Painful Varicose Veins? Why Your Veins Are Failing & Medical Next Steps

Varicose veins are more than a cosmetic issue. If you are dealing with aching, swelling, or heavy legs, your body may be signaling a deeper circulation problem. Understanding why varicose veins develop, what they mean for your health, and what medical steps to take can help you protect your veins and avoid complications.

This guide explains what's really happening inside your veins — in clear, practical terms — and what to do next.

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What Are Varicose Veins?

Varicose veins are enlarged, twisted veins that most often appear on the legs and feet. They can look blue, purple, or flesh-colored and may bulge above the surface of the skin.

They happen when the veins in your legs stop working properly.

Your leg veins have one important job:
They push blood back up to your heart against gravity.

To do that, they rely on:

• Small one-way valves inside the veins
• Calf muscles that squeeze blood upward when you walk

When those valves weaken or fail, blood flows backward and pools in the vein. This pooling increases pressure inside the vein, causing it to stretch and twist. Over time, this leads to visible and often painful varicose veins.

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Why Are Your Veins Failing?

The medical term for this problem is chronic venous insufficiency (CVI). It develops gradually and often worsens over time.

Several factors increase your risk:

• Family history of varicose veins
• Pregnancy
• Standing or sitting for long periods
• Obesity
• Aging
• Prior leg injury or blood clots

When the vein valves fail, pressure builds up in the lower legs. That pressure causes:

• Swelling
• Aching or throbbing
• A feeling of heaviness
• Skin irritation
• Veins that become more visible

If left untreated, chronic venous insufficiency can progress beyond visible varicose veins.

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Symptoms of Painful Varicose Veins

Not all varicose veins hurt. But when they do, the symptoms can interfere with daily life.

Common symptoms include:

• Aching or throbbing legs
• Burning or itching over veins
• Swelling in ankles or calves
• Heaviness, especially at the end of the day
• Night cramps
• Restless legs

More advanced symptoms may include:

• Skin discoloration (brown or reddish areas near the ankles)
• Thickened or hardened skin
• Open sores (venous ulcers)
• Bleeding from a vein

These advanced signs suggest the condition has progressed beyond simple varicose veins into chronic venous insufficiency.

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When Varicose Veins Become Serious

While many cases are manageable, varicose veins can sometimes lead to complications:

1. Superficial Thrombophlebitis

A blood clot forms in a surface vein, causing:

• Redness
• Warmth
• Tenderness along the vein

2. Deep Vein Thrombosis (DVT)

A clot forms in a deeper vein. This is more serious and requires immediate medical care.

Seek urgent care if you experience:

• Sudden leg swelling
• Severe pain
• Warmth in one leg
• Shortness of breath

3. Venous Ulcers

Long-term high pressure damages the skin and causes open wounds, usually near the ankle. These wounds can be slow to heal and prone to infection.

If you notice skin breakdown, discoloration, or non-healing sores, speak to a doctor promptly.

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Why Early Treatment Matters

Varicose veins are progressive. They typically do not improve on their own.

Early treatment can:

• Reduce pain
• Prevent worsening symptoms
• Lower the risk of ulcers
• Improve circulation
• Improve quality of life

Ignoring painful varicose veins allows pressure to build, increasing the likelihood of skin damage and chronic swelling.

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First Steps: What You Can Do at Home

If your symptoms are mild, conservative measures may help.

Elevate Your Legs

Raise your legs above heart level for 15–30 minutes several times a day.

Wear Compression Stockings

Medical-grade compression stockings:

• Improve blood flow
• Reduce swelling
• Decrease discomfort

They work by gently squeezing the legs to support vein function.

Move More

Walking activates your calf muscles, which act as a pump for your veins.

Try to:

• Avoid sitting longer than 30–60 minutes
• Flex ankles and stretch calves
• Take regular short walks

Maintain a Healthy Weight

Excess weight increases pressure in leg veins.

These steps can reduce symptoms but do not repair damaged vein valves.

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Medical Treatments for Varicose Veins

If lifestyle changes are not enough, medical treatments are available. Today's treatments are far less invasive than in the past.

1. Sclerotherapy

A solution is injected into small varicose veins, causing them to close and fade.

2. Endovenous Laser or Radiofrequency Ablation

A catheter uses heat to seal off faulty veins. Blood reroutes to healthier veins.

3. Vein Stripping (Less Common Today)

Surgical removal of large damaged veins.

4. Adhesive Closure (Medical Glue)

A special adhesive seals the vein shut.

These treatments are usually done in outpatient settings and allow quick recovery.

A vascular specialist can determine which option is appropriate based on ultrasound imaging of your veins.

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How to Know If You Should See a Doctor

Make an appointment if you have:

• Persistent leg pain
• Swelling that does not improve
• Skin color changes near the ankle
• Bleeding from a vein
• A non-healing wound

Immediate care is necessary if you develop signs of a possible blood clot, such as sudden swelling, chest pain, or shortness of breath.

When in doubt, speak to a doctor. Early evaluation can prevent serious complications.

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Not Sure What's Causing Your Symptoms?

Leg discomfort is common and not always caused by varicose veins alone. If you're experiencing symptoms that might indicate Varicose Veins, Chronic Venous Insufficiency, or Stasis Dermatitis, a free AI-powered symptom checker can help you understand what's happening and whether you should seek medical attention sooner rather than later.

This can help you better understand your symptoms before speaking with a healthcare provider.

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The Bottom Line

Varicose veins are a sign that your leg veins are under stress and not functioning properly. While they may begin as a cosmetic concern, painful varicose veins often signal underlying circulation problems.

Key points to remember:

• Varicose veins result from valve failure and blood pooling
• Symptoms often worsen over time
• Early treatment prevents complications
• Compression and movement help, but do not cure the condition
• Modern medical treatments are effective and minimally invasive

Most importantly, do not ignore worsening symptoms. If you experience increasing pain, swelling, skin changes, or signs of a blood clot, speak to a doctor promptly. Some complications of varicose veins can become serious or even life threatening if left untreated.

Taking action early protects both your comfort and your long-term vein health.

If you are concerned about painful varicose veins, schedule an evaluation with a healthcare professional to discuss your options and determine the safest, most effective next steps for you.