Nearly 65% of the blood in your body is held within veins as it slowly circulates back to the heart. Veins are elastic vessels and have the ability to stretch and contract depending on whether you need to loose or conserve heat. Small valves inside the veins point their leaflets in the direction of the heart preventing back flow.
In your legs, veins are confronted with the problem of returning blood back up the leg against the force of gravity. Nature has designed an ingenious method of overcoming this problem. As you walk the calf muscles act like a pump and compresses the deep veins pushing the blood back up the leg ("the calf muscle pump"). But this affect only applies to the deep veins inside the muscles and not the superficial veins outside the muscles. Superficial veins rely entirely on the ability of the valves to do their job and not allow blood to reflux back down to your feet. This is where people with varicose veins have a problem.
Varicose vein disease is a process that affects the superficial veins and not the deep veins. People with varicose veins nearly always have a normally functioning deep vein system. On rare occasions varicose veins can actually arise secondary to the deep veins being obstructed or incompetent. In varicose vein disease there is a degenerative process affecting the elastic proteins in the vein walls. The vein walls lose their elasticity, become stretched and the back pressure due to leaking valves causes further distension of the veins.
As varicose veins inevitably become larger and more extensive over time, the increasing back pressure begins to cause congestion and swelling around the foot and ankle. Symptoms of the legs feeling heavy and congested are common. People often report cramps and "restless legs". Depending upon the severity, skin changes eventually occur from tissue damage and this causes symptoms such as rash, itch, pigmentation. The final stages result in a condition called Lipodermatosclerosis and then eventually breakdown of the skin surface causing ulceration.
There is no cure for the process that causes varicose veins and treatments are not directed at fixing varicose veins because they are irreversibly damaged- cardiac surgeons won't use varicose veins for heart bypass surgery.
Regarding varicose vein treatment people often ask the question, "If you remove this vein then how does the blood return back to the heart". To answer this you need to remember that varicose veins are actually impairing the return of blood back to the heart because they are acting like a leak and letting blood fall back down to the bottom of the leg. Sealing a varicose vein with sclerotherapy or laser ablation seals off this leak. The result is improvement in the venous circulation in your legs. So we see that people who have had chronic ulcers on their legs for years find that their ulcers quickly heal following treatment of their varicose veins.
At The Leg Vein Doctor our patients are treated in accordance with the current international guidelines.
Dr Nicholas Kemp discusses the symptoms of Varicose Veins on YouTube.