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Varicose Veins in the Elderly

What Are Varicose Veins?

Varicose Vein in the ElderlyVaricose veins are abnormally widened and twisted veins in the leg. Although any vein in the body can be affected in this way, it is mainly the leg veins that are involved in most people. Varicose veins is one of the most common leg vein problems and it involves the superficial veins of the leg. The other common leg vein problem is deep vein thrombosis (DVT) which involves the deep veins of the leg. Both conditions are however, interrelated in that varicose veins can increase the chances of deep vein thrombosis.

Causes of Varicose Veins

The veins return blood to the heart where it can then be sent to the lungs for re-oxygenation. Blood from the feet and legs have to travel the furthest compared to any other part of the body. The blood from the feet and lower legs drains into the superficial veins of the leg and then into the deep veins. Since blood has to travel up the legs, against the action of gravity, the veins have a special mechanism to help it flow. Valves in the leg veins allow blood to flow in one direction only – from the feet to the heart. Blood is gradually pushed upwards when the muscles in the feet and legs contract during activity. Backward flow is prevented by the closing of the valves.

Weakening of the vein walls or congestion of blood in the legs causes the valves to fail. Some blood that is destined for the heart can therefore flow backward and remain in the legs. Apart from causing swelling, the low oxygen blood pooled in the legs means that the incoming oxygen rich blood can not circulate as effectively. Varicose veins can arise in any person with the following risk factors but is more commonly seen in women and the elderly. These risk factors include :

  • Sitting or standing for long periods
  • Being overweight or obese.
  • Family history of varicose veins.
  • Pregnancy.

Signs and Symptoms

The main sign of varicose veins are visible veins on the leg that appear :

  • Purple to dark blue.
  • Enlarged and twisted.
  • With smaller veins known as spider veins around the larger veins.

There are also other symptoms that may be present such as :

  • Itching of the legs.
  • Heavy aching feeling of the legs.
  • Burning muscle pain or cramps.
  • Skin ulcers usually near the ankle.

Varicose veins are usually painless but pain can develop with more severe cases especially when sitting or standing for long periods. Ulcers that form with varicose veins are very painful. Sometimes the pain may be associated with deep vein thrombosis (DVT).

Treatment of Varicose Veins

Varicose veins cannot be treated with the use of medication. Surgery is helpful but reserved for severe cases. Simple measures are often the most effective in the early stages of varicose veins and in milder cases. These measures include :

  • Exercising regularly.
  • Walking around after standing or sitting for long periods.
  • Losing weight.
  • Elevating the legs when sitting for long periods.

Compression stockings are widely used for varicose veins and are a very effective option. It applies pressure from the exterior on the leg veins. These stockings are available in different compression gradients so that the amount of pressure can be selected as is required.

Surgery can be performed for severely dilated and tortuous veins. Sometimes it is done for cosmetic reasons even though the varicose veins are not severe. These procedures accomplish the following :

  • Destroys the vein with a sclerosing agent, laser and heat – sclerotherapy, simple laser (surface) or endovenous laser treatment (catheter-assisted) and radiofrequency ablation.
  • Removes the vein – ligation and stripping, ambulatory phlebectomy and endoscopic vein surgery.

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