Prevalence, Causes, Prevention, Treatment Options: We answer your questions about spider and varicose veins

How common are vein problems?

According to a large study on vein health in Germany, 90% of adults show varying degrees of vein changes. Spider veins are the most common. These unattractive bluish-red vein networks on the legs affect more than half of all men and women, even at a young age, and can be an early sign of vein weakness. Over time, this can also lead to formation of larger varicose veins, water retention causing the legs to swell, and to the development of prominently knotted varicose veins. At worst, it can also cause damage to the surrounding skin and even lead to leg ulcers. Around 60% of people over 70 in Germany suffer from advanced venous disease and related symptoms.[1]

How do lifestyle and work habits affect the legs?

While vein problems and varicose veins existed since time immemorial, they have now become widespread, often referred to as a “disease of civilization”, due to the increased life expectancy and modern lifestyles of today.  While our ancestors still had to move around a lot to find food or to get from one place to another, today we mostly use transport means, such as cars, buses, or trains, to get around. Furthermore, the percentage of people working in service jobs, which mainly involve standing or sitting for long periods, has risen from 32.7% in the 1950s to 74.9% today.[2] This convenience has its price: lack of physical activity leads to weakening of the muscles crucial for vein function and blood flow in the legs. It also contributes to overweight, which puts extra pressure on already weakened veins.[3]

 

Why do standing and sitting harm the veins?

No other body position places as much pressure on the veins as standing. Studies show that normal blood return from the legs to the heart is impaired after just 20 minutes.² Certain occupational groups, such as hairdressers or sales assistants, stand for most of their working day. It is therefore no surprise that they have a significantly higher risk of developing varicose veins compared to the general population. However, prolonged sitting is also harmful for health, promoting not only varicose veins but also cardiovascular diseases and back problems. Furthermore, when sitting for long periods, blood tends to pool in the legs because the calf muscles are not actively pumping it upwards as they do during walking. Additionally, prolonged sitting increases the risk of thrombosis. Thus, whoever has to sit or stand for extended periods, especially older individuals, should wear compression stockings to prevent vein complaints or venous diseases. Physical exercise is also crucial to compensate for the lack of activity at work.

Why should people with varicose veins exercise?

Exercise, particularly walking, strengthens the calf muscles and promotes blood circulation, which can in turn prevent venous disorders and alleviate symptoms. These positive effects benefit even those with a hereditary predisposition to varicose veins. Exercise can reduce vein complaints such as swollen legs and prevent the development of severe conditions, including skin changes and ulcers. Ideal forms of exercise include walking, cycling, swimming or dancing, all of which are also suitable for less athletic individuals. Special vein exercises specifically aim to prevent vein issues, whereby just 30 minutes a day can already have a positive effect. You can perform the vein exercises both at home and at the office (you can find tips for a simple vein workout here: www.healthy-veins.com/service-2/tips-vein-training). It can also be beneficial to wear compression stockings in your everyday life or during prolonged sitting or standing to further protect and support the veins.

What role does diet play in leg health?

Like exercise, a healthy diet cannot cure or prevent inherent vein weakness, but it can support leg health. Plant-based foods such as fruits, vegetables, whole grain products, legumes, nuts and cold-pressed oils are full of vitamins, minerals and other beneficial substances that strengthen the connective tissue and protect cells. Additionally, a balanced whole-foods diet provides plenty of fibre, which can counteract obesity, due to its satiating properties, and stimulate bowel function. Avoiding excess weight, helps reduce pressure on the veins and the resulting blood congestion in the legs. For good circulation, it is also essential to drink one and a half to two litres daily — ideally water or unsweetened tea.

Why is it important to treat varicose veins early?

Varicose veins are a visible sign of a chronic vein disease, which progresses if left untreated. They usually come with a whole range of troublesome symptoms and significantly reduce the quality of life for those affected. Common symptoms include heavy, swollen legs and calf cramps. There is also a risk of skin discolouration, vein inflammation and, in the worst case, leg ulcers and thromboses. Even if varicose veins do not hurt, they should be examined and treated if necessary. Additionally, many people find prominent varicose veins and smaller spider veins to be a cosmetic problem and, to avoid showing their legs, they sometimes wear long trousers even in warm months and forgo pleasures like swimming pool visits or beach holidays.

How can spider veins and varicose veins be permanently removed?

Compression stockings and vein creams or medications can alleviate leg discomfort but do not eliminate existing varicose and spider veins. Long-lasting, health-promoting and aesthetic results can only be achieved if a doctor removes the varicose veins. Fortunately, this can now be done with gentler methods than surgery. Treatments such as laser beams, radio waves or sclerotherapy can be used. However, some methods may not work, for example, in the case of twisted varicose veins. Sclerotherapy, on the other hand, is the only method that can safely and effectively treat all types of varicose and spider veins.

What characterizes sclerotherapy?

Sclerotherapy is one of the most well-researched treatments for varicose veins and its efficacy and safety have been confirmed in numerous scientific studies.[4]^,[5] According to medical guidelines, sclerotherapy is the method of choice for spider veins and smaller varicose veins, achieving an over 90 percent improvement.[6] It is also remarkably gentle, even for larger varicose veins, as it does not require anaesthesia or skin incisions and is minimally painful. During the outpatient appointment, the doctor injects a special medication into the affected veins with a fine needle, causing them to close and be naturally absorbed by the body over the following weeks. The actual procedure takes less than half an hour. There is no recovery period required and patients can return to work and undertake their normal daily activities immediately. Sclerotherapy is particularly suitable for older individuals and for those, who are overweight. The comparatively little effort involved is also reflected in the costs, which are usually lower for sclerotherapy than for other procedures.

 

Further information on vein and leg health as well as sclerotherapy can be found on the internet at www. www.healthy-veins.com.

[1] Robert Koch-Institut (Hrsg.): Venenerkrankungen der Beine. Gesundheitsberichterstattung des Bundes, Heft 44, Mai 2009.]

  [Robert Koch Institute (Editor) Venous Diseases of the Legs. Federal Health Monitoring System]

[2] Hirsch T et al. Venenleiden und der Einfluss berufsbedingter Exposition. vasomed 2/22, S. 61-65.

[Venous disease and the influence of occupational exposure]

[3] Davies H et al. Obesity and lower limb venous disease – The epidemic of phlebesity. Phlebology 2017 May;32(4):227–33.

[4] Rigby KA et al. Surgery versus sclerotherapy for the treatment of varicose veins. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD004980.

[5]  Rasmussen LH et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg 2011;98:1079–87.

[6]  Rabe E et al. (Fassung von 2018). Leitlinie Sklerosierungsbehandlung der Varikose (ICD 10: I83.0, I83.1, I83.2, I83.9).

AWMF-Leitlinien-Register-Nr.: 037-015. Entwicklungsstufe: S2k.

[Guidelines for sclerotherapy in the treatment of varicose veins (ICD 10: I83.0, I83.1, I83.2, I83.9). Association of the Scientific Medical Societies in Germany – Guideline Register number: 037-015. Development level: S2k]