Varicose veins and heavy legs: chronic venous insufficiency
Valves that no longer close, and blood that flows backwards
Dr. Camille Roux
Internal medicine physician
In simple terms
Why leg veins bulge, which symptoms matter, and what really helps from stockings to modern procedures.
What it is, in plain words
Leg veins carry blood upwards against gravity, helped by one-way valves and by the calf muscles squeezing at every step. When valves become leaky, blood flows back down and pools. Pressure builds in the superficial veins, which stretch, twist and become visible as varicose veins. Over years that pressure damages the skin at the ankle.
Signs to look out for
- Heavy, aching legs that are worse at the end of the day and in hot weather
- Visible bulging blue veins, and finer spider veins
- Ankle swelling, night cramps, restless legs and itching
- Brown pigmentation and hardened skin above the ankle in long-standing disease
- Venous leg ulcer, usually on the inner ankle, in the most advanced stage
Why it happens
Risk rises with family history, age, standing occupations, pregnancy, obesity, and a previous deep vein thrombosis that scarred the deep veins.
How doctors confirm it
A duplex ultrasound scan maps which veins are refluxing and checks that the deep system is open. That map decides whether treatment is possible and which technique suits you.
Treatments and solutions
- Graduated compression stockings worn all day, the foundation of treatment and enough for many people
- Walking daily, elevating the legs, losing excess weight and avoiding long motionless standing
- Endovenous laser or radiofrequency ablation, now the first-line procedure, done under local anaesthetic with a quick return to activity
- Ultrasound-guided foam sclerotherapy for smaller or recurrent veins
- Surgical stripping in selected anatomies, and specialised compression plus wound care for venous ulcers
Living with it day to day
Keep the calf pump working: walk thirty minutes a day, do ankle circles when seated, finish showers with cool water on the legs, and put your feet up above hip level for a quarter of an hour in the evening.
When to seek medical help
See a doctor urgently for a sudden hot painful swollen calf, for bleeding from a varicose vein, or for a skin break that will not heal.
This article explains general health information in simple language. It does not replace advice from your own doctor.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Varicose veins and heavy legs: chronic venous insufficiency?
- Why leg veins bulge, which symptoms matter, and what really helps from stockings to modern procedures.
- What are the main symptoms or signs of Varicose veins and heavy legs: chronic venous insufficiency?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Varicose veins and heavy legs: chronic venous insufficiency?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
Related health topics
Neurology
Restless legs syndrome: no longer enduring your nights
Iron, dopamine agonists, gabapentin: relieving RLS.
Conditions
Deep vein thrombosis: a clot in the leg
How a DVT forms, who is at risk, how it is confirmed and treated, and how to avoid it after surgery or long trips.
Conditions
Peripheral artery disease: leg pain when you walk
Why calf pain appears after a fixed distance, how it is measured, and why walking is the best medicine.
Conditions
Raynaud's phenomenon: fingers that turn white in the cold
Primary versus secondary Raynaud's, the colour sequence, and how to prevent attacks.