Managing and Preventing Varicose Veins

Spider veins started appearing on my legs when I was pregnant with my first child.  In the last 30+ years and with five more children, they've only spread.  As I am at risk for varicose veins, I want to do all I can to prevent them.  And because varicose veins affect about 15% of the population, the topic seems like an important one to cover.

Varicose veins develop as the valves that control blood flow and help return blood to the heart begin to fail.  Blood pools in the veins, particularly in the legs, and they become painful.  There is no medication to treat this condition.  

Risk factors:

• Age--over 50
• Family history 
• Obesity.  Excess weight exerts pressure on the veins.
  
• Pregnancy
  
• Sex--Women are much more likely than men to develop varicose veins
• Sun exposure--spending long hours in the sun will increase the risk of varicose veins on the face.
  
• Taking birth control pills
  
• Women who have had many children
• Work in occupation that requires lots of standing, weight lifting, or sitting with bent legs for long periods of time.

The following information comes directly from The Ship's Medicine Chest and Medical Aid at Sea, a government publication:

"Varicose veins are abnormally dilated veins occurring most often in the lower extremities and the lower trunk.  Often they are found in people whose work requires prolonged standing.  This places a strain on the valves in veins because muscle action is not helping to return the blood.  Chronic systemic disease, as heart disease and cirrhosis of the liver, may interfere with effective return of blood to the heart and contribute to varicosities.  

Varicosities of superficial veins appear as darkened, tortuous, raised blood vessels that become more prominent when the patient stands.  The patient may have pain, fatigue, a feeling of heaviness in the legs and muscular cramps.  The discomfort is increased greatly by prolonged standing and is worse during hot weather or when the patient is in high altitudes.

Treatment

The patient with varicose veins should be advised to elevate his feet for a few minutes at regular two-hour to three-hour intervals throughout the day to improve circulation in the legs.  An elastic stocking or elastic bandage should be worn.  If an elastic bandage is used, it should be applied before the patient gets out of bed while the leg is elevated.  Rest in bed is essential if there is increased swelling of the leg or foot.  The patient should be instructed to seek medical advice when convenient."[1]

Additional actions for alleviating pain and taking care of the varicose veins:

• Use support hose or elastic bandages to hold veins in place during the day only.  They should be removed before bed.[2]
• Sleep with feet elevated above the heart (use a pillow to elevate the feet).[3]
• When standing, walk in place or repeatedly lift heels and put them back down.[4] 
• Eat a low-salt diet.[5]
• Avoid wearing high heels.[6]

Prevention:

Those at risk for developing varicose veins should consider stocking up on compression stockings.  In addition, regularly exercising the legs will strengthen the blood vessels.  Furthermore, those at risk should avoid standing for long periods of time and take short, frequent walks throughout the day.  And finally, maintain a healthy weight.  

References:

[1] The Ship's Medicine Chest and Medical Aid at Sea, 1978, p 140.

[2] David Werner, Where There Is No Doctor, 174.

[3] David Werner, Where There Is No Doctor, 174.

[4] David Werner, Where There Is No Doctor, 174.

[5] Joseph Alton, The Survival Medicine Handbook, 2013, 410. 

[6] Joseph Alton, The Survival Medicine Handbook, 2013, 410. 

08.17.21