TIRED AND HEAVY LEGS
Tired, heavy and swollen legs are the first and most common symptoms of CVD.
Venous disease is the result of a structural alteration in the venous system in the lower limbs. In such cases, the veins lose their ability to transport the venous blood back to the heart. This leads to the apparition of varicose veins.
Chronic venous disease affects over one third of the Portuguese population and is one of the most common chronic illnesses in the country. This figure is far too high, especially taking into account the fact that it is possible to prevent and slow down the appearance of varicose veins if they are diagnosed early enough and if adequate treatment is provided.
Women are more severely affected than men because of female sexual hormonal activity, the use of oral contraceptives (the pill), lower muscle mass, pregnancy and anatomical factors. Women’s veins have fewer valves than men’s.
Varicose veins appear due to blood drainage problems related to the state of the veins themselves and the insufficiency of the valves inside. This affects mainly the lower limbs.
WHAT IS CHRONIC VENOUS INSUFFICIENCY
The veins in the lower limbs conduct blood back to the heart. Within these veins, there are small valves that prevent venous return back to the feet as a result of gravity. When these valves do not close properly and are insufficient, this reflux is unavoidable. Locally, the quantity of blood increases and stagnates, causing the veins to dilate and become deformed, giving them a lumpy, twisted look. Varicose veins are dilated veins with increased volume, and a gnarled, lengthy appearance that worsens over time.
MOST FREQUENT CAUSES
There can be several factors leading to the appearance of venous disease: genetic or lifestyle-related. Primary venous insufficiency is caused by genes. In the beginning, they develop insidiously and rather slowly. The vein walls become less resistant and they become more fragile.
Circumstantial factors come in different shapes and forms. The most well-known venous illness is deep vein thrombosis, trauma, female hormonal therapy, and pregnancy as well as other factors such as obesity, prolonged orthostasis, excessive heat, etc. Thus, venous disease must be treated as soon as it begins evolving. It must be prevented whenever possible by eliminating risk factors.
However, there are other factors that also play an important role in the appearance or worsening of venous disease, such as smoking, excessive alcohol consumption, excessive weight, prolonged periods of standing or sitting or high-intensity activities that are required from many professionals.
The symptoms of venous disease are usually feelings of heaviness, pain, leg and foot oedema (usually more severe in the evenings). At the beginning of the illness, i.e. in the pre-varicose vein periods, the dilated veins (varicose veins) are not visible. As the disease progresses, they become more obvious. The most frequent complaints are: tiredness, feelings of heaviness and pain in the legs, itching, oedema (swelling) of the feet and ankles, numbness and cramps – particularly at night.
These symptoms worsen after prolonged periods in standing positions, and they are relieved during the night. Time and age also worsens the symptoms, unless preventative measures are taken and adequate treatment is provided. If they are not treated, leg ulcers may appear and these are very difficult to treat. In serious cases, this can lead to sick leave or the inability to do housework as well as many other daily tasks.
The main risk factor is age. Varicose veins get worse as the sufferers age. This does not mean that young people cannot get them too, however. Women are more affected than men (seven women to one man). Women undergoing serious hormonal changes must be monitored, such as pregnant or menopausal women. From puberty to the menopause, women undergo several true hormonal revolutions. It is precisely in those moments that they are more susceptible to developing varicose veins.
Hormonal contraceptives are a risk factor too. This is not only the case of the pill, but all other hormonal contraceptive methods too (transdermal adhesives, vaginal rings, implants) are not recommended for women with a family history of venous disease or who have themselves suffered from deep vein thrombosis.
Pregnancy is the period of greatest risk. If no varicose veins appear during the first pregnancy, they may develop during the second. The trend increases as the number of pregnancies does.
According to specialists, exposure to heat in all its forms is also a risk factor. This is true for women who depilate using hot wax, or who like to sunbathe for many hours.
As to the consumption of alcohol or tobacco, it seems that they do not impact the development of venous disease, except possibly at the later stages of the illness, when there are already large-scale alterations of the leg skin and where there is a lack of oxygen. If you smoke, then you will be promoting this lack of oxygen. The blood reaching the leg of a smoker contains less oxygen that that of a non-smoker.
HOW TO PREVENT VARICOSE VEINS
To prevent venous disease, it is fundamental to begin by eliminating the risk factors, or at least reduce them to a minimum level. The first stage of prevention consists of determining hereditary factors, i.e., discover whether there is a family history of varicose veins. If this is the case, more precautions must be taken. The second stage is to diagnose the patient to see whether or not he/she has venous disease, or if there are already symptoms. If the patient is experiencing pain, fatigue, feelings of heaviness, swelling, etc., this is because the illness is already present. In such cases, a doctor should be consulted, preferably a specialist, in order to carry out several tests and for prophylactic treatment. Such measures may include physical exercise such as walking, cycling, swimming or aquarobics.
If you have venous disease in your lower limbs, follow the advice below:
- Use elastic stockings, especially during pregnancy or activities in which you have to remain standing for long periods of time. These are the best form of varicose vein prevention. They work best if put on first thing in the morning, even before getting out of bed, when the legs are the least swollen.
- Monitor your weight and avoid excessive weight. Ensure you eat balanced meals, rich in fibre and fruit. Instead of red meat and fatty foods, eat fish and white meat. Avoid fried foods and some spices (pepper). Use olive oil, preferably. Drink approximately one and a half litres of water a day and avoid alcohol. Smoking affects one’s blood circulation, worsening the problem for those who already have varicose veins.
- Exercise moderately and regularly, avoiding excessive weight on your legs. Walk, ride a bike, run, dance, walk on the beach next to the water, go in the sea, swim… If you usually drive to work, park your car further away from your workplace. If you use different forms of transport (bus or underground), get off one station sooner than you normally would and walk a few extra metres on foot. Avoid transporting excessive weights, do not do exercise such as bodybuilding or high impact sports, because these cause great tension in the veins and consequently they dilate more, thus forming new varicose veins.
- Wear comfortable clothes and shoes. Tight clothes make blood circulation and blood return more difficult. High heels are bad for you.
- Avoid prolonged periods of intense heat on your lower limbs (e.g. sauna, sunbathing, hot baths, radiators, exposure in the sun, braziers, fireplaces, depilation with very hot wax, etc.) because they cause the dilatation of the veins, the appearance of new vessels, oedemas and make venous return more difficult.
- Avoid sitting for too long. If you have to do so, use elastic stockings, move your legs, ankles and toes frequently.
- Avoid crossing your legs when you are sitting. This will put extra pressure on your legs, making it more difficult for the blood to circulate.
- During resting times, keep your legs slightly elevated, or at least stretched over a chair after a day of intense activity or after exercising. This will promote venous return and will improve blood circulation. If you suffer from cramps during the night, sleep with a mattress that is slightly elevated in the area of your feet (1, 4)
QUESTION: CAN WE TRUST MEDICINAL PLANTS?
Can the intake of medicinal plants slow down the ageing process and prevent the appearance of venous diseases that run in the family? Yes!
According to João Beles, “Medicinal plants are the most widely-used anti-ageing treatment in the world. Several clinical and epidemiological studies performed over recent years have proven that the intake of such products can delay the appearance of illnesses that run in families up to 10 to 20 years sooner”.
This specialist also states that many people who are genetically predisposed to contract certain illnesses are actually able to prevent them altogether by ingesting medicinal plants (2).
The use of plants in the treatment of diseases began empirically: the shapes of leaves, fruit and similar products were often likened to diseased parts of the human body on the basis of their shape. Such experiments led to the selection of the most effective plants.
Scientifically, the study of medicinal plants has gained ground in recent years, both in terms of their composition and their pharmaceutical impact. Scientific research has been performed and their results have been disseminated in magazines and to the public at large.
Today, phytotherapy and the usage of medicinal plants have moved on from their traditional use. Nowadays, the quality, efficacy and safety of the products in increasingly the object of focus (3).
Today, the general public is growing more and more concerned by well-being and health, and there is a rising interest in natural and plant products, over chemical, synthetic products that have a toxic effect on the human body. Medicinal products are therefore increasingly considered a safer and more correct choice.
(2) Text: Daniela Gonçalves.
Scientific review: João Beles (Professor of Naturopathy from the Traditional Medicine Institute) and Dr. Serra Brandão (vascular surgeon and Director of the Institute of Vascular Recovery in Lisbon).
(3) Cunha A. P., Silva A., Roque O. Plantas e produtos vegetais em fitoterapia (2nd edition), Fundação Calouste Gulbenkian, 2006.