Who Suffers From Vein Disease?
Over 25 million Americans suffer from chronic venous disease. Venous disease can affect anyone, but some people are more susceptible to certain types of venous disease. For example, women are three times more likely than men to have spider or varicose veins. Varicose veins also have a tendency to run in families. Other risk factors for varicose veins include age, obesity, pregnancy (pregnant women are more likely to develop spider and/or varicose veins) and extreme height. People with jobs that require them to stand for long periods often develop varicose veins as well.
Venous Stasis Ulcers
Varicose veins, over time, can result in increasing symptoms such as leg aching, pain, and swelling. This is a reflection of the increasing venous pressure from progressive valve failure inside the veins. Skin changes, such as dermatitis, may become evident over the medial aspect of the lower leg and ankle. Eventually, the skin can break down (ulcerate) with dramatic wounds that are challenging to heal. By use of venous mapping with diagnostic Duplex ultrasound, areas of venous reflux can be identified and successfully treated with laser ablation and sclerotherapy. Used in combination with compression garments and wraps, these procedures can significantly reduce healing time and recurrences.
Deep Vein Thrombosis
Deep vein thrombosis (DVT) is the formation of a blood clot, known as a thrombus, in the deep leg vein. It is a very serious condition that can cause permanent damage to the leg, known as post-thrombotic syndrome, or a life-threating pulomnary embolism. In the United States alone, 600,000 new cases are diagnosed each year. One in every 100 people who develops DVT dies. Recently, it has been referred to as “Economy Class Syndrome” due to the occurrence after sitting on long flights. When the circulation of the blood slows down due to illness, injury or inactivity, blood can accumulate or “pool,” which provides an ideal setting for clot formation.
- Previous DVT or family history of DVT
- Immobility, such as bed rest or sitting for long periods of time
- Recent surgery
- Above the age of 40
- Hormone therapy or oral contraceptives
- Pregnancy or post-partum
- Previous or current cancer
- Limb trauma and/or orthopedic procedures
- Coagulation abnormalities
- Discoloration of the legs
- Calf or leg pain or tenderness
- Swelling of the leg or lower limb
- Warm skin
- Surface veins become more visible
- Leg fatigue
Post-thrombotic syndrome is an under-recognized, but relatively common sequela, or aftereffect, of having DVT if treated with blood thinners (anticoagulation) alone, because the clot remains in the leg. Contrary to popular belief, anticoagulants do not actively dissolve the clot, they just prevent new clots from forming. The body will eventually dissolve a clot, but often the vein becomes damaged in the meantime. A significant proportion of these patients develop irreversible damage in the affected leg veins and their valves, resulting in abnormal pooling of blood in the leg, chronic leg pain, fatigue, swelling, and, in extreme cases, severe skin ulcers. While this use to be considered an unusual, long-term outcome, it actually occurs frequently, in as many as 60-70 percent of people, and can develop within two months of developing DVT. There is increasing evidence that clot removal via a treatment called interventional catheter-directed thrombolysis in selected cases of DVT can improve quality of life and prevent the debilitating sequela of post-thrombotic syndrome.
Restless Legs Syndrome
Are you kept awake at night with irresistible urges to move your legs; a “creeping” feeling in the legs; persistent leg movement during sleep; or tingling, burning, aching or numbness of the legs? This is known as Restless Leg Syndrome (RLS) and is thought to affect as much as 15 percent of the general population. The symptoms of RLS are worse at night or during periods of relaxation, such as lying down during the day. These symptoms disrupt the sleep not only of the RLS sufferer but can disrupt the sleep of their bed partner as well.
The commonly recommended treatment for RLS is a neurologic medication. Unfortunately, the available medications only relieve the symptoms, they do not cure the condition and must be taken long term. There is additionally the risk of side effects, as there is with any medicine you take.
Venous insufficiency is an often-overlooked cause of RLS. Several studies indicate that as many as 22 percent of those with RLS also have venous insufficiency. In venous insufficiency, or varicose vein disease, the blood valves do not work properly and allow some of the blood to flow backwards and pool in our legs, which can, but not always, result in bulging veins and causes symptoms such as pain, swelling, tiredness, redness or restlessness. The edema, or swelling, that occurs with venous disease often recedes at night and that is believed to somehow cause the “creeping” sensation described by patients with restless leg syndrome. When restless legs occur with venous insufficiency, the RLS can be improved significantly by treating the varicose veins. A study published in the Journal of Phlebology reported that in patients with both RLS and venous disease, 98 percent had their RLS symptoms relieved with varicose vein treatment and 80 percent of experienced long-term relief.
We recommend that you schedule a consultation with us if you suffer from the symptoms of RLS. During this consultation, we will perform a diagnostic ultrasound to assess whether venous insufficiency is present. If so, we will plan a course of treatment for the varicose veins. This treatment will treat the varicose veins and can improve the symptoms of RLS, without the need to take a medication.
Don’t let RLS impede your lifestyle.