Varicose veins are a pathological process in which the diameter of the vein lumen increases, the venous wall thins, and nodes form. Most often the veins of the lower extremities are affected: dilated and tortuous veins appear on the foot, lower leg, and thigh. Below are the mechanism and the causes that are considered risk factors.
What happens to the veins in varicose veins
Veins have one-way valves that help blood move toward the heart. If the valves are weakened or damaged, blood flows backward and stagnates in the veins. This leads to swelling of the vein and the formation of varicose veins. Externally, the veins look swollen and tortuous under the skin and may feel lumpy. Symptoms include pain, heaviness in the legs, night cramps, swelling, and skin changes — itching, discoloration, dryness. Symptoms worsen after prolonged standing and ease at rest with the legs elevated.
Main causes of varicose veins on the legs
The main cause is a hereditary predisposition: the disease occurs in people whose venous wall is weakened due to a genetic mutation. Heredity does not mean the disease is inevitable: its onset and rate of development depend on unfavorable factors. These include a sedentary lifestyle (sedentary work), increased physical strain from lifting and carrying heavy objects, and a reluctance to look after one's health. Regarding high-heeled shoes, there is no reliable evidence of a link with varicose veins: the published studies are small and contradict each other.
Heredity and varicose veins
Having relatives with varicose veins is considered a risk factor. Reticular varicose veins, that is, a fine vascular network, are most often the result of a hereditary predisposition of the vessel walls to dilation. The hereditary nature does not cancel the influence of lifestyle: it is the combination of a weak venous wall and external conditions that determines whether the disease will appear and how quickly it will progress.
Sedentary and standing work, sports, and strain on the veins
Prolonged sitting is considered a risk factor. Prolonged standing and prolonged sitting without elevating the legs are considered factors that worsen the condition of the veins. Increased strain associated with lifting and carrying heavy objects is regarded as an unfavorable factor. Smoking damages the veins. Lack of physical activity is also considered a risk factor.
Other risk factors: age, pregnancy, weight
The risk is higher in older people, in women, with obesity, lack of physical activity, and a family history of varicose veins. Varicose veins are more common during pregnancy.
When to see a doctor
The diagnosis is often made on examination; sometimes additional tests are needed, such as duplex ultrasound scanning to assess blood flow. You should see a doctor if you have pain, itching, or swelling of the legs, if you have a leg ulcer that has not healed for more than 2 weeks, or if the condition of the veins worsens. Bleeding from varicose veins requires emergency care.
- Pain, heaviness, night cramps in the legs
- Swelling of the feet and lower legs by the end of the day
- Itching, discoloration, dry and flaky skin
- A leg ulcer that has not healed for more than 2 weeks
Varicose veins by themselves are not a reason to call an ambulance; 103 or 112 — if bleeding starts from varicose veins.
This material is for reference: it describes the mechanism and risk factors but does not replace a doctor's consultation.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer