Veins are blood vessels that bring blood from the organs and limbs back to the heart. There are two sets of veins in the legs. The important veins are called deep veins and carry nearly all the blood, while the others are called superficial veins, so named because they are closer to the skin. Superficial veins carry only a minimal amount blood but cause nearly all the problems associated with varicose veins. Because of gravity, veins in the legs literally have a difficult uphill battle returning the blood to the heart.

The leg veins work by squeezing blood upwards when contracted, while valves in the vein keep the blood from flowing backwards, or refluxing, back down to the feet. However, sometimes these valves weaken and don’t close properly, thus allowing blood to reflux. This occurs for many reasons, and the valves in the superficial veins are especially prone to this failure. When blood refluxes back down, it fills in and pools into veins near the skin which become elongated, rope-like, bulged, and thickened. These enlarged, swollen vessels are known as varicose veins and are a direct result of increased pressure.

How common are varicose veins?
Chronic venous insufficiency of the legs is one of the most common conditions affecting people of all backgrounds. Approximately half of the U.S. population has venous disease: 50 to 55% of women and 40 to 45% of men. Of these, up to 25% of women and 15% of men will have visible varicose veins. Varicose veins affect 1 out of 2 people age 50 and over and up to 25% of all adults.

What are the symptoms associated with varicose veins?
Symptoms may include sharp or dull pain in the legs, leg heaviness, restlessness in the legs, skin color changes/darkening of skin (especially around the ankles), leg/ankle swelling, bulging veins, small “spider veins” (sometimes blue in color), “charley horses” (or severe cramping), hardening of the skin, easy bruising, and in severe cases, chronic wounds or ulcers on the legs. Some people may experience symptoms without visible varicose veins.

What are the risk factors for varicose veins?
Risk factors include older age, female gender, prior pregnancy, family history, prior trauma or surgery to leg, and occupation or lifestyle that involves standing for long periods of time.

Does restless leg syndrome have anything to do with varicose veins?
Recent research suggests varicose veins and the disease that causes them, chronic venous insufficiency (CVI), as a possible underlying cause. Many of our patients who have symptomatic varicose veins also have “restless legs”, especially at night. This makes sense as varicose veins cause circulation issues and lack of oxygen can cause strange sensations in the legs. Varicose veins, like restless leg syndrome, also have a genetic/hereditary component.

A simple ultrasound can either confirm or rule out CVI. If you do have CVI, treatment will often result in a significant improvement in restless leg syndrome.