What is the recovery time after treatment of varicose veins?

The answer depends on what treatment you have had, and what bandaging you have been given. For all treatments, mobility after the procedure is to be encouraged but what prevents mobility is pain and the restriction of bending the knee caused by heavy bandages or compression garments.

Stripping of varicose veins caused a lot of pain with 27% grading this as more than 8 out of 10 on a pain scale. 37.5% of patients reported pain for 15 to 28 days. Only 52.5% were back to normal mobility within 28 days.

Laser ablation (EVLT) was the first widely used method to ablate veins and this was much better. Return to work 3.6 days on average.

Radiofrequency ablation (RF) is less painful. Return to work 2.9 days on average

ClariVein does not involve injecting large volumes of local anaesthetic and does not work by burning the vein so is much less painful. Return to work 1 day on average, some go straight back to work after the procedure.

The other factor that affects return to normal activity. At the Liverpool Varicose Veins Clinic we pioneered a bandage system that allowed full knee movement so that patients can drive home after a ClariVein ablation.

Following EVLT or RF where the vein has been burnt under local anaesthetic, you are not able to drive immediately.

Are varicose veins dangerous?

The severe complications do not effect most people, but when things go bad, they go really bad and it is not possible to predict.

  1. People with varicose veins are at a significantly higher risk of getting deep vein thrombosis (DVT). This can cause permanent leg swelling and if a clot moves up to the heart, death can occur.
  2. Untreated varicose veins can cause skin damage with Varicose eczema, discoloured skin (lipodermato-sclerosis) and ultimately leg ulcers which are very difficult to heal.
  3. Phlebitis is a localised clot that forms in a varicose vein rather than in a deep vein. It causes severe pain and can progress to a deep vein thrombosis (DVT). Doctors often prescribe antibiotics which is completely useless as it is not an infection. It will normally resolve after a few weeks but commonly recurs and should always be referred for treatment.
  4. Bleeding. This can be very severe. The only way to stop the bleeding is to lie down and put the leg up in the air. Simply applying pressure isn’t enough. Rarely patients have bled to death from this.
  5. Leg ulcers occur when the high pressure blood in the veins damage the skin and the skin breaks down to create a large oozing hole in the leg. Even with best treatment only 50% heal within 3 months and during this time heavy bandages are required. They often get infected and smell. The bandages limit mobility. Latest guidelines say that if anyone gets an ulcer, they should be referred for minimally invasive treatment by a surgeon after 2 weeks. This rarely happens.

Do compression stockings help varicose veins?

Theoretically the pressure should empty the surface varicose veins. However there is no real evidence that this does anything useful and therefore the NICE guidelines specifically state that compression stockings for varicose veins do not help.

Despite this, it is common for GPs to recommend stockings because a decision has been made by the NHS not to refer patients to venous surgeons unless skin damage has already occurred. These skin changes may be permanent. However, since GPs are not supposed to refer patients for treatment some feel they have to do something, so offer stockings.

Is walking good for varicose veins?

Walking is good for everyone who is able. This has general health benefits ranging from keeping weight down to living longer.

The apps which count your paces suggest that we should all be doing 10,000 paces per day. Walking helps venous blood to return to the heart through the deep veins where the blood belongs. Without the exercise the blood loses its oxygen and damages the skin.

If you have varicose veins, the blood in the surface varicose veins just yo-yo’s up and down because a valve has broken in the vein. As a result the veins get bigger over time and ultimately you can get skin damage due to the pressure. The damage can take various forms – Varicose eczema, discoloured skin (lipodermato-sclerosis) and ultimately leg ulcers which are very difficult to heal. Therefore while walking is good for everyone, it won’t improve your varicose veins.