In our circulatory system, arteries are the major blood vessels which carry and distribute oxygenated blood throughout the body with its branches arterioles and capillaries. Capillaries are most permeable for transportation of nutrients and oxygen from blood to tissues. These capillaries, after diversification, tend to unite again to form venules. These venules unite further to form smaller veins which again unite to form large veins. Veins are blood vessels which collect and carry deoxygenated blood towards heart for recharging oxygen. The two largest veins of our body are the superior vena cava (which collects impure blood from the upper part of the body) and the inferior vena cava (which collects and carries impure blood from the lower part of the body i.e. from the legs and abdomen). If veins gets swollen or distended, they are medically called ‘varicose veins’.
Varic is a Latin word which stands for swollen. Varix is meant for an enlarged tortuous vein. Varicose is the condition where varix is present, which means that it is not a disease by itself but it can occur in many cases/diseases due to obstruction or other reasons.
Veins can distend 6 times more than arteries. Veins usually hold/retain about 70 per cent of the total blood volume whereas only 30 per cent is held by arteries. Veins wall are usually thin and can accommodate any amount of blood with distension, but they can collapse readily being empty. They are usually guarded by a pair of valves (non-return valves). This prevents back flow. Normally, the flow in the veins is guided by a muscular pump which works as passive pump whereas artery has speed delivery with heart systolic pump. The pressure of flow in artery is 120mg of Hg during systole which drops slowly during distribution i.e. with arteries (70), arterioles (40), capillaries (30), venules (15) and veins (0-15). Since there is no pressure to direct flow, the activeness of local muscle is needed for pumping the blood towards the heart. If it is not there, pooling of blood will be there. This is the main reason for mild puffiness of the body especially in the extremities which can be seen after sleep. One can notice this with the tightness of the finger ring in the morning which becomes loose after some work.
Also, there are three types of veins. They are superficial veins, deep veins, and perforating veins (that connect superficial and deep veins). Varicose veins usually occur in superficial veins since it lacks muscular support and pressure. This can be seen in elderly people when their skin loses its texture and also in people who work out in gyms (temporarily) when they act to show the muscle bulkiness with contractions. Here blood from deep veins takes alternative route through superficial veins due to strong muscular contractions which totally compress the deep veins.
Even though varicosity can occur anywhere in the body, the commonest part that often suffers is the leg (calf muscle area). This is because gravitational force endures more pressure in the veins of legs due to the erect posture of the human being. Varicosity occurs on two occasions, one, due to lack of muscular pump, and another, due to valve incompetence/damage due to diseases. As blood tend to pool in veins, veins get enlarged to become varicose veins.
commonly suspected CAUSES for development of varicosity
Pressure in the blood vessels may be due to
- Physiological – Pregnancy & delivery can cause temporary increase of venous pressure to cause varicose veins.
- Pathological – Liver and portal vein disorders, pelvic tumours, circulatory disorders, cancer, etc., can cause obstruction and thus varicose veins
- Erect posture of man – from four-legged animals, by evolution, human beings attained the erect posture. This has also been considered as a major susceptible factor for development of varicose veins in the leg due to gravitational force.
- Hereditary – Varicose veins seem to run in families
- Habit of alcohol, sedentary life and drugs can also cause varicose veins
- Obesity, hormonal changes at menopause or under birth control pills
- Long sitting travellers – drivers
- Long standing workers – policeman, salesman/woman
- Sedentary workers
- Distention of veins – worm-like or spider-like enlarged veins seen over the skin
- Discolouration and itching over and nearby distended veins
- Swelling in inner aspect of ankle
- Heavy and tight / lightning / throbbing pain in the affected leg(s)
- Occasional numbness and tiredness due to blood (de-oxygenated) pooling
Diagnosis – nowadays science has advanced in tremendous ways to diagnose the obstructions / blocks (if any) in such a way that a simple 4 to 7 seconds x-ray exposure (CT coronary angiogram) is enough to diagnose minute blocks in heart miniature blood vessels. Regarding varicose veins, even a simple clinical examination with tourniquet can give idea to fix the problem of the varicose vein. To rule out blocks or valvular damage in a simple way, Doppler (ultrasound) study can be done. For more specification, Venogram (angiography) or CT scan is advisable.
COMPLICATIONS – As varicose veins tend to worsen over time, it usually needs care and support. Uncared-for varicose veins can often cause recurrent infection/inflammation (phlebitis) and pain in the affected veins. It can also lead to ulcer formation, necrosis and gangrene. Also, as blood tends to pool for a long time, there comes the chances for development of clot (deep vein thrombosis). It can go in circulation to block blood vessels of the lungs or heart which can endanger life all of a sudden.
PREVENTION & MANAGEMENT
- Restrict salt intake
- Wear stockings or crepe bandage (in the morning itself)
- Exercise moderately (walking and cycling) to improve muscular pump and circulation
- Keep your legs elevated during rest and sleep
- Take care of itching and ulcer immediately
- Standing or sitting for a long time (sedentary habits)
- Crossing over the legs
- Tight undergarments
- Alcohol and smoking
- Unnecessary drugs, especially pain-killers (promotes water retention)
To avoid discomfort, pain, itching, ulceration, bleeding and unwanted progress of the varicose veins, management and treatment should be taken accordingly, at the earliest. Varicose veins usually tend to get worse over time and become more persistent unless otherwise cared-for. Best of all the medicines is elevation of the leg, exercise, rest, water and salt restricted diet, without which no treatment will be helpful.
Any type of localised approach or treatment will usually suppress/mask the complaint for the time being only. Wearing stockings or crepe bandage will arrest further progress of distension or varicose veins, and it does not help in reduction of the size of varicose veins. Also, one should be aware of recurrences of varicose veins even after surgical intervention. This confirms that the cause is not localised and it is the effect of internal circulatory or other systemic diseases. So the cause must be analysed completely and treated accordingly.
Homoeopathy medicines are very effective in management of varicose veins without any painful interventions. But treatment should be started at the earliest to cure it completely or otherwise, it can only be maintained. Homeopathy medicines should be administered after proper analysis of the disease (nature and origin) and sufferings. Homeopathy usually cares both for the patient’s feelings as well as the disease symptoms.
Homeopathic medicines commonly used in cases of varicose veins are Acid flour, Apis mel, Arnica, Bryonia, Calc carb, Calc flour, Capsicum, Carbo veg, Causticum, Hamemelis, Hepa sulf, Lachesis, Lycopodium, Millefolium, Nux Vom, Phosphorus, Pulsatilla, Sulphur, Thuja, Zincum met, etc. For infected varicose veins, Acid flour, Ars alb, Belladonna, Hamamelis, Lachesis, Pyrogen, Vipera, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.
(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)