Fit & Proper: Early treatment is key to curing varicose veins

Varicose veins in the leg affect nearly 25 per cent of women and 20 per cent of men. Left untreated, the condition - which makes the veins look blue-ish, bulgy and twisted - can cause pain in the calf muscle, leg fatigue and skin problems.

When you stand, the blood in your leg veins must work against the gravity to return to your heart. To accomplish this, the calf muscle should contract and squeeze the deep veins. When you walk, the calf muscle squeezes, but when you stand still or sit for long periods of time, blood tends to get pooled inside the calf muscle and the pressure inside the veins can increase, eventually leading to varicose veins.

Don't ignore the signs
The most obvious signs are that your legs may feel heavy, tired or painful. Standing or sitting for too long could worsen the symptoms. Night cramps are not uncommon either. Colour changes in the skin around the ankle could also be noticed, apart from itching and ulcers.

What to expect
To confirm the diagnosis, you will have to undergo a colour duplex assessment. This is a painless ultrasound 20-minute test performed in both standing and lying-down positions. The test confirms reversal of blood flow in the leg veins, in addition to examining the structure of the vessel wall and the flow in the deep veins.

Treatment for mild to moderate varicose veins
By and large, varicose veins are asymptomatic and do not require aggressive treatment. However, if you have already developed skin changes, ulcers or bleeding, you will certainly require aggressive treatment.

Initially, you could try methods that do not require intervention. Patients with mild to moderate symptoms can keep their legs elevated to reduce the swelling.

Compression garments could also be worn to squeeze the dilated veins from outside in order to reduce pressure in the veins.

Sclerotherapy
In this process, the physician injects a chemical that irritates the veins and scars them. The body would eventually absorb the veins that received the injection.

Radio-frequency ablation
One of the latest methods, radio-frequency ablation uses a thin catheter, which is inserted into the varicose vein and the electrode inside at the tip emits waves that generate heat and destroys the vein wall.

The post-operative pain is not severe, since the process involves no dissection. This is usually performed under mild or no anaesthesia. Adequate local anaesthesia is given during the procedure and the patient could recover quickly.

V Balaji
Consultant vascular surgeon, Apollo Hospitals, Chennai