Vein disease, also known as venous insufficiency, is the most common cardiovascular condition that affects primarily the veins in the legs and pelvis of over 40% of the general population more so in women. It occurs when the veins in general cannot return the blood efficiently back to the heart at any anatomical location of the body. Venous walls become weakened due to structural changes and/or damaged vein valves, preventing blood from flowing efficiently back to the heart. In healthy veins, one-way valves help ensure blood flows upward against gravity. When these valves become compromised, blood can pool in the veins under pressure from gravity while standing, leading to a variety of symptoms.
The most commonly seen issues with veins are the leg varicose vein below the inguinal ligament affecting over 75-80% of all venous patients. Vein disease elsewhere will be discussed separately.
Common Symptoms and signs of Vein Disease in Lower Extremities
The signs and symptoms of the leg venous disease can vary in severity, but there are several common findings to watch out for:
- Bulgy Leg Veins
Bulgy leg veins are perhaps the most recognizable signs and symptoms of vein disease . These swollen, twisted veins are often visible just beneath the surface of the skin. They typically appear on the legs and can range in color from blue to dark purple. Bulging varicose veins may cause discomfort, and their appearance can worsen on standing and prolonged sitting over time if left untreated. They improve on elevation of legs and sitting and resting overnight and by using compression stocking.
- Spider Veins
Spider veins are smaller, finer veins on skin level that appear as red, blue, green or purple webs on the skin’s surface. Though they are usually not as prominent as varicose veins, they are still a sign of underlying vein problems and can cause at times symptoms affecting one’s lifestyle. Spider veins are more common on the thighs, calves, and ankles.
- Swelling (Edema)
Swelling in the legs, ankles, and feet is another common sign or symptom of vein disease. This happens when blood pools in the lower legs due to weak veins. Swelling can be worse at the end of the day, particularly after standing or sitting for long periods. In some cases, the swelling may be accompanied by a feeling of heaviness or fullness in the legs.
- Pain and other forms of Discomfort
People with vein disease often experience aching, cramping, throbbing or a heavy sensation in the legs. The discomfort may worsen after prolonged standing or sitting and may improve with elevation or movement. In some cases, the pain may be intermittent or chronic, and it can affect daily activities.
- Itching or Skin Changes
Itching is commonly missed as a symptom of leg vein disease. The skin over the affected veins may become dry, itchy, or irritated. Over time, untreated vein disease can lead to more serious skin changes, such as discoloration (brown or purple stains) or thickening of the skin. This is caused by blood that leaks out of the veins and builds up in the tissues. In some cases, ulcers or open sores may develop on the skin, particularly around the ankles.
- Leg Fatigue
Chronic fatigue in the legs is a common symptom of vein disease. Individuals may feel like their legs are tired, weak, or like they “drag.” This is due to poor circulation and blood pooling in the veins.
- Restless Leg Syndrome
Restless leg syndrome (RLS) can occur in individuals with vein disease, especially at night. People with RLS experience an irresistible urge to move their legs, often accompanied by a tingling or crawling sensation. This can lead to difficulty sleeping and increased discomfort. Symptoms are due to engorgement of the varicose veins when up during the day due to the back flow to the ankles under gravity.
- Numbness, Tingling or Burning Sensations
Some people with vein disease experience numbness, tingling, burning, or pulsing sensations in their legs and feet similar to what people perceive as neuropathic symptoms. This may occur after prolonged periods of standing or at night when lying down. These sensations are often a sign that the veins are under stress and engorged and unable to function properly.
When to Seek Medical Attention
If you experience any of the above signs and symptoms, it’s important to consult with a healthcare provider. Early diagnosis and treatment can prevent the progression of vein disease and reduce the risk of complications and improve quality of life. A doctor may recommend a variety of treatments, including lifestyle changes, compression stockings, supplements, sclerotherapy (injections to close varicose veins under ultrasound guidance), endovenous catheter-based therapy using heath [laser or radio frequency] or, in more severe cases, iliac vein stenting and very rarely surgical interventions.
