Varicose Veins Treatment: 7 Signs You Shouldn't Ignore

What Are Varicose Veins?

Veins carry blood back to the heart. In the legs, this means pushing blood upward against gravity, and small one-way valves inside the veins prevent it from flowing back down. When these valves weaken or fail, blood pools in the vein, which stretches, bulges and becomes visible under the skin. This is called venous insufficiency.

Varicose veins are typically blue or purple, rope-like and raised. Spider veins are a smaller, flatter and more superficial version, often red or purple and web-like. Spider veins are usually harmless, but they can occur together with deeper vein problems.

Why They Develop

• Prolonged standing or sitting: traffic police, teachers, nurses, shopkeepers, surgeons and office workers all spend long hours with legs hanging down, which raises pressure in the leg veins.
• Family history: if your parents had varicose veins, you are more likely to develop them.
• Pregnancy: hormonal changes and the pressure of the growing uterus on pelvic veins increase the risk, and veins may improve after delivery or worsen with each pregnancy.
• Age: valves weaken with time.
• Obesity: extra weight raises pressure in the leg veins.
• Previous leg injury or clot: damage to veins can leave them leaky.
• Gender: women are affected more often than men, partly due to hormones.
• Lack of movement: the calf muscles act as a pump, and they push less blood when you are inactive.

Symptoms

Symptoms vary and do not always match how bad the veins look. Many people experience:

• Visible bulging, twisted veins on the calves, thighs or the back of the knee.
• A heavy, aching or tired feeling in the legs, worse at the end of the day.
• Swelling around the ankles that improves overnight.
• Burning, throbbing, tingling or itching over the veins.
• Night-time leg cramps and restless legs.
• Skin discoloration, dryness or thickening around the ankles.
• Slow-healing sores, or ulcers, near the ankle in advanced disease.

Complications You Should Not Ignore

• Superficial thrombophlebitis: a vein becomes red, hard and painful because of a small clot.
• Bleeding: a vein close to the skin can burst after minor injury and bleed heavily.
• Venous eczema: itchy, scaly, inflamed skin around the lower leg.
• Lipodermatosclerosis: the skin becomes hard and tight and may darken.
• Venous ulcers: painful open wounds near the ankle that are slow to heal and can become infected.
• Deep vein thrombosis (DVT): a clot in a deep vein causes sudden swelling, pain and warmth in one leg. This is an emergency.

How Varicose Veins Are Diagnosed

The doctor will examine your legs while you stand, ask about your work, family history and symptoms, and look for swelling, skin changes and ulcers. The key test is a venous Doppler ultrasound. It is painless and shows the direction of blood flow, identifies which valves have failed, maps the veins to be treated and checks that the deep veins are healthy. This map allows the doctor to choose the best procedure rather than treating only what is visible.

Treatment Options

Treatment depends on symptoms, the size and location of the veins, the results of the Doppler scan and your general health. Most patients start with conservative measures.

Lifestyle measures and compression stockings. Graduated compression stockings squeeze the legs, with more pressure at the ankle, helping blood move upward. They relieve symptoms and slow progression but do not cure the veins. They are most useful during pregnancy, while waiting for treatment, or when procedures are not suitable.

Endovenous laser ablation (EVLA). A thin fibre is inserted into the faulty vein under ultrasound guidance and local anaesthesia. Laser energy heats and seals the vein from the inside. Blood is then rerouted through healthy veins. It is done as a day procedure, and most patients walk the same day.

Radiofrequency ablation (RFA). Similar to laser, but uses radiofrequency energy to close the vein. Many patients report less bruising and discomfort.

Sclerotherapy. A medicine is injected into smaller varicose veins or spider veins, causing them to collapse and fade. Foam sclerotherapy can also treat larger veins in selected patients.

Cyanoacrylate or glue closure. A medical adhesive seals the vein without heat, so it needs fewer or no local anaesthetic injections, and compression stockings may not be required afterward.

Ambulatory phlebectomy. Small bulging veins are removed through tiny punctures under local anaesthesia.

Vein stripping and ligation. Once the standard operation, it is now used less often because less invasive options have faster recovery, but it remains useful in selected cases.

Treatment of ulcers. Venous ulcers need wound care, compression therapy and treatment of the underlying vein disease to prevent recurrence.

Recovery After Treatment

Recovery after endovenous procedures is quick. A typical plan includes:

1. 1Walk for 20 to 30 minutes on the day of the procedure.
2. 2Wear compression stockings for the period your doctor recommends, often one to two weeks, and sometimes longer.
3. 3Avoid heavy lifting, long standing and strenuous exercise for about a week.
4. 4Expect mild bruising, tightness or a pulling sensation along the treated vein, which usually settles within a few weeks.
5. 5Attend a follow-up ultrasound to confirm that the vein has closed.

Most patients return to desk work within one to two days. Because the underlying tendency can persist, new veins may develop later, and some people need further treatment years afterward.

Preventing Varicose Veins and Slowing Progression

• Move regularly. If you sit, stand up and walk every 30 to 60 minutes. If you stand, shift your weight, rise onto your toes and walk when you can.
• Elevate your legs above heart level for 15 to 20 minutes after a long day.
• Maintain a healthy weight.
• Exercise regularly. Walking, cycling and swimming strengthen the calf muscle pump.
• Avoid tight clothing around the waist, groin and thighs.
• Wear compression stockings if your job requires long hours on your feet.
• Eat a high-fibre diet to prevent constipation and reduce straining, and stay hydrated.
• Avoid prolonged hot baths and saunas, which dilate veins.
• Choose comfortable footwear and avoid very high heels for long periods.

Varicose Veins in Pregnancy and in Men

During pregnancy, higher hormone levels relax vein walls while the growing uterus presses on the veins of the pelvis, so varicose veins and vulval varicosities are common. They often improve within a few months of delivery. Compression stockings, elevating the legs and regular walking are the mainstays, and invasive treatment is usually postponed until after pregnancy and breastfeeding. Any sudden one-sided leg swelling in pregnancy must be checked urgently for a clot.

In men, varicose veins are often overlooked because they are assumed to be a women's problem. Men who stand for long hours, lift heavy loads or have a family history are equally at risk, and they frequently present late with skin changes or ulcers. Early assessment gives men the same simple treatment options.

Myths About Varicose Veins

• Crossing your legs causes them. It does not, although it can worsen discomfort. The underlying problem is valve failure.
• Massage cures them. Vigorous massage over a varicose vein can be harmful and does not repair the valve.
• Treatment is only cosmetic. Many patients treat their veins to relieve pain, swelling and to prevent ulcers.
• Exercise makes them worse. Moderate exercise helps the calf pump. Only very heavy straining may aggravate them.
• Creams and herbal products remove them. Topical products may soothe, but they cannot close a diseased vein.

Care at Trustmed Hospital

At Trustmed Hospital in Badshahpur, Gurugram, our surgery department assesses varicose veins with a clinical examination and Doppler ultrasound. We explain the options in plain language and select the least invasive method that suits your veins. Day-care procedures are performed in our operation theatres, and our team will support you through recovery. Book an appointment for an assessment.

Frequently Asked Questions