What causes varicose veins? Why did I get varicose veins?

In normal leg circulation, the heart pumps blood through the arteries. This arterial blood takes nutirents and oxygen to the tissues in the leg and foot.

The blood, now full of waste products and carbon dioxide, is then collected by the veins and has to be pumped back to the heart and lungs.

Unfortunately, when standing or sitting, gravity stops the blood from flowing up hill and, at rest, the venous blood cannot move up the veins.

Therefore we have evolved a 'venous leg pump' to pump the blood back up the veins to the heart and lungs. This venous leg pump is made up of 2 parts:

• 1) Movement by the muscles in the feet and legs
  
• 2) Valves in the veins to stop blood that has been pumped up from falling back down again
  

You can see animations explaining this on www.veins.co.uk under the 'How veins work' section.

In about 1 in 4 adults, the valves stop working, meaning that the blood that is pumped up the veins by movement of the legs, falls back down the veins when the movement stops. The falling of blood back down these veins is called 'venous reflux'.

Blood that refluxes down the veins hits the capilarries in the muscle and skin - causing inflammation - and then this inflammation damages the tissues. The inflammed tissues cause the aching, swelling and skin damage that results in all of the complications that are listed on the first page of this website.

Of course the body doesn't like the damage and does whatever it can to stop the damage happening. The aching and pain of the legs is relieved by putting your leg up - encouraging patients to get in a position where the venous blood cannot reflux back down the veins.

Another thing the body does is to produce 'shock absorbers' to take refluxing blood away from the main vein, stopping it from hitting the inflammed tissues around the ankles and lower leg. The 'shock absorbers' are small veins - or tributaries - connected to the main vein. As the blood falls down past the openings into these tributaries, some dilate over time, becoming big and bulbous and encouraging the blood to flow into them rather than keep refluxing down the main vein. The force of the falling blood is expended by stretching the walls of these 'shock absorber' veins reducing the force hitting the tissues at the ankle and helping to reduce the inflammation and damage in the lower leg.

These abnormally large 'shock absorber' veins are the varicose veins the are seen in some legs.

Therefore, if you have followed this you will see

• that the underlying problem is the valve failure and allowing venous reflux that causes damage to the tissues in the lower leg.
  
• Varicose veins are found in some people with venous reflux - but not in many with venous problems in their lower legs.
• The visible varicose veins are not the underlying problem, in fact they prevent damage to the tissue of the leg.
• Treatment of varicose veins is the treatment of the underlying venous reflux - NOT the veins that can be seen.
• Treatment of leg ulcers, venous skin damage and all of the other things casued by venous reflux is the same.