Medically reviewed by Nachiket J. Patel, MD, FACC, FSCAI. Last reviewed July 2026.
Varicose veins are enlarged, twisted surface veins. They often develop because valves inside the leg veins no longer close effectively, allowing blood to fall backward and pool under pressure.
The visible vein is only part of the problem. Chronic venous insufficiency can cause aching, heaviness, swelling, itching, nighttime cramps, skin discoloration, and eventually a venous ulcer.
Treatment should begin with an ultrasound-based map of the venous system when symptoms or skin changes are significant. Closing the wrong vein—or treating appearance without understanding reflux—can lead to disappointing results.
What symptoms suggest venous insufficiency?
Venous symptoms often worsen later in the day and improve with walking, elevation, or overnight rest. Arterial disease, neuropathy, arthritis, and lymphedema can cause overlapping symptoms.
- Aching, heaviness, or throbbing after standing
- Ankle or lower-leg swelling
- Itching or burning over a vein
- Nighttime cramps or restless legs
- Brown discoloration near the ankle
- Inflamed, firm, or tender surface veins
- A wound near the inner ankle that heals slowly
When should a vein problem be evaluated urgently?
Sudden one-sided swelling may indicate DVT. A red, hard, painful surface vein may be superficial thrombophlebitis and should be assessed, particularly if symptoms extend toward the groin.
Call 911 for sudden shortness of breath, chest pain, coughing blood, or fainting. Significant bleeding from a varicose vein also needs prompt pressure and medical attention.
How is venous reflux diagnosed?
A venous reflux ultrasound examines the deep and superficial veins, checks for clot, and measures whether blood reverses direction when the valves should close.
The test should connect abnormal segments with the visible veins and symptoms. Pelvic outflow obstruction may need consideration when swelling is marked, one-sided, or persistent despite treatment of superficial reflux.
What conservative treatments help?
Walking activates the calf-muscle pump and helps return blood toward the heart. Elevation, weight management when appropriate, skin care, and avoiding long periods of still standing or sitting can reduce pressure.
Graduated compression helps many patients, but proper size and pressure matter. Arterial circulation should be considered before strong compression is used in someone with weak pulses, ischemic symptoms, or a foot wound.
What procedures treat venous insufficiency?
Endovenous ablation closes a refluxing superficial vein using heat, adhesive, or another technique. Blood then returns through healthier veins. Ambulatory phlebectomy or sclerotherapy may address selected visible branches.
A venous stent treats a different problem: a narrowed or obstructed deep pelvic vein. It is not a treatment for every varicose vein.
Dr. Patel reviews the ultrasound, symptoms, skin findings, and treatment goals before recommending a procedure. Cosmetic expectations, medical benefit, insurance requirements, and recurrence risk should be discussed clearly.
Frequently asked questions
Will closing a vein harm circulation?
When the targeted superficial vein is refluxing and the deep system is adequate, blood is redirected through healthier pathways.
Do varicose veins always return?
Treated veins may remain closed, but venous disease can progress and new branches can appear. Follow-up and healthy calf-muscle activity remain useful.
Is treatment only cosmetic?
No. Appearance may be a concern, but pain, swelling, inflammation, skin damage, and ulcers are medical reasons for evaluation.
Related heart and vascular information
- Leg Swelling (Edema)
- Vascular Ultrasound Testing (Arterial, Venous, Carotid)
- Venous Ablation & Stenting
Schedule an appointment
If you have a stable heart or circulation concern, request an appointment with Flow Heart & Vascular in Mesa, Arizona. Call 911 for emergency symptoms.
This page provides general education and does not replace individualized medical advice.
