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The trouble with the legs

Stopping the varicose veins

At first sight, spider veins look like a blue mark or haematoma, but on closer inspection we can see small veins. These unsightly marks can indicate a beginning vein weakness.
Marta Campbell and Isabel Weinert
11.08.2020  13:00 Uhr

A chronic venous insufficiency (CVI) is a progressive degenerative illness in the superficial venous system of the legs. This means with age the frequency and degree of severity of the illness are going to increase. As a long-term effect severe varicose veins (varicosities) and, in the worst case, an »ulcerated leg« (ulcus cruris) can develop. Women suffer from this illness more frequently than men.

In some families, varicose veins occur quite frequently which suggests that there is a genetic disposition. The complaints may often start in the early adulthood. But with specific measures the progress can be slowed down, at best even stopped. People with a beginning vein weakness should pay special attention to two areas: movement and body weight. The heavier the body the more pressure rests on the legs and blood vessels. Each kilogramme less in body weight will bring relief. Without a doubt, overweight has a negative effect on the progress of CVI, but the conclusion that only overweight people will develop varicose veins is nevertheless wrong. People with a normal body weight are equally affected.

Start the treatment early

The earlier the prevention and treatment of CVI is started, the more promising is the success. At the start, physical measures will normally suffice. Daily vein gymnastics are of top priority. These are simple exercises which can be done discreetly fitted inbetween day-to-day life. Patients can find many suitable suggestions in the internet so that they can do something for the health of their veins while standing, sitting or lying down. Sports that are healthy and especially good for the veins are swimming, water gymnastics, cycling as well as running and walking. Movement will get the muscle pump going and the blood is better transported.

Treatment devised by Pastor Sebastian Kneipp has also proven effective, such as cold ablutions or washes, knee pouring and water treading. Even simple methods, such us elevating the legs when sitting or a wedge at the bottom end of the bed will support the weak veins effectively.

As the illness progresses the measures mentioned will at some point no longer suffice and further treatment becomes necessary. However, as a basis of the therapy, regular vein gymnastics should be maintained.

The most effective treatment of CVI is the compression therapy. Here pressure is applied to the veins externally in order to transport the blood to the top against gravity. The vein’s cross-section is reduced thereby increasing the flow velocity of the venous bloodstream. The progression of CVI can be stopped for a long period of time by consistent compression treatment. If, however, noticeable varicose veins have already developed, they will not recede again.

Effective extracts

The medicinal therapy options for CVI are limited. Basically, we can differentiate between an external and an internal treatment. Heparins and heparinoids (60,000 I.E./100 g), which are to prevent the thrombin formation, are applied for the external treatment. They cannot, however, dissolve a thrombin that has already been formed. Some products additionally contain a skin-irritant substance which is to ensure a better absorption and distribution of the heparins. Furthermore, preparations with aescin, flavone derivatives or arnica extract are used topically. Pharmacologists often doubt the effectiveness of the external vein therapy. Nevertheless, patients repeatedly ask for it as they can feel positive effects. Apart from the pleasant massage and cooling effect, there is no doubt a certain placebo effect too.

For the oral therapy the so-called oedema-protective agents are worth considering. These are herbal extracts or semi-synthetical active substances such as Oxerutin, Toxerutin or Trimethylhesperidinschlcon. According to the current S2k-guideline for the diagnosis and therapy of varicosis, the effectiveness of certain standardised extracts from horse chestnuts or red vine leaves as well as Oxerutin is proved scientifically. These extracts can improve symptoms such as heavy, tired legs, pulling pains or nocturnal cramps in the calf, and can ease slight oedemas. Herbal medicines mostly take time to show any effect. The same applies to herbal vein remedies which need some time until the effect is noticed. It takes two to four weeks for a noticeable effect to set in, and that only if taken continually.

Horse chestnut extracts are considered effective if the daily dose amounts to a minimum of 100 mg Aescin. Patients with a sensitive stomach are better served by extended release formulations. The effective dose of red vine leaves extracts amounts to 360 to 720 mg dry extract. Extracts from the rootstock of the butcher’s broom are also used for the treatment of vein ailments. The saponins contained therein have an antiphlogistic effect similar to Aescin, they seal the capillaries and tonify the veins.

Deutsch/German Englisch/English
Adern veins
Arnikaextrakt arnica extract
Besenreiser spider veins
Bewegung movement
Blauer Fleck haematoma, blue mark
Chronisch venöse Insuffizienz chronic venous insufficiency
Gymnastik gymnastics
Heparin heparin
Hochlagern elevate
Kapillaren capillaries
Kompressionstherapie compression therapy
Krampfadern varicous veins
Mäusedorn butcher’s broom
Muskelpumpe muscle pump
Rosskastanie horse chestnut
Rotes Weinlaub red vine leaves
Stützstrumpf compression stocking, support stocking
Venen veins
Veranlagung disposition

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