Venous insufficiency occurs when the veins are no longer able to keep blood flowing in the right direction. Your veins rely on tiny structures, called valves, to keep blood flowing back to the heart. When these valves fail, blood can collect in the lowest part of your body – usually your legs and feet – and cause vein problems.

Blood clots can form in any vein in your body, including the brain, liver, and other major organs. They can also form in your arms and legs, and potentially travel to other areas of your body. A clot that stays in place is called a thrombus. A clot that moves to a different area is called an embolus. Clots are potentially life-threatening because they can block blood flow to a major organ, causing it to stop functioning.

Some leg pain could be a sign of Deep Vein Thrombosis (DVT), a blood clot that forms in a vein deep within the tissues.  DVT is dangerous because it is usually not visible from the surface.  The symptoms of a DVT may include:

• Swelling and redness of the affected leg
• A feeling of heaviness in the affected leg
• The affected leg may also feel warm or look different from the other leg

A sedentary lifestyle is one of the biggest culprits of DVT.  Other factors include:

• Heredity
• Smoking
• Hormonal birth control, especially in conjunction with smoking
• An injury to the legs
• Cancer

One of the best ways to prevent blood clots and DVT is to be physically active.  Adding as little as half an hour of exercise can make a big difference.  Other ways to prevent blood clots or DVT include:

• Wearing compression stockings especially on long trips
• Drinking lots of water
• Quitting smoking
• Changing birth control methods
• Elevating your legs when you are lying down to aid blood flow
• If you have a family history of DVT, consult with your doctor about taking low-dose aspirin or a prescription blood thinner

(Resource: Vein Directory.org – http://www.veindirectory.org/article/7-venous-disease-risk-factors.html; Aug 14, 2014)

Varicose veins are those swollen, bulging veins seen most often on the legs and feet that sometimes appear bluish or purple in color.  These result from blood flow that has backed up and collected in the veins of the lower extremities, usually as a result of malfunctioning valves in the veins. Normally, one-way valves in the veins keep blood flowing toward the heart, against the force of gravity. When the valves become weak and don’t close properly, they allow blood to flow backward, a condition called reflux. Veins that have lost their valve effectiveness, become elongated, rope-like, bulged, and thickened. These enlarged, swollen vessels are known as varicose veins.

Other than visible signs of varicose veins, symptoms may include the following:

• Achiness or heavy feeling in one’s legs – burning throbbing, muscle cramping and swelling in the lower legs (especially as the day progresses)
• Itching around one or more veins in the legs
• Skin ulcers near the ankle which represent a severe form of vascular disease and require immediate attention

Risk factors for varicose veins may include:

• Age – As the veins age they tend to weaken, which can lead to venous insufficiency.
• Family History – If your parent, grandparent, or siblings have venous disease, you could be more likely to develop a similar condition.
• Other Illnesses – Hypertension, diabetes, and certain clotting disorders can all contribute to venous disease.
• Female Gender – Women have a higher chance of developing varicose and spider veins.  Also, pregnancy, especially multiple pregnancies, are common risk factors for varicose veins.
• Medications – Certain medications, such as hormonal birth control, can cause blood clots.
• Lack of Exercise – In addition to the valves, your veins also rely on muscle contractions to keep blood flowing.  Prolonged periods of sitting, or standing in one place, can lead to venous insufficiency and also increase your risk for blood clots.
• Surgery or Trauma – These events can cause venous insufficiency and blood clots.
• Lifestyle – A poor diet can make existing illnesses worse and contribute to venous disease.  Smoking and drug and alcohol use can also cause blood clots and venous insufficiency.

(Resources:  Vein Directory.org – http://www.veindirectory.org/article/7-venous-disease-risk-factors.html; Aug 14, 2014;  Society of Interventional Radiology – Used with permission from the Society of Interventional Radiology 2004, 2010. www.SIRweb.org. All rights reserved.)

Varicose veins are commonly found and treated in legs, but recent studies estimate a third of women will experience pelvic pain due to weakened and bulging veins sometime in their life.  Similar to leg varicose veins, Pelvic Congestion Syndrome (PCS) occurs when the valves assisting blood flow from the pelvic area to the heart begin to break down and leak.  The blood streams backward and pools in the veins.  Over time, the collecting blood causes the vein to stretch – resulting in dull, aching pain and discomfort.

Pelvic Congestion Syndrome generally affects women younger than 45 years old in their child bearing years.  Women who have never been pregnant rarely develop symptoms.  It accounts for 15 percent of outpatient gynecologic visits and, surprisingly, up to 15 percent of women between the ages of 20 and 50 have varicose veins in the pelvis.

You may be at risk for PCS if you’ve experienced one of the following:

• Two or more pregnancies
• Fullness of leg veins
• Polycystic ovaries
• Hormonal dysfunction
• Tipped uterus

The chronic pain and discomfort associated with PCS is usually felt in the lower abdomen and back and increases during the following:

• Menstrual periods
• During or after intercourse
• Pregnancy
• Standing or sitting for an extended period

Other symptoms may include:

• Irritable bladder
• Abnormal menstrual bleeding
• Vaginal discharge
• Varicose veins on vulva, buttocks or thigh
• Aching legs

Treatment

Pelvic Congestion Syndrome is treated using non-surgical, minimally invasive techniques.  The diagnosis is confirmed by selectively catheterizing specific veins and injecting contrast dye.  If varicose veins are found, the veins are blocked to minimize excess blood flow.  Because the procedure is minimally invasive, it is carried out under local anesthesia.  Following the procedure, patients stay overnight at the hospital and after 24 hours the patient is released spending the remainder of the recovery time at home.  Pain relief varies from partial to complete with an 80 percent success rate in pain reduction.

Resources:  Johns Hopkins Medicine, -www.hopkinsmedicine.org; www.veins1.com; Minimally Invasive Surgical Solutions Medical,Inc.-www.endovascularsurgery.com