Can Varicose Veins Cause Leg Pain?

By Michael Lieb, DO, Vascular Surgeon—Virtua Surgical Group 

Varicose veins, appearing on the legs with a purple or blue, ropy look, often are loathed by women as ugly and unattractive. Beyond their unsightly appearance, many people aren’t aware that varicose veins can cause leg pain and other vague symptoms like heaviness and cramping. 

A woman with these symptoms might not think they’re caused by varicose veins. Or, you might assume varicose vein treatment is “cosmetic” and not covered by insurance. But thanks to helpful screening tools, doctors can more easily identify varicose vein symptoms and help patients get appropriate treatment. 

What causes varicose veins?

Leg veins aid in circulation by returning blood to the heart. Each leg vein has a one-way valve that keeps blood flowing upward, toward the heart. When those one-way valves stop working or weaken, the blood flows downward and pools. This causes bluish or dark purple varicose veins to appear on the legs. 

Age is the most common cause of varicose veins. Generally, after experiencing one valve failure below the knee, varicose veins develop in other areas of the calf as well. Some women develop varicose veins during pregnancy, but those usually resolve within a year after delivery. 

Are varicose veins the same as spider veins?

Spider veins are similar to varicose veins. However, they’re smaller and closer to the skin’s surface and usually don’t cause discomfort. Although spider veins appear on the legs, they also can show up on other areas of your body. 

What are the symptoms of varicose veins?

Typically, varicose veins look worse than they feel. Some people can see the enlarged, blue or purple veins, but don’t have any other symptoms. However, varicose veins are associated with leg pain and other symptoms, including: 

• A feeling of heaviness
• Aching
• Burning
• Throbbing
• Muscle cramps
• Swelling
• Itching
• Restlessness
• Tiredness, especially after standing or sitting for long periods of time
• Skin discoloration 

Often, patients don’t attribute the symptoms to varicose veins, or they link them to aging or lack of fitness. If you’re experiencing symptoms related to varicose veins, treatment may be covered by your health insurance.

How are varicose veins diagnosed?

To diagnose varicose veins, your physician examines your legs for signs of swelling. The doctor will ask you to describe any pain or discomfort you’re feeling. In addition, your doctor may conduct a non-invasive, painless ultrasound exam to check for blood clots and to determine if the valves in your veins are functioning properly.

How are varicose veins treated?

When the valves in your leg veins stop functioning, they can’t be repaired. Therefore, varicose vein treatment involves closing the vein so it no longer carries blood. After these veins are closed, blood flows through other veins in the legs. 

You can temporarily relieve pain from varicose veins with treatments such as elevation and compression stockings, as well as with weight loss and avoiding long periods of standing or sitting. But, these don’t resolve the problem. 

Minimally invasive treatment options that alleviate varicose veins and their symptoms include:

• Radiofrequency ablation (RFA): This minimally invasive procedure uses radiofrequency energy to collapse and close off varicose veins.
• Laser ablation: Laser ablation is similar to RFA except it uses laser energy instead of radiofrequency energy.
• Sclerotherapy: This involves injecting malfunctioning veins with a solution that causes them to scar and close. 

Your doctor will recommend the procedure most suitable for you.  

Is varicose vein treatment safe?

Varicose vein treatments generally are safe and effective. Although vascular surgeons perform most vein procedures as outpatient surgery, some are done in the doctor’s office. Usually, patients return home the same day and return to work the following day. 

Patients need to wear thigh-high compression stockings during the day for two weeks after treatment. Most experience minimal discomfort and require little or no pain relief after treatment. Although many people typically return to normal activities immediately after varicose vein treatment, surgeons suggest avoiding strenuous activities such as long runs or heavy lifting until the doctor approves. 

How effective are varicose vein treatments?

Varicose vein treatments are 90-95 percent successful, and patients notice results within two weeks of treatment. Although some patients may experience a recurrence of varicose veins after 5 years or more, most don’t require additional treatment. 

To discuss varicose vein treatment with a Virtua vascular surgeon,
call 1-888-VIRTUA-3.  

Updated December 19, 2018