Varicose veins - what to ask your doctor
What to ask your doctor about varicose veins; Venous insufficiency - what to ask your doctor; Vein stripping - what to ask your doctor
Varicose veins are abnormally swollen, twisted, or painful veins that are filled with blood. They most often occur in the lower legs.
Below are some questions you may want to ask your health care provider to help you take care of your varicose veins.
Questions
What are varicose veins?
- What causes them? What makes them worse?
- Do they always cause symptoms?
- What sort of tests do I need if I have varicose veins?
Do I need to treat my varicose veins? If I do not treat them, how quickly will they get worse? Are there serious complications or problems if I do not treat them?
Are there medicines that can treat my varicose veins?
What are compression (or pressure) stockings?
- Where can I buy them?
- Are there different types?
- Which ones would be best for me?
- Will they get rid of my varicose veins, or will I always need to wear them?
Which procedures for varicose veins do you perform?
- Sclerotherapy?
- Heat ablation or laser ablation?
- Vein stripping?
Questions to ask about different procedures for varicose veins are:
- How does this treatment work? When would it be a good choice for treating my varicose veins?
- Where is this procedure done? Will I have any scars? What are the risks?
- Will my varicose veins come back after this procedure? Will I still get new varicose veins on my legs? How soon?
- Does this procedure work as well as other treatments for varicose veins?
From the outside, your veins look like nothing more than a few faint blue lines under your skin. But inside your body, they work hard to transport blood from your organs to your heart. Sometimes, blood can get stuck in your veins and make them swell up so they really stick out. These swollen veins are called varicose veins. And if you have them, you may be putting a lot of effort into covering them up. Veins have valves in them that prevent blood from flowing the wrong way. They're kind of like the valves in your bathroom plumbing that prevent hot water in the water heater from backing up into the cold water supply. The valves inside your veins make sure that your blood keeps flowing in the right direction, toward your heart. But if those valves aren't working correctly, blood can back up and get stuck inside a vein. As the blood collects, the vein swells. So, what causes the valves in the veins to malfunction? Well, you may have been born with defective valves. Or, you might be putting on extra pressure on the veins in your legs if you stand for long periods of time, or you're pregnant. When you have varicose veins, you, and your doctor, should be able to tell just by looking at them. They look like raised, thick blue or purple veins. Varicose veins can also make your legs ache and your ankles swell. So, how are varicose veins treated? Well, first, your doctor will recommend rest and support for your varicose veins. Avoid standing for long periods of time, and prop up your feet on a pillow or box whenever you sit. Wearing elastic support hose can also help. If you're in a lot of pain from your varicose veins, or their appearance really bothers you, your doctor may recommend a treatment such as lasers to minimize the veins. Or, you may have a type of surgery called vein stripping. During this procedure, the surgeon threads a thin, plastic wire into each varicose vein and then pulls the vein out. At first, varicose veins are more of a cosmetic problem than a health issue. But over time, they can get worse. Some people develop sores, inflammation from phlebitis, clots, or their varicose vein breaks. Talk to your doctor if you have varicose veins, especially if they hurt or they don't improve from wearing support hose or staying off your feet. Call your doctor right away if you have intense pain, swelling, fever, or a sore on your leg.
References
Goldman MP, Weiss RA. Phlebology and treatment of leg veins. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 155.
Iafrati MD. Varicose veins: surgical treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 154.
Sadek M, Kabnick LS. Varicose veins: endovenous ablation and sclerotherapy. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 155.
Version Info
Last reviewed on: 7/25/2022
Reviewed by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
