Exercise & Healthy Legs

Exercise is important for all of us in order to maintain our health, both mentally and physically. Even if you suffer from a venous disease, there is no reason not to exercise. Many of my patients have previously undertaken and also continue to compete in sport at a high-level including swimming, running and cycling. One benefit of the procedures offered at The Leg Vein Doctor is there is no post operative downtime and so there is minimal effect on training schedules, indeed light exercise is encouraged post treatment. If you have varicose veins and are still exploring your treatment options before making a decision, you might in the mean time find this video from the Physiologists at Bodytrack informative as it features some low impact exercises that can be done to promote good health. 

Allied care plays an important role in assisting The Leg Vein Doctor and we get referrals from a wide variety of professionals ranging from (but not limited to!) General Practitioners, Dermatologists, Vascular Surgeons, Physiotherapists, Remedial Masseuses, Personal Trainers, Yoga Instructors and Cosmetic Therapists. By establishing good links within the community in Brisbane and Toowoomba, The Leg Vein Doctor aims to educate the public on venous disease, treatment options and over all better health and wellbeing. I hope you enjoy watching this video - please subscribe to our YouTube channel to keep up with our forthcoming segments. 

Both Bodytrack and The Leg Vein Doctor are situated on Woodstock Road in Toowong, Brisbane. 

Lasers and Leg Veins

I am frequently asked by patients about the use of Laser for the treatment of leg veins, so I want to briefly explain how our vein clinic utilizes Laser in the treatment of venous disease and hopefully provide some clarity on this important topic. 

There are two distinctively different uses of Laser in the treatment of diseased Leg Veins:

• Inside the vein – this is used to treat large varicose veins.
• Outside the vein – this is used to treat small surface veins.

At The Leg Vein Doctor, we use only the “inside the vein” method of Laser treatment.  Medically this is referred to as Endovenous Laser Therapy (ELA, ELVA, ELVT) and it is specifically used for the ablation of the larger primary varicose veins.  A tiny fibre-optic thread is passed up inside the vein and as it is slowly withdrawn the Laser energy burns the inside wall of the vein.  Extensive research over the last decade now supports EVLT as the preferred method of treatment for primary Saphenous vein incompetence as it is more than 99% reliable and not plagued by the high recurrence rates seen with surgical “stripping” of varicose veins.  

The treatment of small surface veins, known as spider veins or Telangiectasia is optimally performed by the use of Sclerotherapy.  This is often done under either direct vision or magnification. Sclerotherapy is regarded as the “Gold Standard” for the treatment of surface veins on the leg.

But there are no absolute rules and so surface Lasers sometimes do have an important role in the treatment of certain types of surface vein disease, particularly on the face.  Surface Laser is also the preferred method of treatment for some types of vascular malformations. Certain complications of Sclerotherapy such as matting and post sclerotic pigmentation often respond better to surface laser.
As a general rule however, treatment of surface veins on the leg respond far better to Sclerotherapy than to surface Laser. It is important to understand what type of laser your practioner will be using for your treatment prior to starting.

Menopause and Varicose Veins: How Are They Connected?

Women approaching menopause can be glad to live in an era when discussion of the process and its accompanying changes is no longer hush-hush and taboo. Any biologically based changes in one’s body will be accepted and responded to better when accompanied by information and education. Since it occurs naturally, some do not consider menopause to be a medical condition per se. However it does have practical ramifications for women’s health, especially for bones and cardiovascular health.

There are many hormonal changes that accompany menopause, primary of these being decreased production of the female hormones estrogen and progesterone by the ovaries. There are also increased levels of two hormones of the pituitary gland – luteinizing hormone and follicle stimulating hormone - that usually stimulate estrogen production by the ovaries in the pre-menopausal years. Other tissues in a menopausal woman’s body continue to produce estrogen, and the adrenal glands make some progesterone, but the overall levels of the two hormones become much lower during and after menopause. This brings on the familiar symptoms of hot flashes, loss of bone density and otherwise unexplained episodes of fatigue or depression.

Less well known is the fact that estrogen and progesterone have positive effects on all of the circulatory system, not just the heart. Veins of the leg in particular are known to express receptors for progesterone – even in men! (There are low levels of all the sex hormones in both men and women.) Therefore some doctors believe the decreased levels of progesterone during and after menopause may contribute to the development of varicose veins, which women are more predisposed to than men. The drop in hormone levels may also contribute to the weakening of the valves that veins contain, which is known to be important in the development of varicose veins.

Menopause of course can’t be prevented, but the negative symptoms are often treated with hormone replacement therapy (HRT). Whether HRT reduces a woman’s chance of developing varicose veins has not been studied directly. However, most HRT preparations include both estrogen and progesterone – the combination seems safer than estrogen alone – and progesterone is predicted to be necessary for healthy veins, based on the presence of its receptors there.

Menopausal women concerned about varicose or spider veins can do a number of things in addition to HRT to reduce the likelihood of their appearance. Perhaps the most powerful preventative is regular exercise for the legs – walking, running, biking and swimming all stimulate circulation in the legs. Good circulation is key to preventing the pooling of blood in veins that causes them to become varicose. One can also avoid some of the common risk factors for developing varicose veins, such as smoking, becoming diabetic and a sedentary lifestyle.

Both sitting and standing in one place for hours at a time increase the risk of varicose veins. Therefore those in jobs requiring long hours of sitting or standing in place should take frequent but very short breaks, just to walk around a bit. Any additional exercise after work hours will only help. Wearing of support stockings is generally good for the veins of the leg and can also help prevent the onset of varicose veins. Lastly, keeping the legs and feet elevated when sitting is helpful – and it feels great, too!

The Leg Vein Doctor is proud to associate with Dr Zimmet one of the American pioneers in leg vein health. Dr Zimmet and his esteemed colleagues contribute regularly on DoctorQA.com which helps spider and varicose veins sufferers find information and connect with local vein care specialists not just in Queensland but all over the world. 

Is Glue the Future of Varicose Vein Treatment?

A new technique of injecting a glue (Cyanoacrylate) into varicose veins has recently been the focus of attention in Europe.  The authors have highlighted what they believe are several advantages over current treatment methods such as Surgery, Laser Ablation, Radiofrequency Ablation and Foam Sclerotherapy.  There is no anaesthesia required and less post procedural pain. The procedure is faster than other methods and patients don’t need to wear stockings!

The first published trial appeared in July 2011 so there is no data available on long term outcomes. The European Sapheon Closure System Observational ProspectivE (eSCOPE) Trial commenced in November 2011 so we at The Leg Vein Doctor will be following this new development with interest.

VenaSeal Sapheon Closure System

Leg Pain and Leg Veins

The leg pain from leg veins is typically an ache which tends to occur towards the end of the day or after prolonged standing. The ache is throbbing or burning in nature and tends not to be severe. Relief often occurs if the legs are elevated.

Symptoms are more noticeable towards the bottom of the leg, around the calves and feet.  If the distribution of pain is only above the knee then it is unlikely to be due to veins.  Sometimes spider veins over the lateral aspect of the upper thighs can cause a mild ache but then symptoms are only localized to a smaller area in the distribution of the veins.

If the pain is severe and continuous, radiates from the buttocks to the feet or causes a person to wake at night then there is a low likelihood that the cause is due to venous disease.

 Other causes that need to be considered are:

• Spinal nerve root compression from a lumbosacral disc prolapsed causing referred pain.
• Pelvic pathology referring pain down into the leg. Pelvic infections, ovarian disease or malignant diseases. 
• Hip and knee disease can refer pain widely into the lower limb.

An exception to this rule is a relatively rare condition called Post Thrombotic Syndrome (PTS). PTS is an unfortunate condition where a deep vein thrombosis has occurred and subsequently the valves inside the veins become permanently damaged so that the venous system is unable to return de-oxygenated blood back out of the leg and back to the heart. The leg becomes permanently swollen and the skin becomes damaged over time.  The ache in the leg is sometimes severe and continuous compression of the leg with medical stockings is required. Dr Kemp investigating leg pain.