Vein disease affects nearly half the U.S. adult population, and for those who struggle with vein disease, it’s more than cosmetic.
It’s a condition that causes significant leg pain and fatigue which affects your daily lifestyle.
Listen in to Sara Murray, MD to find out if you are at risk for developing varicose veins. And, learn about of variety of medical treatment options.
Selected Podcast
Get A Leg Up On Varicose Veins
Featured Speaker:
Sara Murray, MD
Sara Murray, MD, is board-certified in Cardiovascular Disease. Her clinical interests include office-based cardiology, peripheral vascular disease, and coronary and peripheral interventions. Transcription:
Get A Leg Up On Varicose Veins
Melanie Cole (Host): Vein disease affects nearly half the U.S adult population and for those who struggle with vein disease, it’s more than just cosmetic. It’s a condition that causes significant leg pain and fatigue which can affect your daily lifestyle. My guest today is Dr. Sara Murray. She’s board certified in cardiovascular disease at United Health and Vascular Clinic with Allina Health. Welcome to the show. Dr. Murray, what are varicose veins?
Dr. Sara Murray (Guest): Well, thanks for inviting me to the show, Melanie. Varicose veins are actually really common. They are large, ropey, twisted-like dilated veins that many times you can see on the surface of peoples’ legs. Or, it can be the underlying veins that you don’t actually see that are the problem causing those varicose veins. They are typically located--you know, it can be both legs; it could be just one leg, but it’s usually on the thighs and calves are typically where you see them.
Melanie: So, what causes them?
Dr. Murray: Varicose veins are caused by improperly functioning veins inside your leg. A normal vein is nice and small and it has a one-way valve to keep blood from going back down into the leg when you stand. With people that have vein disease and varicose veins, those veins become real dilated and it stretches that valve leaflet apart so that it can’t close and then blood pools down into the leg with prolonged standing, sitting, and those kinds of activities.
Melanie: Is this something that’s genetic? Is it developed over time? You know, is there a hereditary component?
Dr. Murray: Yes, there is a strong hereditary component. Most of the time, if both parents have them then their offspring are most likely going to develop them as well. And it does slowly progress over time. Things that can trigger it or hasten it are obesity; a standing profession where you’re on your feet for a significant amount of the day; pregnancy; multiple pregnancies; age; female gender. Those are the most common factors that cause it. But, by far, the biggest factor is hereditary, so you can blame your mom and dad for that.
Melanie: Interesting. Now, people hear about the word spider vein and then they hear the word varicose veins. What’s the difference?
Dr. Murray: Size. Basically, spider veins are real small and flat and sometimes it can look like a spider because it has multiple--not sure of the word--multiple little veins that you can see on the skin, like a starburst kind of pattern. Otherwise, varicose veins are bigger. They are not flat. They are large ropey, twisted-like veins that you can see underneath the skin. Bulging veins.
Melanie: Is there a risk to not doing anything about them? If they are not painful, is there a risk of blood clots or anything? Are these something that are dangerous?
Dr. Murray: Yes, there are risks of blood clots. The clots that would typically form in varicose veins are not the kind that go to other parts of your body, like, say, your lung. If part of the clot breaks off, it tends to cause something called “superficial thrombophlebitis”, which is inflammation and clotting in the superficial vein and that can be painful. It can cause infection, potentially. Sometimes they can bleed but mostly they are very uncomfortable for patients and there’s not a lot of great therapy to treat them other than conservative measures like heat packs or anti-inflammatory medication.
Melanie: So then, what should we do for them? What treatments are available and does something like lifestyle modification—exercise and that sort of thing. Does that help varicose veins?
Dr. Murray: It can help alleviate some of the symptoms but it’s usually not going to be curative or a long-standing treatment. I do encourage everyone that has veins disease, however, if they are overweight, to try to lose that weight and one of the best ways to do that is to exercise and increase your metabolism. Other treatment options are--medical treatment options--would be compression stockings which are tight knee high or thigh high stockings, for example, that provide compression on those veins. A lot of times, they give people symptomatic relief. I don’t think we’ve talked about the symptoms of vein disease but those symptoms include typically, again, with standing: heaviness, aching, throbbing, swelling, itching. I’ve heard all kinds of symptoms and so the stockings would help alleviate some of those symptoms but it’s not going to treat the veins or necessarily help the progression. Other options include a catheter-based outpatient procedure called an “endovenous ablation”. There’s a couple different catheters, either a radio frequency heated tip or a laser tip that heats up inside the vein and that causes the vein to contract and shrink around the catheter and once we take that catheter out that vein is essentially closed and that does lead to a lot of symptomatic relief. That is considered a medically necessary procedure and that is covered by insurance. Other options that aren’t necessarily always covered by insurance and, in fact, most of the time not covered by insurance, is sclerotherapy. Sometimes, again, we can get insurance coverage but most of the time it’s considered “cosmetic” by the insurance companies and that’s typically going to be an out-of-pocket cost for a person who’s interested in having that done.
Melanie: Dr. Murray with ablation, and the vein wall contracts, the vein closes. Is this a permanent condition and is it okay to close up certain veins? Do we develop that collateral circulation so that the blood goes elsewhere? What happens with that?
Dr. Murray: Yes. That’s a great question, Melanie. Once we “close” a vein, the blood does get rerouted into the healthier veins in the leg and eventually into the deep veins, which return all the blood flow out of your leg. So, that’s usually not any concern. My thought, when I'm recommending treatment for vein disease is, if the vein is not working properly, if it’s leading to decreased quality of life, daily symptoms for patients. I strongly encourage them to get that treated so that they do get that release and are able to move on with their active lifestyle.
Melanie: So, when does someone contact their healthcare provider? When should somebody be worried about their varicose veins?
Dr. Murray: I tell people to have a low threshold to contact their healthcare provider about this sort of thing. Again, because it can markedly improve your quality of life. If symptoms are bad in your legs or they keep you from doing your daily activities that would be one indication to contact your provider. If you have an injury that where say, you’re shaving your legs and your varicose vein starts to bleed, that’s definitely an indication because that can be a serious problem. If you have problems with clotting or thrombophlebitis, or, in general, if you have any questions or concerns about the possibilities of having vein disease.
Melanie: So, in just the last few minutes give us your best advice, because so many people suffer from these. Pregnant women start to see them, even men in their 60’s and 70’s start to notice them. So, give us your best advice about those suffering with varicose veins and what they should do about them.
Dr. Murray: Well, I would tell this population of people that you don’t have to just live it. It’s something that’s very treatable with very safe procedures that can be done. Again, you’re going to have a much better satisfaction with your life if you’re not living with daily discomfort and pain in your legs. So, please seek medical advice to find out more about this if you feel that this is something you struggle with.
Melanie: Definitely great advice. You’re listening to The WELLcast with Allina Health. For more information, you can go to AllinaHealth.org. That’s AllinaHealth.org. This is Melanie Cole. Thank you so much for listening.
Get A Leg Up On Varicose Veins
Melanie Cole (Host): Vein disease affects nearly half the U.S adult population and for those who struggle with vein disease, it’s more than just cosmetic. It’s a condition that causes significant leg pain and fatigue which can affect your daily lifestyle. My guest today is Dr. Sara Murray. She’s board certified in cardiovascular disease at United Health and Vascular Clinic with Allina Health. Welcome to the show. Dr. Murray, what are varicose veins?
Dr. Sara Murray (Guest): Well, thanks for inviting me to the show, Melanie. Varicose veins are actually really common. They are large, ropey, twisted-like dilated veins that many times you can see on the surface of peoples’ legs. Or, it can be the underlying veins that you don’t actually see that are the problem causing those varicose veins. They are typically located--you know, it can be both legs; it could be just one leg, but it’s usually on the thighs and calves are typically where you see them.
Melanie: So, what causes them?
Dr. Murray: Varicose veins are caused by improperly functioning veins inside your leg. A normal vein is nice and small and it has a one-way valve to keep blood from going back down into the leg when you stand. With people that have vein disease and varicose veins, those veins become real dilated and it stretches that valve leaflet apart so that it can’t close and then blood pools down into the leg with prolonged standing, sitting, and those kinds of activities.
Melanie: Is this something that’s genetic? Is it developed over time? You know, is there a hereditary component?
Dr. Murray: Yes, there is a strong hereditary component. Most of the time, if both parents have them then their offspring are most likely going to develop them as well. And it does slowly progress over time. Things that can trigger it or hasten it are obesity; a standing profession where you’re on your feet for a significant amount of the day; pregnancy; multiple pregnancies; age; female gender. Those are the most common factors that cause it. But, by far, the biggest factor is hereditary, so you can blame your mom and dad for that.
Melanie: Interesting. Now, people hear about the word spider vein and then they hear the word varicose veins. What’s the difference?
Dr. Murray: Size. Basically, spider veins are real small and flat and sometimes it can look like a spider because it has multiple--not sure of the word--multiple little veins that you can see on the skin, like a starburst kind of pattern. Otherwise, varicose veins are bigger. They are not flat. They are large ropey, twisted-like veins that you can see underneath the skin. Bulging veins.
Melanie: Is there a risk to not doing anything about them? If they are not painful, is there a risk of blood clots or anything? Are these something that are dangerous?
Dr. Murray: Yes, there are risks of blood clots. The clots that would typically form in varicose veins are not the kind that go to other parts of your body, like, say, your lung. If part of the clot breaks off, it tends to cause something called “superficial thrombophlebitis”, which is inflammation and clotting in the superficial vein and that can be painful. It can cause infection, potentially. Sometimes they can bleed but mostly they are very uncomfortable for patients and there’s not a lot of great therapy to treat them other than conservative measures like heat packs or anti-inflammatory medication.
Melanie: So then, what should we do for them? What treatments are available and does something like lifestyle modification—exercise and that sort of thing. Does that help varicose veins?
Dr. Murray: It can help alleviate some of the symptoms but it’s usually not going to be curative or a long-standing treatment. I do encourage everyone that has veins disease, however, if they are overweight, to try to lose that weight and one of the best ways to do that is to exercise and increase your metabolism. Other treatment options are--medical treatment options--would be compression stockings which are tight knee high or thigh high stockings, for example, that provide compression on those veins. A lot of times, they give people symptomatic relief. I don’t think we’ve talked about the symptoms of vein disease but those symptoms include typically, again, with standing: heaviness, aching, throbbing, swelling, itching. I’ve heard all kinds of symptoms and so the stockings would help alleviate some of those symptoms but it’s not going to treat the veins or necessarily help the progression. Other options include a catheter-based outpatient procedure called an “endovenous ablation”. There’s a couple different catheters, either a radio frequency heated tip or a laser tip that heats up inside the vein and that causes the vein to contract and shrink around the catheter and once we take that catheter out that vein is essentially closed and that does lead to a lot of symptomatic relief. That is considered a medically necessary procedure and that is covered by insurance. Other options that aren’t necessarily always covered by insurance and, in fact, most of the time not covered by insurance, is sclerotherapy. Sometimes, again, we can get insurance coverage but most of the time it’s considered “cosmetic” by the insurance companies and that’s typically going to be an out-of-pocket cost for a person who’s interested in having that done.
Melanie: Dr. Murray with ablation, and the vein wall contracts, the vein closes. Is this a permanent condition and is it okay to close up certain veins? Do we develop that collateral circulation so that the blood goes elsewhere? What happens with that?
Dr. Murray: Yes. That’s a great question, Melanie. Once we “close” a vein, the blood does get rerouted into the healthier veins in the leg and eventually into the deep veins, which return all the blood flow out of your leg. So, that’s usually not any concern. My thought, when I'm recommending treatment for vein disease is, if the vein is not working properly, if it’s leading to decreased quality of life, daily symptoms for patients. I strongly encourage them to get that treated so that they do get that release and are able to move on with their active lifestyle.
Melanie: So, when does someone contact their healthcare provider? When should somebody be worried about their varicose veins?
Dr. Murray: I tell people to have a low threshold to contact their healthcare provider about this sort of thing. Again, because it can markedly improve your quality of life. If symptoms are bad in your legs or they keep you from doing your daily activities that would be one indication to contact your provider. If you have an injury that where say, you’re shaving your legs and your varicose vein starts to bleed, that’s definitely an indication because that can be a serious problem. If you have problems with clotting or thrombophlebitis, or, in general, if you have any questions or concerns about the possibilities of having vein disease.
Melanie: So, in just the last few minutes give us your best advice, because so many people suffer from these. Pregnant women start to see them, even men in their 60’s and 70’s start to notice them. So, give us your best advice about those suffering with varicose veins and what they should do about them.
Dr. Murray: Well, I would tell this population of people that you don’t have to just live it. It’s something that’s very treatable with very safe procedures that can be done. Again, you’re going to have a much better satisfaction with your life if you’re not living with daily discomfort and pain in your legs. So, please seek medical advice to find out more about this if you feel that this is something you struggle with.
Melanie: Definitely great advice. You’re listening to The WELLcast with Allina Health. For more information, you can go to AllinaHealth.org. That’s AllinaHealth.org. This is Melanie Cole. Thank you so much for listening.