Table of Contents
Definition
What are varicose veins?
Varicose veins occur when the superficial veins in the lower extremities become enlarged due to the accumulation of blood. They have a blue or purple appearance and a diameter of three or more millimetres.
The human body contains multiple valves in the veins that play a crucial role in facilitating blood circulation in one direction (towards the heart) and preventing the backflow of the blood. In varicose veins, these valves become incompetent or weakened, failing to close properly, leading to pooling or accumulating blood within the vein, causing it to stretch and enlarge. As a result, the affected veins become visibly swollen twisted, and often appear blue or purple. This condition not only causes cosmetic concerns but can also lead to symptoms such as pain, fatigue, itching, and leg cramps.
Varicose veins can be ugly but are usually not dangerous. However, if left untreated, they can lead to serious health problems. Therefore, early diagnosis and treatment can help prevent complications and improve the overall health.
What is the epidemiology of varicose veins?
Around 20 to 25 million people in the United States suffer from varicose veins. The global incidence hovers between 20 to 60% in different parts of the world. It is a common condition across different populations, with women affected twice as much as men.
What are the types of varicose veins?
Varicose veins can happen in different parts of the body. In addition, they can occur in different types of veins, even though they are the most common in superficial veins. These differences are reflected in the different types of varicose veins, which include:
Trunk or Saphenous Varicose Veins
Saphenous or trunk varicose veins are the most common type of varicose vein. They affect the saphenous vein or saphenous trunk, a vein present in each lower limb. Saphenous varicose veins mostly appear on the legs.
Reticular Varicose Veins
Numerous professionals do not consider reticular varicose veins true varicose veins as they do not bulge out the way varicose veins do. However, they cause similar pain, discomfort and cosmetic issues. They usually appear on the calf, knee and ankles.
Telangiectasia
Telangiectasias are clusters of small veins that appear blue or red and are commonly found on the face and legs. While they are harmless, their visibility can cause cosmetic concerns.
Perforator Varicose Veins
Perforator veins connect the superficial venous system with the deep venous system. They are called so because they often “perforate” the connective tissue surrounding body organs like muscles. Blood flows in these veins from outward to inward, i.e., superficial to deep. Any pathology in the valves present in them can disrupt this blood flow. As a result, an individual may develop perforator varicose veins.
Secondary Varicose Veins
Secondary varicose veins result from a medical condition in the body, such as trauma or infection. They are not a direct consequence of venous insufficiency. Causes of secondary varicose veins include:
- Masses in the pelvic region
- Deep vein thrombosis
- Arteriovenous malformations
Pathophysiology of varicose veins:
Varicose veins are a manifestation of increased venous pressure in the body’s venous system. The body has two venous systems — deep veins and superficial veins. They are interconnected with perforating veins.
The deep veins in the body, such as those present deep within muscles, are exposed to high blood pressure. On the other hand, the venous pressures inside superficial veins are very low. When these superficial and perforator veins have to bear high pressure, they widen and become dilated. They also twist upon themselves and become torturous.
This increased venous pressure is most commonly the result of venous insufficiency, which results from abnormal valves within the veins. Valves are internal structures that prevent the backflow of blood and keep its course unilaminar throughout the body. These structures become faulty during the pathophysiology of varicose veins, usually due to obstruction of venous blood flow.
What are the causes and risk factors for varicose veins?
Numerous environmental and biological factors can put a person at risk for varicose veins, such as:
Age
The incidence of varicose veins rises with increasing age, reaching over 50 to 60% in senior citizens. Like other parts of the body, veins undergo wear and tear with age, reducing their efficiency in conducting blood. This results in the development of varicose veins, especially in weight-bearing parts like the legs.
Gender
Women are twice as prone to developing varicose veins in comparison with men. This difference has been attributed to female sex hormones, estrogen and progesterone, and how they relax blood vessels in the body. Women also undergo many hormonal changes during pregnancy, menopause, and while taking birth control, all of which can put them at further risk for varicose veins.
Excessive Weight
People who are obese or overweight have a much higher risk of developing varicose veins. Having abnormally high-fat content in the body increases the pressure on superficial veins, the veins most commonly affected by varicosities.
Lifestyle
Varicose veins are more common among people who sit or stand for long periods. These actions cause blood to pool as a result of gravity. People with occupations requiring continuous standing or a sedentary lifestyle are more prone to varicose veins.
Medical History
People who have cardiovascular and connective tissue disorders or have experienced traumatic injuries involving their limbs and blood vessels are more likely to develop varicose veins. Examples include:
- Hypertension
- Heart failure
- Valvular lesions
- Limb infections
- Ehlar Danlos syndrome
- Blunt trauma during accidents
Genetic Factors
A person’s risk for developing varicose veins increases if they have a close relative with the disorder. In addition, genes related to inflammation and connective tissue have also been implicated in the pathophysiology of venous disorders like varicose veins.
Tobacco use:
People who use tobacco are more prone to varicose veins than others.
Chronic invisible inflammation:
According to Dr Mikel H-G Hoff, chronic inflammation of the vein walls blocks the passage of blood and increases the risk of varicose veins.
Negative circulation of the cardiovascular system:
The cardiovascular system is essential for supplying blood to all body parts. Poor circulation can cause blood to accumulate in the veins, leading to varicose veins.
Dehydration:
Water is a vital component of the human body, helping to keep blood thin and flowing smoothly. When dehydrated, the blood becomes thicker and can pool in the vessels, leading to varicose veins.
Decrease nitric oxide level:
Nitric oxide is a potent vasodilator in the human body. A decrease in nitric oxide levels causes vasoconstriction, which impedes blood circulation and increases the likelihood of varicose veins.
What are the signs and symptoms of varicose veins?
The usual clinical presentation of a patient with varicose veins is a middle-aged adult (mostly a woman) whose occupation requires them to stand for long periods. They usually present with visible, bulging veins on their legs. Most common complaints include discomfort from pain and swelling and cosmetic problems because of skin discolouration.
Aching
Most patients complain about pain when they first seek treatment for varicose veins. The pain associated with varicose veins has been described as dull, throbbing, and burning. It often gets worse in extreme environments.
Discolouration
Often, varicose veins become “leaky,” causing the constituents of the blood to become visible under the skin. This causes blue, purple, or brown discolouration of the skin, which is a significant cosmetic concern for patients.
Swelling
Venous oedema is the swelling in the calves and ankles due to venous insufficiency in varicose veins. Varicose veins are often associated with a higher degree of inflammatory changes in the body, which cause swelling of body parts such as legs.
Heaviness
Patients with varicose veins often complain of leg heaviness, usually associated with pain. This heaviness is caused by excessive blood pooling in their lower limbs.
Cramps
The bulging and increased pressure within the venous system can compress the nerves and muscles they supply. Circulation in the affected areas is also reduced. As a result, patients with varicose veins often experience painful muscle cramps, especially in the legs.
Fatigue
Patients with varicose veins often complain about reduced energy or fatigue. They are unable to perform actions they were able to do with ease before the onset of the disease.
Management of varicose veins with ANF Therapy®️:
ANF Therapy®️ is an innovative approach to managing different health problems. This therapy works on the principle of neuro-frequency modulation. It uses ANF Devices that are charged with certain frequencies, aiming to strengthen weakened neurological frequencies of the body. Normalisation of these frequencies activates natural process of the body.
ANF Therapists diagnose varicose veins clinically by taking a history and performing a physical examination.
History:
The ANF Therapist will take a detailed history of the patients that includes the following:
- Presenting complaints
- What is the location of varicose veins?
- Do you feel pain in your legs?
- Occupational history
- History of Tobacco Use
- Any previous medical illness
Physical examination:
According to Doctor Mikel H-G Hoff, the ANF Practitioner will examine both limbs to check blood circulation. During physical examination, they will do a thorough exam. That includes:
Inspection:
During the inspection, they will inspect the location, extent, and colour of varicosities.
Palpation:
After inspection, they will palpate the affected part to check the temperature and tenderness of the affected area. ANF Therapists palpate different muscles, systems, and nerves to assess the severity of pain and inflammation. They follow a technique for palpation called “clinical surgery” with their fingers. This technique helps them check the extent of tissue damage.
Application of ANF Devices:
Dr. Mikel H-G Hoff explains that ANF Devices are applied to the affected varicose areas to remove chronic inflammation and restore healthy blood flow. These devices use innovative technology to target specific issues within the vascular system. There are different types of ANF Devices designed to address various aspects of venous health:
Anti-inflammatory Devices:
These devices utilise positive and negative charges to create a therapeutic effect. By applying these charges to the skin, the devices help to reduce both active and chronic inflammation. These Devices do not only aim to alleviate pain and discomfort but also prevent further complications related to poor blood flow, such as ulcerations or more severe vascular issues.
Nitric Oxide Devices:
Nitric oxide is a naturally occurring potent vasodilator in the body. These devices help increase the level of nitric oxide in the body and enhance blood circulation.
Blood Flow Devices:
These devices are specifically designed to enhance blood circulation to the affected areas. They work by stimulating the blood vessels and surrounding tissues to increase blood flow.
Expected outcome:
According to Dr. Mikel H-G Hoff, the founder of ANF Therapy®️, most patients feel an improvement in their symptoms after a few minutes of applying ANF Devices. It normally takes 1-6 weeks, depending upon the severity of the disease.
Follow-up:
Regular follow-ups are essential to treat varicose veins by using ANF Devices. Your ANF Therapist will guide you on the number of follow-up sessions and treatment duration. You will need to change ANF Devices after 72 hours. Your therapist will create a personalised treatment plan for you and educate you on changes and training exercises.
Join ANF Therapy®️ as a healthcare professional:
ANF Academy offers comprehensive training for medical professionals in frequency medicine, focusing on neurological oscillations, neurochemical processes, and advanced palpation skills. The ANF Clinical Training Program equips practitioners with the expertise to manage injuries and inflammation for optimal patient outcomes.
Training Highlights:
- Master advanced neurological examination techniques.
- Identify healthy vs. inflamed nerves.
- Investigate the physical effects of disrupted neurological oscillations.
- Pinpoint and treat the root causes of pain and pathology.
The ANF Clinical Training Program:
- It starts with developing the ability to locate, palpate, and evaluate nerves and the level of inflammation.
- Enhances advanced clinical skills to discover the interconnections among different body systems and the underlying causes of symptoms.
- Provides education on the various stages of treatment using ANF neuro tech Devices tailored to match the healing phases of injured tissues.
How to prevent varicose veins?
Some lifestyle modifications help to decrease the risk of having varicose veins. These include:
- Avoid prolonged standing and take breaks
- Decrease weight
- Stop using tobacco
- Stay active
- Avoid wearing tight clothes
- Leg elevation
- Use compression stockings
What can be mistaken as varicose veins?
A number of disorders have similar appearances and symptoms to varicose veins, which can make diagnosis tricky at times. Differential diagnoses for varicose veins include:
- Lymphedema
- Contact dermatitis
- Ulcers caused by trauma
- Cancer
- Deep venous thrombosis (DVT)
- Liver disease
- Renal disease
- Hyperpigmentation
What are the complications of varicose veins?
Even though varicose veins cause pain and discomfort, they are not life-threatening. With good treatment, they do not result in higher rates of limb loss, which is often a cause of concern among patients. However, they can result in a number of complications if the patients do not receive timely treatment, such as:
- Venous ulcers (most common)
- Stasis dermatitis
- Cellulitis
- Thrombophlebitis
- Osteomyelitis
- Venous eczema
- Septicemia
Venous Ulcers
Venous ulcers are open wounds at the site of varicose veins. They are the most common complication of varicose veins and the result of unmanaged varicose veins. Untreated cases of varicose veins have a 3 to 6% chance of morphing into venous ulcers, which can cause significant distress to the patient.
References:
1. Varicose veins | NHLBI, NIH. (2023, September 26). NHLBI, NIH. https://www.nhlbi.nih.gov/health/varicose-veins
2. Varicose veins. (2021, August 8). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/varicose-veins
2. Antani, M. R., & Dattilo, J. B. (2023, August 8). Varicose veins. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470194/
About Authors
Writer:
Dr. Shahzaib Nasir
Dr. Shazaib Nasir, MBBS, RMP, is a medical writer at ANF Academy. He graduated from Multan Medical and Dental College, Pakistan. He works as a medical officer in the Oethpaedics department at Ibn-e-sina Hospital and Research Institute, Multan. He deals with patients suffering from chronic orthopaedic problems and pain. He is passionate about healthy eating and exercising. Moreover, he believes that frequency medicine can be the future of Orthopaedics.
Editor:
Dr. Shama Nosheen
Dr. Shama Nosheen, MBBS, RMP, is a skilled medical editor and writer at ANF Academy, specializing in medical communications. For 5 years, she has been working with renowned international healthcare companies as a medical writer, aiming to bridge the gap between patients and doctors. She is a graduate of Nishtar Medical University Multan. She grabbed American Board certification (ABAMS) in Aesthetic Medicine after graduation. Working with ANF Academy, she has developed a thorough understanding of ANF Therapy® that works on the principles of frequency medicine.
Reviewer:
PT. Irina Heinisuo Berná
Her background includes a Degree in Physiotherapy and a Master’s in Innovation and Research in Health Sciences, enriching her expertise in holistic health care. At ANF Academy, she seamlessly integrates clinical practice, academic teaching, and research into her daily activities to shape the future of ANF Therapy®. Irina’s work symbolizes integrating education and compassionate care to improve global health outcomes.
Final Reviewer:
Dr. Mikel H-G Hoff
Dr. Mikel H-G Hoff, Founder of ANF Therapy®, holds a bachelor’s degree in medicine and a Ph.D. in biochemistry, specializing in the bio function of the human body, specifically the neurological system. He is a manual therapist and sports psychologist. He is committed to revolutionizing healthcare by educating medical professionals and directly treating patients to enhance their quality of life. His extensive background in sports injury therapy, manual therapy, and various medical specializations, including biochemistry and nerve system signalization, empowers him to deliver pain-free solutions and lasting patient outcomes.
