Our heart relies upon arteries and veins to transport blood throughout our entire body. Arteries carry oxygen-rich blood from the heart to our extremities. Veins, with the assistance of one-way valves, carry oxygen-depleted blood back up to the heart.
In healthy veins, the one-way valves close tightly to prevent any backflow or leaking of blood back down into the leg. When vein disease is present; however, these unique valves are weak and do not close all the way, allowing for blood to flow back (known as venous reflux) and pool in the legs.
The pooling of blood in the lower extremities causes vein walls to weaken and enlarge, creating a variety of symptoms and potential health complications.
Types of Leg Veins

We have 3 types of leg veins in the leg. Venous disorders can affect any of these veins. More severe cases of the disease occur when venous disorders occur in more than 1 type of leg vein.
Superficial Veins
Superficial veins are visible veins that are within or just below the skin. Superficial veins include spider veins, reticular veins, and varicose veins.
Deep Veins
Deep veins are the main veins located within the leg muscles, pelvis, or abdomen.
Perforator Veins
Perforator veins connect superficial and deep veins.
Symptoms of Vein Disease
Below is a list of common symptoms associated with venous insufficiency:
- Swelling in legs or ankles
- Cramping, aching, throbbing, and itching
- Feeling of heaviness and fatigue in the legs
- Skin discoloration
- Skin changes
- Varicose veins
- Tightness in the calves
- Leg Ulcers (open sores)
Diagnosing Vein Disease

There are several ways to diagnose vein disease:
Ultrasound
Ultrasound is a highly effective and successful way to diagnose nearly all vein problems.
An ultrasound (doppler) study is completely painless, non-invasive, and safe. This type of exam uses sound waves to view and examine the veins in your legs, how the veins are working, including the presence of blood clots.
Venous ultrasounds typically take no more than 20 minutes to complete.
Venogram
In some instances, a venogram is ordered to get a more in-depth look into the venous system. During a venogram, an intravenous (IV) administers a contrast dye that will make the veins look opaque in x-ray images.
A venogram may be helpful to get a closer look at the structure of the veins and to determine the progression of vein disease.
Duplex Sonogram
A duplex sonogram is another tool used to study and evaluate the venous system. Painless, non-invasive, and efficient, the duplex sonogram uses sound waves to analyze the speed and direction of blood flow.
Risk Factors for Vein Disease
Several risk factors increase the chances of developing vein disease:
- Family history
- Hormonal factors and fluctuations
- Age
- Obesity
- Smoking
- Cancer
- Standing or sitting for long periods
- Family history of blot clots
- Injury or trauma to the veins
- Conditions that increase pressure in the abdomen: heart failure, living disease, fluid build-up in the abdomen, prior surgery in the groin
Causes of Vein Disease

Venous insufficiency is most commonly caused by blood clots or varicose veins. It is almost more common in individuals over 50 and in women than in men.
Blood Clots (deep vein thrombosis)
Healthy veins require the smooth, continuous flow of blood from the extremities back to the heart. A blood clot obstructs the forward flow of blood, causing blood to build up below the clot, potentially leading to venous insufficiency.
A deep vein thrombosis happens when a blood clot develops deep in a large vein. Typically, DVTs develop in the leg or pelvis.
Varicose Veins
In healthy veins, the one-way valves in our veins, work to push blood forward toward the heart. In varicose veins, the valves are weakened, damaged, or missing, allowing for blood to flow backward and pool in the lower leg.
How To Treat Chronic Venous Insufficiency
Treatment will depend on several factors, including your overall health and history.
Additional factors that your doctor will take into consideration:
- Age
- The severity of the condition
- The severity of the symptoms
- How you personally tolerate procedures/medication
- Personal preference for treatment
Compression Therapy
The most common prescription and treatment for venous insufficiencies is the use of compression stockings.
Compression stockings are elastics stockings that apply pressure to the lower leg and ankle. They work to gently squeeze the lower limb to help push blood flow upward and reduce swelling.
Your doctor can help guide you through what particular strength and length best suits your needs.
Ways To Improve Blood Flow
There are several ways you can improve blood flow:
- Wear compression stockings
- Elevate your legs above your heart
- Do not cross your legs while seated
- Exercise regularly
Medication That Helps With Vein Disease
There are medications available to help individuals that have diagnosed vein disease:
- Diuretics: work to remove excess fluid from the body
- Blood thinners (anticoagulants): prevent blood clots
- Pentoxifylline (Trental): reduces inflammation and improves blood flow
Treatment Options For Chronic Venous Insufficiency
Surgical options are available to treat several symptoms:
Sclerotherapy
Often used for small to medium-sized varicose veins, sclerotherapy is performed on an out-patient basis. Your doctor will inject a solution directly into the diseased vein, causing it to scar and collapse. As a result, blood flow will be redirected to nearby healthy veins.
Endovenous Laser Ablation or Radiofrequency Ablation (RFA)
RFA and endovenous laser ablation use high-frequency radio waves or laser to create high heat within the diseased vein. Heat is delivered into the vein through a catheter, causing it to shrink and collapse.
Surgery
In more severe cases of vein disease, the following surgical procedures may be advised:
- Stripping (removing) the damaged vein (there are better and less painful options)
- Surgical repair of the vein or valves
- Endoscopic surgery: use of a tiny camera that helps direct the surgeon to tie off a varicose vein
- Vein bypass: transplanting a healthy vein from another part of the body