Phlebology is a new field of medicine where we assess and treat patients with venous disease. It is estimated that 20% of American women and 7% of American men will suffer from Venous Disease, and among this 20% will develop leg ulcers due to their varicose veins.
All veins have valves that direct blood flow towards the heart. The deep venous system is embedded into the leg muscles. When the muscles contract, they squeeze the blood towards the heart, and the blood is emptied into the heart. Aided by gravity, when blood flow is blocked the blood pools in the leg causing pressure in the veins. This is how varicose veins are formed.Leg veins are divided into two systems: deep and superficial systems. The superficial system drains into the deep venous system by a direct connection, and other connections known as perforating veins.
Varicose veins can cause pain, achiness, swelling and redness that can worsen with prolonged standing, sitting and heat. If left untreated, varicose veins can cause skin changes and ulcerations.
An ultrasound of the leg will be taken for venous mapping to see where the problem is and how to correct it.
Management of the varicose veins starts with conservative measures.
The first measure is regular exercise as it will help veins empty blood into the heart. We recommend 30 minutes of exercise daily, incorporating lower extremity exercises. The benefits of exercise include:
- Reduces symptoms such as aching and pain
- Reduces ulcer recurrence
Patients can keep legs elevated when sitting. We also advise patients to keep their legs at heart level for 10 minutes twice a day. Other measures such as not wearing high heels or controlling weight are important, too.
One of the most important measures we have patients take is to wear support hoes. These are special compression hoes where the pressure is higher at the lower leg and gradually decreases towards the top, so blood is squeezed up towards the heart and aids the emptying of the blood in the vein. Patients should wear the compression hoes when they are sitting or standing.
The Elastic Compression Stockings:
- Must be graduated
- At least calf high
- Should be replaced every 6 months to assure proper pressure
- Available in a variety of strengths, styles, colors and fabrics
You can take Ibuprofen or Horse Chesnut Seed Extract is also known to help decrease pain and swelling.
If these simple measures don’t help, you can discuss with your physician about office procedures. These procedures are done under local anesthesia and patients can walk immediately after the procedure.
About Dr. Ravi:
Dr. Ram Ravi is Board Certified in Internal Medicine. His special Interests include Acute Medical Care and Preventive Medicine. He also specializes in varicose vein treatment. Dr. Ravi sees adult patients in our Middleburg Heights (Southwest) & Westlake offices.