From the Guidelines
Pain associated with varicose veins is primarily caused by increased intravenous pressure, incompetent valves, and weakened vascular walls, leading to a heavy, achy feeling and itching or burning sensation, especially with prolonged standing. This is supported by a study published in the American Family Physician in 2019 1, which highlights the pathophysiology of varicose veins and their associated symptoms.
Key Factors Contributing to Varicose Vein Pain
- Genetic predisposition
- Incompetent valves
- Weakened vascular walls
- Increased intravenous pressure
- Risk factors such as family history of venous disease, female sex, older age, and chronically increased intra-abdominal pressure
Symptoms and Complications
- Heavy, achy feeling
- Itching or burning sensation
- Worsening of symptoms with prolonged standing
- Potential complications include infection, leg ulcers, stasis changes, and thrombosis, as noted in the study 1
Management and Treatment
To manage varicose vein pain, it is essential to address the underlying causes and reduce symptoms.
- Conservative treatment options include external compression, lifestyle modifications, and medical therapy, as discussed in the study 1
- Elevating the affected leg, weight loss, and avoiding prolonged standing can help alleviate pain and improve circulation.
- Interventional treatments like endovenous thermal ablation may be necessary for persistent or severe pain, and the study 1 suggests that this treatment can be performed under local anesthesia with potentially better outcomes and fewer complications than other treatments.
- Regular low-impact exercise, such as walking or swimming, can also improve circulation and reduce pain, although specific exercise recommendations are not detailed in the provided study 1.
From the Research
Causes of Pain Associated with Varicose Veins
The exact causes of pain associated with varicose veins are not explicitly stated in the provided studies. However, some studies suggest that varicose veins are a manifestation of increased venous pressure in the lower limb caused by impaired venous return 2.
Factors Contributing to Pain
Some factors that may contribute to pain associated with varicose veins include:
- Impaired venous return 2
- Increased venous pressure in the lower limb 2
- Poor drainage from the superficial to the deep venous system 2
- Underlying pathology impeding venous drainage, such as deep venous thrombosis or increased intra-abdominal pressure caused by a mass, pregnancy, or obesity 2
Symptoms of Varicose Veins
Some common symptoms of varicose veins include:
- Pain or aching 3
- Limitation of activities due to symptoms 3
- Bleeding varicose veins 2
- Lower limb skin changes thought to be caused by chronic venous insufficiency 2
- Superficial vein thrombosis and suspected venous incompetence 2
- Venous leg ulcer or healed venous leg ulcer 2
Treatment of Varicose Veins
Some treatment options for varicose veins include: