers from tired-legs syndrome and 15% have varicose veins. Approximately four times more women than men have venous disorders. This difference is probably associated with pregnancy, the use of oral contraceptives and lifestyle habits.
Predisposing factors Hereditary factors. A predisposition to varicose veins, with a similar topography, is often found among members of the same family. Patient s profession. Professions involving long periods of sitting or standing, or exposure to heat. Pregnancy. Intra-abdominal pressure during pregnancy may weaken the veins. Furthermore, pregnant women have double the progesterone levels of menstruating women in their bodies owing to the presence of placenta. Progesterone reduces normal vein tone and makes the veins more flaccid. Obesity. The tissues in obese people s bodies become slacker, and this has a detrimental effect on venous return flow. Constipation. Constipation increases intra-abdominal pressure.
Symptoms The main symptoms are as follows: Heavy, tired legs: discomfort that increases when standing for long periods. Cramp in the calves of the legs, especially in the evening and at night, owing to fatigue. Burning or intense itchiness on parts of the legs.
Signs The main physical signs include the following: Varicosity (bulging caused by dilatation of superficial veins, with veins taking on a darker-blue appearance). Oedema (swelling), initially around the ankle, but which spreads to the lower third of the leg. The oedema disappears when the leg is rested. The skin sometimes gets hot and red, accompanied by pain along the varicose vein.
Kinds of varicose veins Primary or essential varicose veins. These are the most frequent kind of varicose veins and do not correspond to any specific aetiology, the defect being in the superficial venous system. Secondary varicose veins. Secondary varicose veins are caused by other disorders and usually have their origin in the deep venous system. Depending on their aetiology, they can be classified as being due to postthrombotic syndrome, pregnancy, exertion and/or trauma, congenital varicose veins due to anatomic anomalies, etc.
Advice for varicose-vein vein sufferers and prevention Avoid any kind of compression on muscles and legs, such as tight shoes and clothing. Control excess weight and constipation by following a diet rich in fibre and protein and drinking plenty of water. Avoid standing still for long periods: take frequent short walks. Avoid high temperatures.
Put your legs up for at least 30 minutes during the day and, unless you suffer from cardiac or respiratory insufficiency or gastroesophagic reflux, sleep with the foot of your bed slightly raised (10-20 cm). Do plenty of sport (preferably swimming or cycling) and suitable gym exercises. Avoid direct heat sources and use support hose when necessary.
Alternately bathe your legs in hot water (maximum 38ºC) for 2-3 minutes and then give them a cold shower for 20-30 seconds, working upwards from the foot towards the knee. Sit with your legs up and massage them from the ankle to the thigh with an ointment containing antithrombotic and fibrinolytic agents. To make the massage more effective, use an oily, slowabsorption ointment that allows for a longer, deeper massage.