Varicose veins, in combination with their symptoms and complications, are the most common vascular problem of the legs.  Published data reveals that 20 million people in the United States alone are affected. What's more, the condition is not only painful, but may develop into open sores, disabling pain, increased risk of infection and loss of the limb if untreated.

Veins are the tubes that move blood from the feet back to the heart. What makes this task more complicated is that the veins must move the blood against the forces of gravity. However, the transport of blood is facilitated by an elaborate mechanism of one-way valves in the veins. When you walk, the muscles in the legs actually push the blood through the one-way valves back toward your heart.  When those valves break, blood pools in the legs and cause varicose veins.

Common Misconceptions
Although treating varicose veins is considered by many to be for cosmetic reasons only, this is not typically the case. Millions of people have disabling pain and swelling related to varicose veins. Those who do not seek treatment because they wrongly assume it is only cosmetic and will not be covered under their insurance plans should be aware that many carriers now cover certain treatments for varicose veins associated with pain and swelling.  In fact, numerous insurance carriers realize the long-term healthcare savings related to early treatment of varicose veins. 

In addition, many people feel that their only option to treating varicose veins is a painful surgery that requires a long recovery. But the treatment of varicose veins has changed by leaps and bounds. There are now numerous options to traditional surgery.  The more cutting-edge options are actually minimally invasive and offer many advantages to traditional surgical procedures.  These newer treatments also decrease post-procedure pain and recovery time. Oftentimes, a minimally invasive procedure can even be available as an office-based procedure, eliminating a trip to the hospital and avoiding the risks of anesthesia.

Common Treatments
The first line treatment of varicose veins involves compression stocking therapy. Some patients may need nothing else to control their symptoms of pain and/or swelling. As manufacturers compete to develop newer, lightweight stockings that are pleasing to the eye, patients have found more comfortable options and relief.

If compression stockings do not help the problem, then there are a number of “surgical” options available... with more being developed all the time.  Although a minimally invasive treatment is preferred and most often can be sufficient for the treatment of varicose veins, the old-fashioned vein stripping may still be required in some cases. Vein stripping does require an anesthetic, a day in the hospital, incisions on the affected leg and a recovery process.  A newer alternative is radiofrequency ablation (RFA).  The VNUS(r) Closure(r) technique is an office-based alternative that can be performed with a local anesthetic and no real downtime.  The technique involves placing a tube similar to an IV in a vein just under the skin.  The vein is then treated and accomplishes the same thing as removal of the vein.  In most cases, patients can return to normal activities within a day, with no real activity limitations.  Smaller varicosities not treatable with vein stripping or RFA may still be treated with direct injections in the office. The good news is that patients now have numerous treatment options that have not been available in the past. If you are worried about whether you or a loved one is developing varicose veins, please either call or have your primary healthcare provider refer you to a vein care specialist.

Dr. Scott Reid is a surgeon at Mid Illini Surgical Associates and specializes in the treatment of varicose veins and vascular diseases.  He also currently serves on the Board of Directors at Methodist Medical Center.