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What causes varicose veins to twist and enlarge?

I noticed that my varicose veins look almost twisted and gnarled. What causes this? What does the thickness of the vein mean?

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Doctors Answers (5)

Increased venous pressure and injury to the thin vein walls causes the vein to enlarge unevenly with twisting and bending due to some connective tissue tethering on the outside of the vein. This results in enlargement with a very irregular shape and path, destruction of the internal valves, distortion and further thinning of the vein wall, and a reduction in vein function, allowing turbulent and reverse blood flow which will further increase venous pressure, stretching and damage to the vein wall. The initial factors can involve a combination of genetics and environment such as prolonged standing, inadequate shoes such as high heels, pregnancies, and a lifetime of small and large traumas to the legs. Some factors that have been shown not to be a significant factor is crossing of the legs and increased weight (provided in does not reduce the frequency of walking and normal activity).

Veins will become twisted because your blood is backing up inside these veins. When the reflux occurs it causes the veins to swell and twist. The thicker the vein the more severe the disease. Once the cause of the problem is fixed your circulation will improve. The first step is to obtain an ultrasound to determine the extent of your disease.

The reversal of blood flow, or reflux, overwhelms the vein's capacity to contain blood. This causes them to take tortuous courses, some stretching larger than others.

Varicose veins are dilated stretched out veins. Take a balloon and blow it up 10 times. Notice how distorted and stretched out it is. Varicose veins lack the elasticity to return to normal size once they have been dilated. Eventually, they become very tortuous and gnarled. They may be removed or closed once this happens. If you have symptoms with varicose veins, itching, cramping, Charlie horses, swelling or restlessness, then insurance will usually pay for treatment.

Incompetent vein valves causes venous reflux disease. Blood flow, instead of flowing upward towards the heart, the incompetent valves allow the force of gravity to reverse blood flow direction "towards the ankles"). This results in increases venous pressure. This pressure increase, dilates and elongates the affected veins giving them their twisted appearance. These veins are called varicose veins because they resemble grapes beneath the skin.

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