04.24.15 Dr. Garth Rosenberg Varicose Veins

What Causes Your Varicose Veins?

My patients often ask me "what caused my varicose veins?" It's a typical question that arises, because many people who are relatively young and healthy develop these prominent protruding veins in the lower leg that can be sources of aching, throbbing, cramps, discoloration, and even blood clots.

While injury can lead to varicosities, most commonly, the cause of varicose veins is a hereditary predisposition to weak vein walls or valves. The lower leg veins naturally work to propel blood up the leg, against the force of gravity pushing downwards. When you are upright, there is more gravitational pressure than when you are laying down.

If the vein has a tendency to lose the ability to resist gravity, vein blood starts pooling down the leg and settles in the calf and ankle, leading to the common symptoms I noted above. The evaluation of venous disease involves a duplex ultrasound to daignose which veins are working well and which have reflux (back flow). Once this is know, we can then target therapy to the weak veins, restoring normal circulation and venous flow in the leg.

Family history is very important in understanding the reasons patients develop varicosities in the legs In addition, multiple pregnancies, blood clots and many years of a job that requires many hours of standing also can play a role. Varicose veins develop in patients of all ages, as the youngest I have treated was a 14 year old boy and the oldest a 102 year old woman.

The common procedures that successfully treat this condition are endovenous ablation (VNUS Closure) phlebectomy and sclerotherapy. Any one, or a combination of these treatments, very easily eliminates the venous insufficiency and leads to symptom resolution and elimination of the unsightly varicose veins. All of the procedures are done in the office under local anesthesia (or in the case of sclerotherapy, no anesthesia), so recovery is prompt.

Luckily, when symptoms that are appropriate for the varicose veins are found, your health insurance often will consider treatment medically necessary, meaning that there is at least some coverage of the treatments that are recommended.

Be sure to see a qualified and experienced vascular physician who understands the complexity of venous disease. Sources that can help you are found at the American Venous Forum and the American College of Phlebology.

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