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CASE STUDY ON PATIENT WITH VARICOSE VEINS

Authors:
  • CENTRAL COUNCIL FOR RESEARCH IN YOGA AND NATUROPATHY
  • central council for research in yoga and naturopathy, New Delhi

Abstract

Varicose Veins can be explained as a disorder of the veins (especially of legs) wherein they get affected due to the backward flow and turbulence in the circulation of the blood. The veins get perverted, become enlarged due to a condition called edema. The disease also shows many associated symptoms which worsens the condition of the varicose veins. In this study we have seen role of yoga, naturopathy and diet. How yoga reduces the varicosity of vein and stress, same in naturopathy how it improves the circulation of blood and reduce the swelling of veins, same as diet helps in preventing blood clots, acts like a natural blood thinner.
CASE STUDY ON PATIENT WITH VARICOSE VEINS
Siddappa Naragatti
Central Council for Research in Yoga and Naturopathy, New Delhi,
A R T I C L E I N F O
Varicose Veins can be explained as a disorder of the veins (especially of legs) wherein they
get affected due to the backward flow and turbulence in the circulation of the blood. The
veins g
shows many associated symptoms which worsens the condition of the varicose veins. In
this study we have seen role of yoga, naturopathy and diet. How yoga reduces the
varicosity
and reduce the swelling of veins, same as diet helps in
natural blood thinner.
INTRODUCTION
Varicose Veins is common disease
which affects one third of
the population of which prevalence is observed in the Western
Europe and the United States. A study revealed that, from the
affected population, there is around 1-
73% of females
(especially during pregnancy) exposed to this disea
an average 2-
56% of males. Thus, we may conclude that
women are more likely to be affected than men. Varicose
Veins or Venous Insufficiency is a disease which involves
enlargement and gnarling of the Veins usually of legs. In this
disorder, there
is reflux flow of blood through the valves of
legs, hence instability in circulation of blood.
The risk factors of includes age, hereditary, pregnancy,
obesity, occupation which involves prolonged hours of
standing, Diet, Type of physical activity, Exces
hormones, etc
. These factors are not clearly known yet.
Symptoms related to Varicose may not be observed in case of
some affected population. If seen the symptoms at initial
stages include severe pain, swelling, itching, heavy legs, and
lipoderma
tosclerosis (skin thickening). If left untreated, the
further complications lead to bleeding veins, eczema, skin
pigmentation or discoloration, venous ulcers, and hence
complete vein incompetence.
Causes
The veins have one-
way valves so that the blood c
only one direction. If the walls of the vein become stretched
and less flexible (elastic), the valves may get weaker.
International Journal of Current Advanced Research
ISSN: O: 2319-6475, ISSN: P: 2319-
6505,
Available Online at
www.journalijcar.org
Volume 8; Issue 10 (B); October 2019
; Page No.
DOI: http:
//dx.doi.org/10.24327/ijcar.2019
Copyright©2019
Siddappa Naragatti and Rakesh Gupta
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
Article History:
Received 12th June, 2019
Received in revised form 23rd
August, 2019
Accepted 7th September, 2019
Published online 28th October, 2019
Key words:
Varicose vein Yoga Intervention Naturopathy
Management Dietary Regimen Case Study.
*Corresponding author: Siddappa Naragatti
Central Council for Research in Yoga and Naturopathy,
New Delhi, India
CASE STUDY ON PATIENT WITH VARICOSE VEINS
Siddappa Naragatti
and Rakesh Gupta
Central Council for Research in Yoga and Naturopathy, New Delhi,
India
A B S T R A C T
Varicose Veins can be explained as a disorder of the veins (especially of legs) wherein they
get affected due to the backward flow and turbulence in the circulation of the blood. The
veins get perverted, become enlarged due to a condition called edema. The disease also
shows many associated symptoms which worsens the condition of the varicose veins. In
this study we have seen role of yoga, naturopathy and diet. How yoga reduces the
varicosity
of vein and stress, same in naturopathy how it improves the circulation of blood
and reduce the swelling of veins, same as diet helps in
preventing blood clots, acts like a
natural blood thinner.
which affects one third of
the population of which prevalence is observed in the Western
Europe and the United States. A study revealed that, from the
73% of females
(especially during pregnancy) exposed to this disea
se and on
56% of males. Thus, we may conclude that
women are more likely to be affected than men. Varicose
Veins or Venous Insufficiency is a disease which involves
enlargement and gnarling of the Veins usually of legs. In this
is reflux flow of blood through the valves of
The risk factors of includes age, hereditary, pregnancy,
obesity, occupation which involves prolonged hours of
standing, Diet, Type of physical activity, Exces
s use of
. These factors are not clearly known yet.
Symptoms related to Varicose may not be observed in case of
some affected population. If seen the symptoms at initial
stages include severe pain, swelling, itching, heavy legs, and
tosclerosis (skin thickening). If left untreated, the
further complications lead to bleeding veins, eczema, skin
pigmentation or discoloration, venous ulcers, and hence
way valves so that the blood c
an travel in
only one direction. If the walls of the vein become stretched
and less flexible (elastic), the valves may get weaker.
A
weakened valve can allow blood to leak backward and
eventually flow in the opposite direction. When this occurs,
blood can accumulate in the vein(s), which then become
enlarged and swollen.
The veins furthest from the heart are most often affected, such
as those in the legs. This is because gravity makes it harder for
blood to flow back to the heart. Any condition that puts
pressure on the abdomen has the potential to cause varicose
veins; for instance, pregnancy,
constipation
tumors.
Case presentation
A 39 years old married Hindu female patient working as house
wife came with the following problems such as pain in both
the legs due
to varicosity of veins, stress, hyperacidity,
weakness and decreased concentration since 2
While examine we found her B.P. is 100/70mmHg and weight
65.5kg.
Intervention:
patient practiced yoga therapy session of one
hour for 6 days per week for
one and half month including
loosening exercises, Asanas, pranayamas, meditation and
Kriyas and followed diet which is advised during consultation.
Duration: 45 days
Frequency:
one hour yogic practices for 6 days a week
followed by proper diet.
Yogic management
Loosening exercises: 10 minutes
Ankle rotation, Air cycling, Backward leg raises, Elevate legs,
Rocking feet, Spinal twisting, Side lunges and flexing
exercises.
International Journal of Current Advanced Research
6505,
Impact Factor: 6.614
www.journalijcar.org
; Page No.
20198-20200
//dx.doi.org/10.24327/ijcar.2019
.20200.3938
Gupta.
This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
Central Council for Research in Yoga and Naturopathy,
Varicose Veins can be explained as a disorder of the veins (especially of legs) wherein they
get affected due to the backward flow and turbulence in the circulation of the blood. The
et perverted, become enlarged due to a condition called edema. The disease also
shows many associated symptoms which worsens the condition of the varicose veins. In
this study we have seen role of yoga, naturopathy and diet. How yoga reduces the
of vein and stress, same in naturopathy how it improves the circulation of blood
preventing blood clots, acts like a
weakened valve can allow blood to leak backward and
eventually flow in the opposite direction. When this occurs,
blood can accumulate in the vein(s), which then become
The veins furthest from the heart are most often affected, such
as those in the legs. This is because gravity makes it harder for
blood to flow back to the heart. Any condition that puts
pressure on the abdomen has the potential to cause varicose
constipation
and, in rare cases,
A 39 years old married Hindu female patient working as house
wife came with the following problems such as pain in both
to varicosity of veins, stress, hyperacidity,
weakness and decreased concentration since 2
-3 months.
While examine we found her B.P. is 100/70mmHg and weight
patient practiced yoga therapy session of one
one and half month including
loosening exercises, Asanas, pranayamas, meditation and
Kriyas and followed diet which is advised during consultation.
one hour yogic practices for 6 days a week
Ankle rotation, Air cycling, Backward leg raises, Elevate legs,
Rocking feet, Spinal twisting, Side lunges and flexing
This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
International Journal of Current Advanced Research Vol 8, Issue 10(B), pp 20198-20200, October 2019
20199
Suryanamaskara - 3 rounds (5 min.)
Asanas: 20 minutes
Asanas are very effective in the treatment of varicose veins,
providing relief from symptoms and in some cases allowing
valves to regain their efficacy. All the inverted asanas are most
important. They allow the stagnant pooled blood to drain back
to the heart, permitting damaged veins to resume more normal
dimensions and facilitating valvular competence. We
conducted asanas which stretch the muscles of the legs, toning
and developing the muscle pump because the pumping system
is inefficient and weak.
1. Tadasana (3 min. / 5 round)
2. Uttanasana (2 min. / 3 round)
3. Navasana (3 min. / 5 round)
4. Viparita karani (2 min. / 1round)
5. Sarvangasana (1 min. / 1 round)
6. Matsyasana (3 min. / 2 round)
7. Pawanmuktasana (3 min. / 2 round)
8. Padahastasana ( 3 min. / 3 round)
Pranayama: 12 Min. (each 3 minutes)
1. Anulom-vilom pranayama
2. Chandrabhedi pranayama
3. Bhramari pranayama
4. Sitkari pranayama
Meditation: Omkara chanting or guided meditation focusing
on the affected part. (5 min.)
Relaxation: Deep relaxation technique (5 min.)
Bandha: Uddiyana bandha
Kriyas: Madhyama nauli (3 min.)
Naturopathy Management
Warm water enema weekly twice.
Daily alternate hot and cold hip bath.
Hot Epsom salt bath twice a week.
Mud therapy and steam bath twice a week.
Cold packs applied over the affected part.
Dietary Regimen: Advised to take potassium & magnesium
rich foods, such as almonds, pistachio nuts, potatoes, leafy
vegetables, blueberries, lentils, white beans, avocado, bananas,
cruciferous veggies and sweet potatoes, high fiber food,
vitamin C & E, high antioxidant foods, which help to reduce
blood pressure in the arteries and can relax blood vessels.
General precautions
Take rest in between prolonged long standing hours.
Sleeping with feet raised slightly above the level of
the heart helps the blood flow away from ankles.
Mobility helps general circulation. Walking,
swimming is beneficial as the movements of leg
muscles help push the blood upward.
When seated for prolonged hours elevate your feet
and rest your legs on a chair or stool.
Stockings & round garters should never be worn
continuously, especially when seated for a long time.
Objective data
Patient has followed prescribed yoga practice with lifestyle
modification for one and half months. She provided the
following information:
1. Leg pain reduced & varicosity of vein significantly
reduced.
2. Increased stamina
3. Decreased weakness, Hyperacidity
4. Increased concentration
5. Reduced stress & anger
6. Improved sleep
7. Happy with the physical & mental health satisfaction.
General examination results
Weight – 63 kg, BP - 122/80, HR - 80/min
Deep Veins- All deep veins of left leg are normal with no e/o
Deep vein thrombosis. The calf veins shows good filling &
augmentation.
DISCUSSION
A 39 year old female came stressed, weak and anxious mental
state. She was troubled by varicose veins problem & advised
operation. She wanted to reverse back varicose veins problem
without surgery & get back to positive mental health.
A varicose vein problem is one of vascular disorder in which
there is poor circulation of blood. Lower limbs are mainly
affected part due to natural & anatomical weight bearing
structure. If you see patient she is not obese but her history
says that she has more muscular mass & rigidity over lower
limbs. During first pregnancy she added more weight on lower
limbs due to which the wall of veins became weak. She was
suffering for 7-8 years. This affected her mental health &
stamina. Then patient took invasive treatment of yoga &
naturopathy followed by proper dietary regimen and heals
herself.
CONCLUSION
Regular yogic practices with proper medical counseling and
guidance helped patient regain physical and mental health. In
this case patient experienced the satisfaction within one and
half month of regular practice & her investigation reports
supported the result. Radiologist acknowledged that the
varicosity of affected veins had reduced significantly. Inverted
Asanas contribute a lot to unloading the veins of lower
extremities and pelvis. Combinations of upside down poses
and dynamic movements of the feet (rotation, flexion,
extension in the ankle joints), performance of Uddiyana
Bandha in inverted Asanas – all these are good for venous and
lymphatic system of the legs. Venous system of the pelvis
benefits from twisting variations of inverted Asanas, such as
Sarvangasana and others.
Abdominal manipulations (Uddiyana Bandha and Nauli) are
powerful vacuum techniques that create negative pressure in
the cavities of the body and therefore increase the venous
return. The most powerful vacuum technique is Madhyama
Nauli. It is important to use breathing techniques in a specific
mode aimed to improve venous return.
In this case patient feel the changes that yoga reduces the
varicosity of vein and stress, same in naturopathy treatment
improves the circulation of blood and reduce the swelling of
Case Study on Patient with Varicose Veins
20200
veins and diet followed by her helped in preventing blood clots
and acts like a natural blood thinner.
References
1. Ushasree, P. (2018). A Case Report on Varicose Veins.
Journal of Basic and Clinical Pharmacy, 9(2).
2. Thomason, M. E., Scheinost, D., Manning, J. H., Grove,
L. E., Hect, J., Marshall, N., ... & Hassan, S. S. (2017).
Weak functional connectivity in the human fetal brain
prior to preterm birth. Scientific reports, 7, 39286.
3. Rayman, M. P., & Stranges, S. (2013). Epidemiology of
selenium and type 2 diabetes: can we make sense of
it?. Free Radical Biology and Medicine, 65, 1557-1564.
4. Allen, J. (2007). Photoplethysmography and its
application in clinical physiological measurement.
Physiological measurement, 28(3), R1.
5. Rial, S. A., Karelis, A. D., Bergeron, K. F., & Mounier,
C. (2016). Gut microbiota and metabolic health: the
potential beneficial effects of a medium chain
triglyceride diet in obese individuals. Nutrients, 8(5),
281.
6. Lim, C. S., & Davies, A. H. (2009). Pathogenesis of
primary varicose veins. British Journal of Surgery:
Incorporating European Journal of Surgery and Swiss
Surgery, 96(11), 1231-1242.
7. Hamel-Desnos, C., & Miserey, G. (2018). Choosing
wisely for Chemical or Thermal Ablation in the
Treatment of the incomptent Saphenous Veins and
Recurrences. Phlébologie, 71(4), 1-9.
8. Negrao, B. L., Crafford, D., & Viljoen, M. (2009). The
effect of sympathomimetic medication on
cardiovascular functioning of children with attention-
deficit/hyperactivity disorder. Cardiovascular journal of
Africa, 20(5), 296.
9. Ross, T. D., Coon, B. G., Yun, S., Baeyens, N., Tanaka,
K., Ouyang, M., & Schwartz, M. A. (2013). Integrins in
mechanotransduction. Current opinion in cell
biology, 25(5), 613-618.
10. Introduction to Massage Therapy- Page 504 - Google
Books Result Mary Beth Braun, Stephanie J.
Simonson - 2008
11. C. J. Evans, F. G. Fowkes, C. V. Ruckley, A. J. Lee.
(1999, March). Prevalence of varicose veins and chronic
venous insufficiency in men and women in the general
population: Edinburgh Vein Study. Journal of
Epidemiology & Community Health. 53(3): 149–153.
Retrieved
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1
756838/
12. Vignon-Clementel, I. E., Figueroa, C. A., Jansen, K. E.,
& Taylor, C. A. (2010). Outflow boundary conditions
for 3D simulations of non-periodic blood flow and
pressure fields in deformable arteries. Computer
methods in biomechanics and biomedical
engineering, 13(5), 625-640.
13. Brazier, Y. (2017, December 14). "What can I do about
varicose veins?." Medical News Today. Retrieved
fromhttps://www.medicalnewstoday.com/articles/24012
9.php.
How to cite this article:
Siddappa Naragatti and Rakesh Gupta (2019) 'Case Study on Patient with Varicose Veins', International Journal of Current
Advanced Research, 08(10), pp. 20198-20200. DOI: http://dx.doi.org/10.24327/ijcar.2019.20200.3938
*******
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A Case Report on Varicose Veins
  • P Ushasree
Ushasree, P. (2018). A Case Report on Varicose Veins. Journal of Basic and Clinical Pharmacy, 9(2).
Choosing wisely for Chemical or Thermal Ablation in the Treatment of the incomptent Saphenous Veins and Recurrences
  • C Hamel-Desnos
  • G Miserey
Hamel-Desnos, C., & Miserey, G. (2018). Choosing wisely for Chemical or Thermal Ablation in the Treatment of the incomptent Saphenous Veins and Recurrences. Phlébologie, 71(4), 1-9.