What Are Varicose Veins? The Basics

Varicose veins are enlarged, twisted veins that develop most often in the legs. They are very common and can become more noticeable with age, but they are not simply a cosmetic problem. For some people, varicose veins cause aching, heaviness, swelling, itching, or other symptoms that can interfere with daily life.

Varicose veins develop when the veins in the legs have difficulty returning blood to the heart. Over time, increased pressure within the veins can cause them to enlarge and become more prominent beneath the skin.

Your veins have the job of carrying blood from your legs back up to your heart, working against gravity. In order to accomplish this, the veins contain small one-way valves that help keep blood moving in the right direction.

When these valves become weak or damaged, blood can flow backward and pool in the veins. This is called venous reflux. The increased pressure causes the affected veins to stretch and enlarge, eventually producing the twisted, bulging appearance associated with varicose veins.

Several factors can increase your likelihood of developing them, including age, genetics, pregnancy, excess weight, prolonged periods of sitting or standing, and a history of blood clots or other vein problems.

For many people, varicose veins develop gradually. What may begin as a few small visible veins can eventually become larger and more noticeable as venous disease progresses.

What Do Varicose Veins Feel Like?

Some people have varicose veins without experiencing any symptoms. For others, they can cause significant discomfort. Common symptoms include aching or throbbing in the legs, a feeling of heaviness or fatigue, swelling around the ankles or lower legs, itching or burning around the affected veins, muscle cramping, and discomfort that becomes worse after prolonged standing or sitting.

Symptoms may improve when the legs are elevated or after walking and moving around. This is because movement helps the calf muscles push blood back toward the heart.

In more advanced cases, chronic vein problems can lead to skin discoloration, inflammation, skin changes, and even venous ulcers near the ankles.

Varicose veins are usually not dangerous by themselves, but they can be a sign of an underlying problem with the veins. When venous reflux is left untreated, increased pressure can continue to affect the tissues and veins of the lower legs.

In some cases, varicose veins can be associated with complications such as superficial thrombophlebitis, bleeding, skin changes, or venous ulcers. A healthcare professional can evaluate your veins and determine whether your symptoms are related to underlying venous disease.

Sudden leg swelling, significant pain, redness, warmth, or other new symptoms should be evaluated promptly because they can have causes that require medical attention.

Who Is Most Likely to Develop Varicose Veins?

Anyone can develop varicose veins, but certain factors increase the risk.

Age: Vein valves can become less effective over time, making venous reflux more likely.

Family history: Genetics play an important role. If close family members have varicose veins, you may be more likely to develop them yourself.

Pregnancy: Pregnancy increases blood volume and places additional pressure on the veins in the pelvis and legs. Hormonal changes can also relax the walls of the veins.

Prolonged sitting or standing: Remaining in one position for long periods can make it more difficult for blood to return efficiently from the legs.

Excess weight: Additional weight can increase pressure on the veins and make it more difficult for blood to circulate back toward the heart.

Previous vein problems: A history of blood clots or other damage to the veins can increase the risk of developing chronic venous problems.

How Are Varicose Veins Diagnosed?

A vein evaluation typically begins with a physical examination and discussion of your symptoms and medical history. Your provider may examine your legs while you are standing to identify enlarged veins, swelling, skin changes, or other signs of venous disease.

A lower-extremity venous ultrasound is often used to look beneath the skin and evaluate how blood is moving through the veins. Ultrasound can identify abnormal blood flow, locate venous reflux, and help determine which veins are contributing to the problem.

Understanding what is causing the varicose veins is important because treating only the visible vein may not address the underlying source of the problem.

How Are Varicose Veins Treated?

Treatment depends on the severity of the vein disease, your symptoms, and which veins are affected. Modern vein treatment is often minimally invasive and can frequently be performed in an outpatient setting.

Endovenous Ablation

Endovenous ablation is a minimally invasive treatment used to close an unhealthy vein that is allowing blood to flow backward. Using ultrasound guidance, a small catheter is inserted into the affected vein. Energy is then used to seal the vein closed.

Once the problematic vein is closed, blood naturally redirects through healthier veins. The procedure generally requires only a small access point and typically involves much less recovery than traditional surgical vein removal.

Sclerotherapy

Sclerotherapy is commonly used to treat smaller varicose veins and spider veins. A specialized solution is injected into the affected vein, causing it to close. Over time, the body naturally absorbs the treated vein.

Sclerotherapy can be particularly useful for veins that remain visible after treatment of an underlying source of venous reflux.

Vein Surgery

In certain cases, larger or more complex varicose veins may require a surgical approach. Modern vein procedures are significantly less invasive than traditional vein surgery once was, and the appropriate technique depends on the size, location, and condition of the affected veins.

Your provider can determine whether a minimally invasive procedure or surgical treatment is appropriate based on your ultrasound findings and individual circumstances.

There is no guaranteed way to prevent varicose veins, particularly when genetics and age play a role. However, things like maintaining a healthy weight, exercising regularly, avoiding prolonged periods of sitting or standing when possible, and taking regular walking breaks can support healthy circulation.

Elevating your legs when resting may also help reduce swelling and discomfort. Compression stockings can be useful for managing symptoms in some people, although they do not correct the underlying vein problem.

If you already have varicose veins that are becoming painful, increasingly prominent, or associated with swelling or skin changes, an evaluation can help determine whether treatment is appropriate.

You don't have to wait until varicose veins become severe before having them evaluated. Consider scheduling a vein evaluation if you have persistent leg pain or aching, swelling, heaviness or fatigue in your legs, visible varicose veins that are becoming larger or more numerous, skin changes around the ankles, or symptoms that interfere with your normal activities.

A proper evaluation can determine whether your varicose veins are primarily a cosmetic concern or whether they are being caused by underlying venous reflux that should be treated.

At Thunderbird Vein, we use diagnostic ultrasound to identify the source of venous problems and develop treatment plans based on the individual patient's needs. Depending on the condition of your veins, treatment may include endovenous ablation, sclerotherapy, or vein surgery.

Varicose veins are common, but they don't have to be something you simply learn to live with. With today's minimally invasive treatments, many patients can address both the underlying vein problem and the visible veins that have been bothering them.

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