Can you prevent varicose veins?
Even if you have a family history of varicose veins, they aren’t always inevitable, says Dr. Sherry Scovell, a vascular and endovascular surgeon at Harvard-affiliated Massachusetts General Hospital. Three simple strategies can help to prevent them.
1. Get moving. “Leading an active lifestyle is probably the most important thing that you can do for prevention,” says Dr. Scovell. Exercise, particularly walking, induces calf muscle contractions that keep blood flowing efficiently. “The calf muscles act like a heart for the veins,” she says. People sometimes believe that if they stand more and sit less, they can prevent vein problems. But that’s not true if you’re mostly standing still. “It’s better to move as much as possible,” says Dr. Scovell. Exercise also helps you maintain a healthy weight, which can keep varicose veins at bay.
2. Put your feet up. Give your legs a break by elevating your feet at the end of the day, and even during the middle of the day if you’ve got some spare time. This can relieve pressure on the veins to help keep them healthy.
3. Pull on compression stockings. These garments fit snugly on your legs, squeezing them slightly to help keep blood moving. People sometimes think they’re unfashionable and are reluctant to wear them. But today’s stockings don’t resemble old-fashioned versions, says Dr. Scovell. Compression stockings come in numerous styles, including calf-high tube socks, dress socks, and tall stockings that look like tights. “They make them in so many cool colors and patterns,” says Dr. Scovell. “They can be fashionable and still help your veins at the same time.” You can purchase over-the-counter compression stockings at a drugstore or get medical-grade options through your primary care doctor or a specialist.
COMMENTARY:
Varicose veins entered my vocabulary when I noticed that my feet were different in their coloration; my left foot was darker than my right, and had a bruise-like discoloration at the heel. Some enlargement and irregular “snaking” of my veins was also apparant at that time.
I went to see a vascular surgeon who performed an ultrasound on my veins, and informed me that my popliteal valve, the one in the vein behind my knee, wasn’t working. This caused a constant column of blood, unchecked by a valve, to enlarge my veins.
I have been wearing compression stockings ever since, to slow down the enlargement of those veins.
My right leg has done better than my left, but still has a few varicose veins.
The compression stockings are hard for me to put on my legs, especially since I have arthritis in my hands. However, by learning a few tricks, this is not an intolerable burden.
First, you have to select your stockings. Jobst was the brand first suggested to me, and I used them for years. Recently, my big toe has been starting to cross over the second toe, a condition called “scissor toe”. The jobst stockings had toes in them, like most stockings, and I thought the compression acting on the toes was partially responsible for the scissor toe. Jobst has no open toe option that I can find. After going through several different brands, I settled on Sigvaris open toe. The label states the number of millimeters compression that is provided. More than 30 mm would be best, but 20-30mm. Is the tightest that my fingers will allow. More commonly I use 15 to 20, because after I swim the skin is wet, and wet skin simply gives too much friction to allow my painful hands to get the stockings on.
In the Harvard article, walking is also suggested, since the calf muscles act like a pumping mechanism on the deep veins to get the blood back to the heart. I learned from the article that the deep veins return 80% of the blood, and the superficial varicose veins only 20%, making them expendable. There are a number of different options for getting rid of the varicose veins, “sclerosing” them, including thermal and chemical treatments.
I walk a lot, going along with another suggestion from the article, although I don’t usually prop my legs up; I’m too busy running around to make propping a viable option.
Preventative treatment, such as I’ve been discussing, certainly beats having edematous legs with ulcers, such as I see in many older people.
—Dr. C.
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