Apart from the force of gravity, the causes of varicose veins are uncertain. Research has cast doubt on the idea that certain lifestyle factors—including habitually sitting with your legs crossed, standing too much, a low-fiber diet and straining due to constipation—cause them. But these may worsen varicose veins, if you have them. Obesity and chronic lack of exercise, however, do seem to raise the risk of varicose veins. The strongest factor appears to be genetic: if varicose veins run in your family, you are at higher risk.
Women have long been said to be more prone to varicose veins, particularly in pregnancy. If varicose veins appear in a first pregnancy, they may disappear after the birth, but return in subsequent pregnancies. However, gender may not be a factor: in a study of more than 1,500 people aged 18 to 64, for example, researchers at the University of Edinburgh actually found that men—and taller people of both sexes—were more likely to have varicose veins.
Walking, swimming and cycling (particularly recumbent cycling) may help prevent varicose veins. They stimulate circulation gently, without increasing pressure on the legs. If you already have varicose veins, strenuous running, cycling, jumping and aerobic dance are not recommended. Reduced circulation in the legs can cause pain and swelling during high-impact or very vigorous activity. Talk to your physician about the right exercise program for you.
Often varicose veins are not painful and do not require treatment. But even so, many people would prefer to get rid of them, if only for cosmetic reasons. If you have swollen, painful veins, see a doctor as soon as possible—early treatment is best. Your doctor may also suggest compression stockings or special elastic bands that fasten with Velcro. The bands are easier to put on than compression stockings. Both stockings and bands can be uncomfortable, however.
Highly effective nonsurgical treatments can be done on an outpatient basis under local anesthesia; discuss these with your doctor. The idea behind them is to remove (strip) the bad veins or cause them to collapse and be re-absorbed by the body. (You have enough veins in your legs to carry blood back to your heart, even if you lose a few.) Only after careful diagnosis can your physician recommend the best procedure for you. You may also want the advice of a phlebologist, a vein specialist.
In endovenous laser ablation, veins are closed off by a small laser beam. In ultrasound-guided sclerotherapy, veins are injected with a chemical solution that hardens them and blocks blood flow. Blocked veins form a kind of scar tissue and are eventually re-absorbed. Treatment with radiofrequency energy is another possibility. After these treatments, you may need compression stockings. Most people can be back to regular activities in a day or two. Surgical methods of stripping veins, done in the hospital under anesthesia, are seldom needed anymore.