Condition

Varicose Veins

Overview

Varicose veins are twisted, enlarged veins. Any superficial vein may become varicose, but the veins most commonly affected are those in your legs. That’s because standing and walking upright increases the pressure in the veins of your lower body. For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more serious problems.
Treatment may involve self-care measures or procedures by your doctor to close or remove veins.

Symptoms

Varicose veins may not cause any pain. Signs you may have varicose veins include:
  • Veins that are dark purple or blue in color
  • Veins that appear twisted and bulging; they are often like cords on your legs
When painful signs and symptoms occur, they may include:
  • An achy or heavy feeling in your legs
  • Burning, throbbing, muscle cramping and swelling in your lower legs
  • Worsened pain after sitting or standing for a long time
  • Itching around one or more of your veins
  • Skin discoloration around a varicose vein
Spider veins are similar to varicose veins, but they’re smaller.
Varicose Vein

Causes

Weak or damaged valves can lead to varicose veins. Arteries carry blood from your heart to the rest of your tissues, and veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity.
Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the vein, causing the veins to stretch or twist.

When to see a doctor

Self-care — such as exercise, elevating your legs or wearing compression stockings — can help you ease the pain of varicose veins and may prevent them from getting worse. But if you’re concerned about how your veins look and feel and self-care measures haven’t stopped your condition from getting worse, see your doctor.

How are varicose veins diagnosed?

In addition to a complete medical history and physical exam, diagnostic procedures for varicose veins may include:
  • Duplex ultrasound: A type of vascular ultrasound done to check blood flow and the structure of the leg veins. Duplex means two types of ultrasound are used.

What is the treatment for varicose veins?

Specific treatment for varicose veins will be determined by your healthcare provider based on:
  • Your age, overall health, and medical history
  • Extent of the condition
  • Your signs and symptoms
  • Your tolerance of specific medicines, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference
Medical treatment may not be necessary if there are no symptoms. However, varicose veins may sometimes worsen without treatment. Medical treatment may include:
  • Elevation of the legs: You may be instructed to elevate your feet above the level of your heart 3 or 4 times a day for about 15 minutes at a time. If you need to sit or stand for a long period of time, flexing (bending) your legs occasionally can help keep blood circulating. If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and relieve other symptoms.
  • Compression stockings: These elastic stockings squeeze the veins and prevent blood from pooling. Compression stockings can be effective if they are worn every day.
  • Sclerotherapy: Sclerotherapy is the most common treatment for both spider and varicose veins. A salt (saline) or chemical solution is injected into the varicose veins. They no longer carry blood. And, other veins take over.
  • Endovenous Laser Ablation: Lasers energy may be used to treat varicose veins. A tiny fiber is inserted into a varicose vein through a catheter. The laser or radiofrequency energy is used to deliver heat that destroys the wall of the varicose vein.
  • Vein stripping: This is surgery to remove varicose veins.
  • Microphlebectomy: Special tools inserted through small cuts (incisions) are used to remove varicose veins. It may be done alone or with vein stripping.

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