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HOW DO VARICOSE VEINS DEVELOP?

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In order that the tissues and organs survive in every part of our body, the arteries should bring oxygenated blood and the veins should be able to send the deoxygenated blood to the lungs. In this way, the cells will receive oxygen and nutrients from the arterial blood, and transfer carbon dioxide and toxins into the venous blood.

 

Our legs have the disadvantage that the venous blood must be sent upwards in the opposite direction to gravity. In this respect, for example, our arms and head and neck regions are more fortunate because gravity makes it easier for the blood to go to the lungs. Considering that we spend approximately 75% of our life in a standing or sitting position, the difficulty experienced by leg veins can be better understood. Because of this disadvantageous condition, venous insufficiency and varicose veins are seen much more frequently in our legs compared to other parts of the body.

 

How do our legs send venous blood to the lungs?

 

Our body has two mechanisms in order to transfer the venous blood from the leg to the lungs. The first is that our leg muscles compress the veins like a pump during movements such as walking and running, and the second is that the walves in the veins allow the blood to flow unidirectionally. When the leg muscles contract, the walves of the veins open and blood is sent upwards. When the muscles relax, the blood tends to flow back, but  the walves close and prevent the blood from flowing back. Thanks to the harmonious functioning of these two mechanisms, the venous blood in our legs flows intermittently but unidirectionally towards the lung.

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If one of these two mechanisms fails the venous blood begins to accumulate in the leg. This may cause symptoms such as leg pain, cramps, burning, swelling and itching. After a while, with the increased pressure of the blood, the veins under the skin begin to swell and protrude outwards, forming the enlarged vessels which we call varicose veins. In later stages, skin wounds (venous ulcers) may occur due to impaired circulation caused by the accumulation of deoxigenated blood in the leg.

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Accumulation of venous blood in the leg may result from impaired contraction of the muscles or incompetent venous valves. For example, people with paralysis, as in some neuromuscular diseases, legs can swell and varicose veins may occur because the leg muscles cannot pump the blood upwards. People with chronic pain due to bone problems such as rheumatism, meniscus and arthrosis in their legs also move their legs less and slowlier than normal individuals. This may also result in swelling of the feet and varicose veins over time due to the same reason. In practice however, the the most important reason that causes the accumulation of  blood in the leg is the valve failure in the veins. This valve failure is usually in the superficial veins close to the skin and is referred to as "superficial vein insufficiency." Rarely, valve failure occurs in deep veins, which are the main veins of our leg. This condition is called "deep vein insufficiency".

 

In conclusion, all conditions that cause an increase in blood pressure in the leg veins can cause varicose veins over time. However, the most common cause is the venous insufficiency. In order to achieve a good and durable result in varicose veins, not only the varices themselves but also venous insufficiency causing varicose veins should be treated.