Varicose veins are twisted, dilated veins usually apparent on the lower extremities. Some conditions are known to precipitate the formation of varicose veins and they include venous disease, chronic cough, obesity, pregnancy, constipation, and prolonged standing. There is also a positive association with the female sex, older age, and development of varicose veins. It is not yet known exactly how varicose veins form, but it is agreed that genetic predisposition may play a significant role.
Other factors may include weakened walls of the veins, increased blood (venous) pressure, and incompetent valves (unlike arteries, healthy veins have valves that prevent back flow of blood against gravity). Some complications may include infection, ulcers, and thrombosis.
There is little evidence to preferentially support any single treatment modality, some conservative options include:
- avoidance of prolonged standing and straining
- elevation of the affected leg
- modification of cardiovascular risk factors
- reduction of peripheral edema
- weight loss
- and of course, exercise!
Is it good to exercise if we have varicose veins? Why?
The simple answer is, “yes”, but some exercises may be more beneficial than others. The good news is that you have a bit of choice. It is worth pointing that it is important to have realistic expectations. While exercise may not necessarily undo the damage to already present varicose veins, rest assured that it can reduce risk factors leading to further damage and further development of varicose veins.
Exercise accomplishes this because when you are active—for example, going for a walk—it forces your leg muscles to contract and relax with every step. This works as a pump that brings blood back to your heart. There is no other pumping mechanism in your lower extremities, so veins have valves that prevent the back flow of blood against gravity.
When you remain standing for too long, or sitting down for too long, blood has a more difficult time making it back to the heart. If there is damage to the vein walls (e.g. bulging), or to the valves, then blood can pool.
Furthermore, exercise increase the metabolic demand for energy. Fat stores a great amount of energy required by your muscles. The more energy your muscle need, the more fat will be “burned”. The good news is that you do not have to run a marathon. There is evidence that walking for as little as 30 minutes a day can have positive impact on your health!
What kind of exercise can and cannot be done and what are their benefits/downside?
It has been suggested that one should avoid exercises that increase strain on your body. These include most weight lifting exercises, especially the ones that increase abdominal pressure (e.g. squatting with weights over your shoulders). However, this does not mean that you should stop doing all weight bearing exercises.
Weight bearing exercises have been shown to help reduce the risk of developing osteoporosis in women. For more information, speak with a qualified athletic therapist or kinesiologist.
The most commonly recommended exercises include walking, biking, swimming, stairs—essentially, cardiovascular exercises that engages your muscles and promotes the pumping action of your heart. As stated earlier, contraction of your muscles allow blood to flow back from the lower extremities preventing their pooling. These exercises require a great deal of energy, and so your body will take that energy from fat storages, thus helping with weight loss. As a result, a positive health cycle is accomplished when you exercise. The downside is that already present varicose veins may not disappear, but the benefit is that you’re slowing down their progression.
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What can be done to ease the pain?
Clinical presentations differ from patient to patient, but pain, cramping, burning, itching, swelling are common symptoms associated with varicose veins. The first thing is to have a qualified health care provider assess you. Treatment for pain can be based on patient preference, but it is important to speak with your health care provider before self-prescribing pain medication—no matter if it’s natural or not.
Lifestyle change is perhaps the one form of “treatment” that can have the most impact. For those of you that lead a sedentary lifestyle, a bit of physical exercise can greatly benefit you. This is something you may accomplish by downloading a “fit” app on your phone and keeping track of how much you walk each day, then challenge yourself to do a bit more every week.
When it comes to foods, increasing fibre and rutin-containing foods (buckwheat, citrus, grapes, apricots, cherries, blackberries, apple peel, etc) may be very helping. Avoiding alcohol, white flour, and sugars can also help reduce inflammation and damage to your veins. A registered dietician can help you come up with a diet that caters to your needs and likes.
There are two medicinal plants with some evidence to suggest their use in the managements of varicose veins, they include Ruscus aculeatus (butcher’s broom) and Aesculus hippocastanum(horse chestnut). For proper dosing, it may be best to speak with a licensed naturopathic doctor in order to ensure proper and safe use.