The basic cause of varicose veins is linked to an increase in pressure in the vein due to a defective or damaged valve. This damaged valve allows blood to flow backward creating swelling or engorgement of the vein. The reason the valves become defective or damaged however, is still relatively unknown.

The following factors may put one at an increased risk:

Heredity – If someone in your family has had varicose veins, there is an increased possibility that you will develop them as well.

Gender – Females are far more likely to develop spider or varicose veins than males.

Obesity – Excessive weight puts added pressure on your entire circulatory system, including your veins.

Lifestyle – People that lead a more sedentary lifestyle or have an occupation that involves a lot of sitting or standing may be more susceptible to vein disorders.

Injury – An injury could damage veins or valves.

Age – The elasticity in the vein walls decreases as we age, increasing the possibility that veins or valves will have a failure.

Pregnancy – A pregnancy can put additional stress and pressure on veins.

Varicose Vein Causes

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There’s a pretty cool video on youtube about varicose vein procedures. It does contain some graphic medical images.

Dr. Gerant Rivera, Associate Professor of Radiology at UCSD describes how new minimaly invasive techniques in interventional radiology are being used to treat a variety of conditions from aortic aneurysms to varicose veins.

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If you do not have either varicose veins or spider veins, you are in the minority as nearly 70% of American women and more than 40% of American men will encounter varicose and spider vein issues before they reach retirement age. As these percentages continue to grow more individuals will likely encounter a venous condition – either spider veins or varicose veins – at some point in your lifetime.
While no one knows the exact cause of spider veins and varicose veins. Several risk factors can cause a person to be more likely to spider veins and varicose vein issues. The following risk factors increase your chances of developing the condition but do not always guarantee you will develop spider veins or varicose veins. Conversely, the absence of all of the following risk factors does not ensure you will never develop the condition either.
Risk factors for Developing Varicose and Spider Vein Issues:
The following factors may put one at an increased risk of developing varicose or spider veins:

Heredity – If someone in your family has had varicose veins, there is an increased possibility that you will develop them as well. Statistics show that approximately 50% of the people who have varicose veins have a family history of them.

Gender – Women tend to get varicose veins and spider veins about twice as often as men. Hormonal changes that occur during puberty, pregnancy, menopause, or with the use of birth control pills may raise a woman’s chances of developing vein conditions. Female hormones tend to relax the vein walls, causing the valves to separate and become ineffective in stopping the backflow of blood in the veins. Hormone replacement therapy may also lead to an increased risk.

Age – The possibility of developing spider veins or vericose veins increases as you age, with most cases being reported in patients between the ages of 40 and 70. Aging causes wear and tear on the veins, increasing the possibility that veins and/or valves will have a failure.

Obesity – Excessive weight puts added pressure on your entire circulatory system, including your veins and will cause your heart to work harder to push the blood through the aggravated veins.

Pregnancy – During pregnancy, a growing fetus puts extra demands on the circulatory system and extra pressure on your veins as well. Varicose veins may appear for the first time or existing ones may worsen. (See PREGNANCY) Often, varicose veins that appear for the first time may actually get better within 3 to 12 months after the delivery.

Lifestyle – Standing or sitting for an extended period of time, especially with your legs bent or crossed, may raise your risk for varicose or spider veins. Staying in one position for a long time may weaken the walls of your veins and aggravate existing inflamed veins. People that lead a more sedentary lifestyle or have an occupation that involves a lot of sitting or standing may be more at an increased risk to vein disorders.

Injury – An injury, especially to the leg, could damage veins or valves and increase the risk of varicose veins or spider veins.

Risk Factors at www.1800varicose.com

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I thought this was interesting. I’ts from the National Heart Lung and Blood Institute.

How Are Varicose Veins Diagnosed?
Doctors often diagnose varicose veins based on a physical exam alone. Sometimes tests or procedures are done to find out the extent of the problem and to rule out other disorders.

Specialists Involved
If you have varicose veins, you may see a vascular medicine specialist or vascular surgeon. These are doctors who specialize in blood vessel conditions. You also may see a dermatologist. This is a doctor who specializes in skin conditions.

Physical Exam
To check for varicose veins in your legs, your doctor will look at your legs while you’re standing or sitting with your legs dangling. He or she may ask you about your signs and symptoms, including any pain you’re having.

Diagnostic Tests and Procedures
Doppler Ultrasound
Your doctor may recommend a Doppler ultrasound to check blood flow in your veins and to look for blood clots. A Doppler ultrasound uses sound waves to create pictures of structures in your body.

During this test, a handheld device will be placed on your body and passed back and forth over the affected area. A computer will convert the sound waves into a picture of the blood flow in your arteries and veins.

Angiogram
Although rare, your doctor may order an angiogram to get a more detailed look at the blood flow through your blood vessels. For this procedure, dye is injected into your veins. The dye outlines your veins on x-ray images.

An angiogram can help your doctor confirm whether you have varicose veins or another problem.

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Many women first develop varicose veins or find that they get worse during pregnancy. First, your progesterone levels rise, causing the walls of your blood vessels to relax. Secondly, as your uterus grows, it puts pressure on the large vein on the right side of your body (the inferior vena cava), which in turn increases pressure in the leg veins. (Veins are the blood vessels that return blood from your extremities to your heart, so the blood in your leg veins is already working against gravity.) The amount of blood in your body increases when you’re pregnant, adding to the burden on your veins. Up to 40% of all women develop varicose veins during pregnancy.

There are valves in the veins which prevent the back flow of blood back into the legs. When these valves become damaged or defective, the blood flows backwards and causes swelling and enlargement of the veins. In addition, during pregnancy, there is a gain of weight and volume which causes the baby in utero to compress some parts of the pelvis (lower abdomen) and lead to an engorgement of the veins in the vulva/vagina.

Varicose veins commonly occur on the legs and thighs but may also occur in the vulva or vagina. If a female has varicose veins of the vulva during pregnancy, she will always have varicose veins in the legs.

There are three main causes for the development of varicose veins during pregnancy:

The principal cause is the hormonal changes that occur during pregnancy. Increased levels of the hormone progesterone cause blood vessels to relax. This may allow the two halves of the valves in the vein to separate slightly, so that they don’t meet to block the back-flow of blood.
The enlarged uterus (the organ that holds a developing fetus), pressing against the major veins in the pelvic region, tends to add to the overall problem. The result is an increase in the pressure in the leg veins that are subject to becoming varicose.
A family history of varicose veins tends to increase the likelihood of varicose veins developing during pregnancy.
Unfortunately, in the majority of cases, the varicose veins of the legs worsen with time. The varicose veins start to become more prominent and swell and with time, the veins become engorged with blood and cause localized pain and itching. Once the leg veins become prominent, it is very unlikely that they will spontaneously resolve without any treatment. However, varicose veins on the vulva/vagina often do get better once the baby has been delivered. The majority of women who do develop varicose veins in the legs will retain these varicosities after pregnancy.

You may or may not be able to prevent varicose veins during pregnancy. Fortunately you can take steps to minimize the severity of varicose veins and treat the veins you do have during pregnancy. If one starts early in pregnancy, varicose veins can be prevented. Here are some simple steps for treating and minimizing varicose veins during pregnancy:

The major preventive measure is to exercise and walk to stimulate the muscles which can push the blood away from the leg.
Elevation of the legs at all times is also recommended.
During pregnancy, one should always lie on the left side with the legs elevated on a pillow. This prevents the fetus from pressing on the leg veins and decreases the chance of developing varicosities.
Don’t cross your legs when sitting down.
Avoid standing or sitting still for long periods of time. Take frequent breaks to stretch while at your desk and shift your weight while standing. This can help decrease the amount of pressure on your legs and help keep your circulation moving. Wiggle your toes regularly and flex your muscles to also promote better circulation in your legs.
Buy some pregnancy support hose that provide graduated compression. This will not only help reduce bulging but will also help reduce any swelling you experience in your extremities during pregnancy. You can get these online or from a medical supply store or pharmacy. These stockings unlike normal pantyhose are quite thick and help maintain blood circulation. They can also help prevent blood from pooling in your legs if you put them on first thing in the morning.
Be sure to gain an appropriate amount of weight. Carrying too much weight can contribute to varicose veins.
Avoid tight clothing that can compress the waist or groin.
Eat a low-salt diet (salt does have the ability to retain water).
For many women varicose veins become much less severe after pregnancy. For others they may find they are still uncomfortable after pregnancy. A small number of women are more at risk for developing blood clots in their veins. This condition should be monitored by a doctor. In some cases a clot may need to be treated.

If you do find your varicose veins are problematic after delivery, you can consult with a qualified surgeon to help decide the best course of treatment. Many veins can be minimized or eliminated using modern treatment methods. If you do decide to have your veins treated you should probably wait until after you are done having children, otherwise you may develop new varicose veins in subsequent pregnancies.

http://www.1800varicose.com/varicose_veins_and_pregnancy.html

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What happens if I don’t have my varicose veins treated?

The pressure in the backflow of the blood in your legs will probably only get worse over time and it may result in the formation of new varicose or spider veins. Untreated varicose veins may also cause blood clots, leg ulcers, and varicose eczema.

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Can I prevent varicose veins from occurring?

It is doubtful that varicose veins can be prevented but certain actions may limit the progress and symptoms. Routine exercise, maintaining a normal weight, avoiding long periods of sitting or standing, and using compression stockings may all help alleviate symptoms.
http://www.1800varicose.com/frequently_asked_questions.html

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The guardian has a great section on varicose veins. It can be found here.

If you’ve been diagnosed with varicose veins, you may want to talk to your doctor to find out more.

Here are some questions that you might want to ask:

Which veins in my legs are causing the problem?
Where are they?
Will my varicose veins get worse?
What might have caused my varicose veins?
Will my varicose veins cause medical problems?
How likely is this?
Are my deep veins healthy?
Do I need to see a specialist?
What treatment choices do I have?
Will treatment make my varicose veins go away?
Will treatment ease my tired, aching legs?
Will my veins come back after treatment?
How likely is this?
How soon will they come back?
Will I get other varicose veins?
What are the risks of injections for varicose veins?
What are the risks of surgery?
If I choose surgery, how will the doctor do the operation?
Will it hurt?
Will I need to take time off work?

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I thought this was an interesting article. It can be found at http://heartlung.osu.edu/article.cfm?ID=1920
COLUMBUS – When blood clots form in veins close to the skin surface in the legs, the presence of varicose veins can actually be a good sign despite their typically unattractive appearance, doctors say.
Any blood clots in the legs should be examined by a physician, but if they accompany varicose veins, that’s a strong indication that valves in the veins are malfunctioning rather than suggesting the presence of a much more dangerous clotting disorder, said Dr. Bhagwan Satiani, a vascular surgeon at the Richard M. Ross Heart Hospital at The Ohio State University.

In a recent observational study of patients with superficial venous thrombosis, or surface blood clots, in their legs, about 80 percent of patients had varicose veins. Among these patients, more serious deep-vein clots were uncommon. However, in the 20 percent of patients who had no varicose veins, the incidence of deep vein clots was 33 percent, Satiani said.

The study results were published in a recent issue of the journal Vascular Medicine.

Clots in the deeper veins of the leg can be important indicators of a clotting disorder that requires treatment beyond a vascular repair. Clotting disorders can be dangerous because of the elevated risk of a blood clot traveling to or lodging in blood vessels in the lungs. Such disorders, and any deep vein clots associated with them, are typically treated with blood-thinning agents delivered through injections or in pills.

“Most superficial clots are not associated with deep vein clots, which means the surface clots are not going to move,” Satiani said. “They’re not as scary as people may think.”

Symptoms of surface blood clots in the legs include isolated redness, pain and swelling that indicate the body is reacting to the clot, Satiani said. Most patients with surface blood clots can be safely treated with applications of heat, compression stockings or elastic bandages, nonsteroidal anti-inflammatory drugs, frequent walking and elevation of the affected leg. Many such clotting problems are resolved within two to three weeks.

Even when varicose veins are a good indicator that a surface blood clot in the leg is unlikely to move or involve deeper veins, physicians routinely perform an ultrasound scan to rule out involvement of deeper veins and to monitor the status of the clot, Satiani said.

Satiani described varicose veins themselves as a mechanical problem. “Within the veins, the valves that act as gates don’t work properly, and blood heading upward toward the heart reverses direction,” he said. “Most clots in varicose veins are not dangerous as long as they are not close to the junction of the leg and the abdomen. There’s a cause for concern when these clots seem to move upward, because those may involve the femoral vein, the main vein in the leg.”

However, larger varicose veins even without clots can cause aching, swelling and fatigue of the lower legs and may require treatment to close off or remove the vein. The malfunctioning valves cannot be repaired, so physicians use heat, injected agents or surgery to close or remove the veins with the most severe mechanical problems, Satiani said.

Between 80 percent and 90 percent of varicose vein cases are inherited, so there is little people can do to prevent the problem, he said. Pregnancy or injury to the deep vein system also can cause varicose veins to form.

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We’ve mentioned that long periods of sitting or standing is a risk factor for varicose veins. But what should you do if, like me, you work at a desk all day?

About.com has a good article about workplace exercise that I’ve excerpted below. The full article can be found at http://exercise.about.com/cs/fittingitin/a/officeexercise.htm

It’s hard to find time to exercise, especially for those of us who work in an office. Exercising at work may seem impossible, but it’s one option for staying fit and keeping your energy up. It takes some creativity, but there are opportunities to exercise at work if you pay attention. All it takes is a little planning and some inspiration to squeeze in a little movement all day long.

The Basics

You probably know a few tricks for staying active at work. Taking the stairs when you can, parking further away from the door and walking around the office when you can are good places to start. Beyond that, there are a few other options to keep you moving:

Sit on an exercise ball instead of a chair. This will strengthen your abs and back and you’ll work on your posture without even trying.

Set an alarm to go off every hour to remind you to stand up and move around. Even if you just swing your arms or take a deep breath, you’ll feel more alert.

Use the restroom on another floor and take the stairs

Use a pedometer and keep track of how many steps you take. Aim for 6,000 to 10,000 steps a day.

Leave something important in your car (your lunch, your briefcase, etc.) so you have to run out to get it (and take the stairs)

Deliver documents or messages to co-workers in person rather than by email

Go to the mall for lunch and park on the opposite end of the food court. Don’t forget to buy something healthy.

Get a headset for your phone so you can move around while you talk.

Be creative. Any movement is better than none, so don’t feel like you have to do sprints all day long. Adding short bouts of exercise throughout the day will help you burn more calories and will also reduce stress so you can easily smile at your boss when she piles more work on you.

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