Varicose veins usually appear as bulging, bluish cords running just beneath the surface of the skin behind the knees and on the calves and thighs. They occur when vein walls weaken and valves do not close properly. When inflamed, they become tender to the touch and can hinder circulation causing swollen ankles, itchy skin, and aching in the affected limb.
Varicose veins are a relatively common condition, and often run in families. Although they can be painful and unattractive, they are usually harmless. Varicose veins can occur in almost anyone and affect up to 35% of people in the United States. Women are at least twice as likely as men to develop them.
Some patients with varicose veins may experience no symptoms at all. When there is pain, common complaints include aching, cramping, burning, throbbing, tingling, or heaviness in the legs. Symptoms typically worsen throughout the day and are partially relieved by elevation or wearing compression socks or stockings.
Among other things, veins are responsible for bringing blood back to the heart, sometimes working against gravity. When you walk, muscles in your leg squeeze the veins and help blood flow back into the heart. In normal veins, a series of valves assist this process. With varicose veins poorly functioning valves allow the blood to pool in the lower leg and cause symptoms. Any condition that puts excessive pressure on the legs or abdomen can lead to varicose veins. Some common pressure inducers are pregnancy, obesity, and standing for long periods of time. Chronic constipation, and in rare cases, tumors can cause varicose veins.
You will be asked questions about symptoms and medical history, including questions about family members. The vascular surgeon will perform a physical exam that includes gently probing for problem areas on your legs while you are standing. A venous ultrasound is usually given during the same office visit to pinpoint problem veins and determine the best way to treat them.
There are different levels of intervention to treat varicose veins, including sclerotherapy, vein ablation (laser or radio-frequency), stripping and ligation and ambulatory phlebectomy. Knee-high compression stockings will often help relieve symptoms such as aching or swelling. These stockings compress the veins and prevent blood from traveling down pooling in the legs. Your vascular surgeon can discuss the best treatment approach for your individual condition. Current treatments are very successful at alleviating pain and improving appearance and patients are usually very pleased with the results.