Varicose Veins: Swollen, Twisted Leg Veins, Causes and When to Be Seen

What it involves

MedlinePlus defines varicose veins as swollen, twisted, or enlarged veins you can see under the skin, often red or blue, most often in the legs. They develop when the one-way valves that keep blood moving toward the heart weaken, letting blood back up and pool.

Who this is for

• Patients with visible, bulging, or twisted veins in the legs
• Patients whose legs ache or feel heavy after a day of standing or sitting
• Patients with new swelling in the feet or ankles and skin changes on the lower legs
• Patients with a family history of varicose veins who want to know what to watch for

What to expect

• Questions about when the veins appeared, what the legs feel like at the end of the day, and any past blood clots
• An exam of both legs for swelling, color change, and sores
• A review of weight, activity, and how long you stand or sit at work
• A plan that may include self-care steps, compression stockings, tests of blood flow, or a referral to a vein specialist

Who tends to get them

MedlinePlus says varicose veins are common and affect more women than men. Risk goes up with older age, hormone changes from puberty, pregnancy, and menopause, birth control pills or hormone replacement, obesity, a history of blood clots in the legs, long periods of standing or sitting, a family history, and being born with defective vein valves. For most people they do not cause problems.

What you might notice

MedlinePlus lists symptoms that start mild and can progress:

• Fullness, heaviness, aching, and sometimes pain in the legs
• Visible, swollen veins, and tiny spider veins on the skin surface
• Thigh or calf cramps, often at night, and mild swelling of the feet or ankles
• Itching near the veins, and restless leg symptoms
• With poor blood flow, skin color changes, dry scaly skin, and sores that do not heal easily

What to do for yourself

MedlinePlus recommends compression stockings to reduce swelling, avoiding long periods of sitting or standing, raising the legs above the heart 3 or 4 times a day for 15 minutes, losing weight if needed, and getting more exercise such as walking or swimming. It also advises moisturizing dry, cracked skin, though some skin products can make the problem worse, so ask first. The leg swelling guide explains other causes of puffy legs to rule out.

Blood flow and clots

MedlinePlus notes that when flow through the veins becomes poor enough, problems such as leg swelling and pain, blood clots, and skin changes can appear. A provider may check blood flow in the veins and look for other leg problems, including a clot. A swollen, painful, warm calf on one side needs to be looked at promptly. The shortness of breath guide and the chest pain guide explain when symptoms elsewhere make it an emergency.

Looking after open sores

Skin sores near varicose veins heal slowly. MedlinePlus advises caring for any open sores or infections and says a provider can show you how. A sore on the lower leg that turns red, hot, and painful can be an infection, which the cellulitis guide describes. For patients with diabetes, any leg or foot sore deserves extra attention, as the wound care page explains.

When a procedure comes up

MedlinePlus says that if varicose veins are painful or you do not like how they look, a doctor may recommend procedures to remove or close them. Those treatments are done by vein specialists rather than in primary care, so a provider here would refer you after examining your legs and talking through your options.

Sources

• MedlinePlus — Varicose veins
• MedlinePlus — Varicose Veins health topic