Many people think varicose veins are caused by pressure from standing on their legs too long during work or exercise or that they just develop during old age. Actually they are caused by a disease in the major leg vein at the top of the leg called the greater saphenous vein, and can affect people as young as 20. Heredity is the most important factor, followed by gender and age. Women have a higher incidence of varicose vein disease; up to 25% of all women and 18% of all men will suffer from vein reflux disease to some degree. Women are more susceptible in part to the female hormones affecting the vein walls, especially during pregnancy when there is also a temporary increase in blood pressure and volume in the veins. Age is a factor because vein walls loose elasticity, causing the valve system in veins to work less effectively.
The greater saphenous vein is the major vessel in the superficial venous system, running from the groin to the ankle. This vein branches into many tributaries and connects to the “Deep Vein System” at a number of points through vessels known as perforator veins. The most common medical origin of varicose veins is known as “reflux of the greater saphenous vein.” Within all veins there are a series of one-way valves that assure blood flow in the direction of the heart. “Reflux” relates to a failure of these one-way valves that causes blood to flow backwards, pool and stretch the walls of veins in the lower leg causing the unsightly blue, bulging and painful veins known as varicose veins. Although varicose veins often occur in the lower thigh, around the knee and in the calf, the cause of the problem is often related to a disease process or failure occurring higher up in the leg.
There are other factors that are associated with varicose veins that can speed up the development of this disease and make them worse but do not cause it, including obesity, prolonged standing, and physical trauma. Patients can change their lifestyles to address these secondary factors and may be able to slow down the development of vein reflux disease. Unfortunately, in most cases if you are going to develop the problem, there is little which can be done to avoid it.