NEW YORK—Chalk it up to old age or the cold weather, but soreness and a heavy feeling in the legs could be warning signs of varicose veins, the precursor to a condition called deep vein thrombosis (DVT).
The Centers for Disease Control estimates that 1 to 2 Americans in every 1,000 are affected by DVT, which occurs when a blood clot forms in a deep vein, usually in the legs or pelvis.
The risk increases to 1 in 100 for individuals 80 and older. Between 60,000 and 100,000 people in the United States die from DVT each year.
Because of the pervasive myth that varicose veins are merely a cosmetic blight, the CDC in 2010 teamed up with the Venous Disease Coalition (VDC) to launch ThisIsSerious.org, a website aimed to increase awareness of DVT among women.
At New York Vein Center, medical director David M. Glass, M.D., F.A.C.S., is educating patients—both men and women—about risk factors and treatment options, which have improved significantly in the 25 years that Glass has been practicing.
Spiders and Ropes
There are internal veins and surface veins. The latter can manifest as spider veins or varicose veins.
“The spidery veins are strictly cosmetic. They have no impact on your health, and they don’t hurt,” Glass said.
“The ropey, big veins on the skin are definitely a problem because as you get older and the blood seems to stagnate in your legs as your circulation slows down, your vessels have a tendency to clot.”
In a healthy person, blood circulates from the heart to the muscles and skin and comes back through the veins every five seconds, Glass said. But in people with vein insufficiency or vein reflux, the valve system that directs blood in the right direction malfunctions, and blood ends up stagnating in the veins for minutes at a time.
This leads to swelling, pain, tenderness, cramps, and with prolonged lack of treatment, bleeding and ulcers. The ultimate consequence of varicose veins is a blood clot.
“If you have these ropey veins on your legs, you’re definitely at a high risk for thrombosis [DVT],” Glass said.
Varicose veins affect all ethnic groups equally, and the condition affects both sexes, though women have a slightly higher prevalence, according to Stanford Hospital.
Moms and Varicose Veins
While occupation has a part to play—those who are on their feet a lot are at a slightly higher risk—being overweight, sedentary, or pregnant also increases the risks, but the No. 1 indicator is genetics, Glass said.
You are likely to develop varicose veins if someone in your family has them, particularly if your mother does.
“Varicose veins by the mother was most frequent compared to varicose veins by the father or both,” according to a 2004 study published by the National Institutes of Health.
Becoming a mother worsens this risk.
“When a baby develops, it presses on the pelvic veins, one from the right leg, one from the left leg—confluence around the belly button into the vena cava that goes up to the heart,” Glass said. “When that child is sitting there for months, he puts a back pressure on the two veins.”
In a large number of women, this leads to valve damage once the baby is delivered.
For mothers-to-be, preventing varicose veins is extremely simple—see a vein doctor early in the pregnancy and wear vein stockings until the baby arrives.
“It’s a small price to pay to keep your legs nice,” Glass said. “Once you destroy that valve system, that vein is not likely to shrink back down to a healthy size.”
At that point, surgery is the only option, but it’s not as scary as it sounds.
When Glass started out as a vein doctor, treatments for varicose veins seemed like something from the Spanish Inquisition playbook.
“Old fashioned treatments left patients out of work for weeks. It was brutally painful. You’d tie a string onto someone’s vein and yank it out. It’s called vein stripping. And the condition was always doomed to come back in a couple years.”
It should never be performed anymore, Glass said—not with the painless technologies available today.
At New York Vein Center, Glass uses new equipment, including a $15,000 cryo-sclerotherapy machine to cool the skin and reduce sensitivity to zero.
Glass is one of the few doctors in the Tri-State Area who has the technology.
He personally does all the steps: interviewing the patient and doing the ultrasounds, testing, and all operations.
Most patients require a vein closure treatment, a phlebotomy, and cosmetic injections.
For varicose veins, a fine needle allows Glass to pass a catheter into the vein up to the highest point of damage. Then he applies a radio frequency that seals the vein. Radio frequency is far less damaging to the skin and tissue than a conventionally used laser, which can result in major bruising.
The procedure takes 12 minutes and virtually eliminates the risks for DVT, Glass said. The blood is shuttled into the healthy veins and leaves deep intramuscular veins unharmed.
Afterward, the patient should walk frequently, at least half an hour a day, avoid long periods of sitting, wear compression stockings, and come back for a follow-up scan within 72 hours.
Symptoms of Vein Problems
- Aches and cramping in the legs
- Burning or itching of the skin
- Leg or ankle swelling
- Heavy feeling in the legs
- Open wounds, ulcers, or sores
- Restless legs
- Varicose veins
- Skin discoloration or texture changes
New York Vein Center (Manhattan Locations)
47 E. 63rd St. and 5 Hamilton Place
New York, NY