Treatment Options for Vein Disease
Treatment options depend on evaluation findings from your consultation, examination focused on the venous system, and Doppler Duplex Ultrasound. Dr. Sellers may recommend one or more of these options as often the best results are seen by combining treatments.
Options 1 & 2 are considered Conservative Care Options. To learn more about Conservative Care visit the Conservative Care Resource Center here on our website.
Click on the option below to learn more about it.
1. Changes in Lifestyle (Conservative Care)
A. Leg Elevation. Get your feet up above your heart. This puts gravity to work for you instead of against you. Stacking a few books under the foot of your matress or using a wedge shaped pillow under your feet while you sleep can help get those legs up and bring relief, too.
B. Exercise. Strengthen your leg muscles through exercise.
1. Walking: Simply walking moderately will help relieve symptoms and reduce future severity. Inactivity tends to make the disease worse. Any moderate exercise like swimming, yoga, or running will help, but walking is a good place to start. Patients are encouraged to start walking as little as 5 minutes a day and work up to 30 minutes. Those patients with veins disorders who walk, often have less pain and swelling. Avoid sports that require sudden hard stops like tennis, squash, hockey, volleyball and basketball if you are experiencing symptoms.
2. Heel Lifts: Heel lifts are a great way to strengthen your calf muscles that provide 85% of the pumping action in your legs. Simply raise yourself up on the balls of your feet and slowly lower yourself back down. Do a few whenever you have a few moments, i.e. while brushing your teeth, waiting in line, watching the tv, or waiting for that pot of coffee or tea to brew. Take hold of a counter or chairs while doing this exercise if you need help with your balance.
3. Ankle Flexions: This exercise involves the pointing of the toes and flexing of the ankle.
C. Diet. Being overweight or obese elevates your risk of vein disease. Those who shed excess pounds reduce the recurrence of the disease. A healthy, diet full of foods high in nutrients is typically recommended, but special needs for diabetics and other conditions are considered. There are also food choices and supplements that will aid in the reduction of swelling and pain due to their anti-inflammatory properties like spinach, grapefruit, ginger, and horse chestnut extract.
D. Avoid high heel shoes for extended periods of time. Short stints in heels for social occasions are acceptable, but eight to ten hours in heels a day is discouraged. The problem with high heels is that they limit your ankle motion and this interferes with the efficiency of your vein pump. When patients wear high heels, they frequently notice an increase in leg aching and swelling. This is because, unlike your heart, which pumps blood continuously through your arteries, your vein pump relies on the contraction of your calf and foot muscles to get blood back from your feet to your heart. For these muscles to contract and squeeze the blood out of your deep veins in the most efficient way, you need to be able to flex and extend your ankle fully. Heels keep this from happening.
2. Compression Therapy (Conservative Care)
Use graduated compression hose, socks, and wraps.
As a person walks the contraction and relaxation of the calf muscles around the veins aid in moving blood toward the heart. The external graduated compression of hose, socks or wraps act as a layer of muscle by gently squeezing the stretched vein walls together, allowing the valves to close. The cavity of the valves is reduced, and it restores blood flow to a normal state, aiding the overall circulation. To be most effective, the socks, hose or wraps should be put on at the start of the day and removed at bed time unless otherwise directed by your physician.
For individuals who get relief from compression therapy, the relief only lasts while the compression hose are worn. Discontinued use means return of symptoms like pain and swelling. For maximum effectiveness they should be worn everyday. They can slow the disease progression, but not stop it completely.
You may also want to avoid standing or sitting for extended periods of time. This tends to make vein disease worse.
Many insurance companies insist that patients try conservative measures for 4-6 weeks such a compression hose, leg elevation, and pain medications (Ibuprofen, Aleve, or Tylenol) before granting preauthorization reimbursement for surgical or laser treatments.
Sclerotherapy can be used to treat both varicose and spider veins. A tiny needle is used to inject the veins with one of several different kinds of chemical irritant, or sclerosant, that irritates the lining of the vein. In response, the veins collapse, seal shut, and are absorbed by the body. The number of sclerotherapy treatments needed is variable, depending on the number, size, and type of veins being treated. Typically, a patient will receive several injections per treatment session. The procedure is almost always preformed in a doctor’s office, and generally, normal activities can be resumed after sclerotherapy. Prescription compression stockings and/or leg wraps may need to be worn for several days after treatment.
This procedure is typically performed in the doctor's office using an anesthetic.
4. Ambulatory Phlebectomy
Ambulatory Phlebectomy is a method of surgical removal of varicose veins at the surface of the skin. Small incisions are made next to the vein and sections of vein are removed through these small nicks.
This procedure is frequently done in the doctors office using only local anesthesia. Afterwards a leg wrap and/or compression stocking is worn for a short period of time. Generally, normal activities may be resumed after several days.
This proceduer is done in the doctor's office.
5. Surgery- Including Ligation & Stripping
Surgical techniques to treat varicose veins include ligation (tying off a vein), stripping (removing a vein by pulling it out with a special instrument), and ambulatory phlebectomy (removing veins through tiny incisions). Surgery may be preformed using local, spinal, or general anesthesia. Now done almost exclusively as an outpatient procedure, patients will usually go home the same day as the procedure. It is necessary to wear leg wraps and/or compression stockings for several weeks after surgery. Normal activities may generally be resumed after several days.
6. Surface Laser/Light Source Treatment
A variety of laser/light source treatment are available today. A light beam created heat inside treated veins that causes them to be sealed off and reabsorbed by the body. By and large, surface laser/light source treatments are used only to treat the smallest of spider veins. Multiple treatments are regularly required. This procedure is also usually preformed in a doctor’s office, requires no local anesthesia, and normal activity can be resumed following treatment. Prescription compression stockings may need to be worn for a few days after treatment
7. Endovenous Thermal Ablation
Endovenous Thermal Ablation is a treatment alternative to surgical stripping of varicose veins. With ultrasound visualization, a small catheter or tube is inserted into the damaged vein, usually through a needle. Thermal energy, or heat, is then delivered inside the vein, which causes the vein to collapse and seal shut.
The procedure is typically done in the doctor’s office under local anesthesia. Afterwards, a leg wrap or prescription compression stocking is usually paced on the treated leg for 1-2 weeks. Patients are able to walk immediately after the procedure and most individuals are able to return to work the next day.
This procedure often results in better looking and feeling legs in a matter of days.
8. Endovenous Chemical Ablation
Also known as ultrasound-guided sclerotherapy, endovenous chemical ablation is another treatment alternative to surgical removal of varicose veins. With this procedure, a chemical irritant, called sclerosant, is injected into the vein while the doctor observes the injection process on an ultrasound screen. This allows veins that are blow the surface of the skin to be treated. Since these veins cannot be seen visually, they would otherwise require surgical removal. This technique causes the vein to collapse and seal shut, and may be preformed with liquid or foamed sclerosant.
The procedure is usually preformed in a doctor’s office and may not require local anesthesia. It is not uncommon for a leg wrap or prescription compression stocking to be placed on the treated leg for 1-2 weeks. Patients are able to walk immediately after the procedure and most individuals are able to return to work the next day.
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171 Town Center Drive, Anniston, Alabama 36205 • Lewis E. Sellers MD
Content on this website is not considered medical advice. Please see a physician before making any medical or lifestyle changes.