If varicose veins are present, the doctor will check whether conservative treatment measures are sufficient or if surgery is necessary. Decisive for which treatment is carried out, in addition to the severity of the disease and the varicose vein type.
Types of varicose veins
In general, the following types of varicose veins are distinguished:
- Broom veins are extensions of the smallest skin veins.
- Reticular varices are extensions of tiny skin veins, which are distributed in a net shape and have a slightly tortuous shape.
- Stem varices are extensions of the major veins of the superficial venous system. These include the large rose vein on the inside of the legs and the small rose vein on the back of the calf. An extension of the trunk veins is particularly common, in about 85 percent of cases, these veins are affected.
- Side branch varices are extensions of the lateral branches of the trunk veins. They are often severely tortuous and easily visible through the skin.
- Perforating varices are extensions of the connections between the superficial and deep veins.
Physical therapy and venous medications
There are several ways to treat varicose veins. As an accompanying measure, the physical therapy comes into question. This conservative treatment includes, for example, light leg massages. However, they should not be performed on inflamed veins or thrombosis.
In addition to massages, Kneipp treatments also have a positive effect on the veins. Likewise, running, walking and venous gymnastics help to promote blood circulation and strengthen the function of the muscle pump. Often 10 minutes of daily gymnastics are enough to alleviate the symptoms significantly.
So-called venous remedies are also among the conservative treatment methods. They are used in the same way as the physical therapy. Venous remedies usually have a decongestant effect and are available in the form of capsules, sprays, ointments and gels. Common active ingredients include horse chestnut extracts, extracts of red vine leaves and arnica.
Treat varicose veins: compression therapy
In the case of incipient venous insufficiency, the development of varicose veins can be prevented or at least delayed by timely compression treatment. Even with an already advanced disease, the symptoms can be alleviated by wearing compression stockings.
Due to the compression, the venous valves and the muscle pump are supported in their function. This prevents the blood in the legs from sinking. For optimum performance, the compression stockings should be individually adjusted and replaced after about six months.
Remove varicose veins
If the conservative methods are no longer sufficient and the varicose veins have to be removed, there are various methods available:
- become deserted
- laser therapy
- Radio wave therapy
Desolate varicose veins
The sclerotherapy of varicose veins (sclerotherapy), a sclerosing agent is sprayed into the ragged vein. For small spider veins, a liquid, for larger veins a foam-like agent is used. It ensures that the inner walls of the vein stick together and over time develop a connective tissue-like strand.
In general, the sclerosing is particularly suitable for spider veins, reticular varices and Seitenastvarizen. For larger varicose veins, however, an operation is recommended. Even with smaller varicose veins, it may take several sessions to complete the treatment. Afterwards, compression stockings usually have to be worn for a certain period of time.
Laser and radio wave therapy
In laser therapy, a thin laser probe is inserted into the affected varicose vein. The laser causes the venous walls to heat up and close. This method is particularly suitable for not too pronounced stem varices that have a straight course. The procedure can usually be performed on an outpatient basis under local anesthesia. After treatment, patients must wear compression stockings for approximately four weeks.
Radiowave therapy is similar to laser therapy. Again, the dilated veins are closed by heat. In both procedures, over 90 percent of the time, only one procedure is needed to occlude the affected vessel.
Remove varicose veins surgically
Due to the complete or partial removal of varicose veins (stripping / partial stripping) there is only a very slight risk of relapse after surgery. During the procedure, a small probe is inserted into the affected vein and pushed out again at the end of the varicose vein. Then the wire is severed and pulled out with the help of the probe. Alternatively, the varicose vein can also be removed by a cold probe. The surgery is performed minimally invasive, so that hardly any scars remain.
The surgery can be performed either on an outpatient or inpatient basis. If there are several varicose veins, they can be removed during surgery. Discuss with your doctor if local anesthesia is sufficient or if partial anesthesia is necessary. After surgery, it is important to follow the doctor's instructions to prevent complications. Most need to be worn for several weeks compression stockings.
Further treatment options at a glance
In addition to the previously presented methods, there are other ways to treat varicose veins:
- CHIVA method: In this method, the doctor uses ultrasound to look for varicose veins and binds the diseased vein sections. As a result, they regress over time and become deserted. However, this procedure should not be used on severely varicose veins.
- External valvuloplasty: In mild cases of common varicose veins, the area of the mouth of the rose vein can be narrowed slightly by attaching a small polyester cuff. This will allow the venous valves to function without having to remove any part of the vein.
- Miniphlebectomy: If there are only small, extended branches, they can be removed by miniphlebectomy. About small cuts, the veins are removed similar to a crochet hook.
- Crossectomy: In crossectomy, the connections between the superficial and deep veins into the deep veins are severed. The surgery is often performed just prior to venous stripping.
Prevent varicose veins
If there is a genetic predisposition, it is not always possible to prevent the development of varicose veins with certainty. Certain precautionary measures can, however, significantly reduce the risk:
- Move regularly: Especially endurance sports such as running, swimming or cycling are suitable to prevent varicose veins. Sports such as tennis or badminton as well as weight training are less recommended in case of an already existing venous insufficiency.
- Pay attention to your weight: obesity may favor the development of varicose veins.
- Go Kneipping: Wading a round through a cold Kneipp pool can do wonders. Otherwise cold leg and knee joints or a change shower will do the same.
- Venous gymnastics helps: Strengthen your veins by specific gym exercises.
- Standing a little: Long standing or sitting has an unfavorable effect on the leg veins. The same applies to wearing tight clothing and high heels.
- Elevating Legs: Elevating the legs makes it easier for the blood to drain away and prevents blood from accumulating in the veins.
- Avoid high heat: During heat, the blood vessels dilate and the blood flow slows down. This may favor the development of varicose veins.
Not only do these behaviors help prevent the development of varicose veins, they are also recommended if varicose veins have already been removed.