Varicose veins in the lower limbs: what they are, symptoms, causes and treatment

Varicose veins in the lower limbs are common in men and women, especially from adulthood, and this condition can affect quality of life. 
Although they are often viewed as an aesthetic problem, varicose veins can cause uncomfortable symptoms and require medical supervision, which is why it’s essential to know the warning signs.

What are varicose veins in the lower limbs?

Varicose veins in the lower limbs are dilated and tortuous veins that occur when the venous system fails to function effectively. 

Veins in the legs have valves that help blood circulate against gravity, towards the heart. When these valves become impaired, blood tends to pool in the veins, thereby increasing pressure in them and causing them to bulge.

This process is often associated with chronic venous insufficiency (CVI), a condition caused by impaired venous return and which can worsen over time.

What are the symptoms of varicose veins in the lower limbs?

The symptoms can vary from person to person and are not always related to the size or visibility of the varicose veins. We list below some of the most frequent symptoms:

1.    Leg fatigue and heaviness

This is one of the most common symptoms, especially at the end of the day or after spending long periods standing or sitting.

2.    Pain and discomfort

Pain and discomfort can be localised, or cause a burning sensation or pressure along the affected veins, which can worsen with heat.

3.    Swelling (oedema)

It is common for ankles and legs to swell, especially at the end of the day, resulting from impaired venous return (the circulation that returns blood back to the heart).

4.    Skin changes

In advanced stages, varicose veins can cause brown blemishes, dry or hardened skin and, in severe cases, venous ulcers.

5.    Visible and dilated veins 

Varicose veins can have a blue or purple appearance, looking swollen and rope-like, visible just under the skin’s surface.

How are varicose veins in the lower limbs diagnosed?

Diagnosing varicose veins in the lower limbs is based on a clinical assessment and medical exams.

•    Physical examination and medical assessment: the physician analyses the patient’s symptoms, medical history and examines the legs in different positions.
•    Venous Doppler ultrasound: this exam is essential to assess blood flow, the condition of the valves and identify the extent of venous insufficiency.

How are varicose veins in the lower limbs treated?

The treatment for varicose veins in the lower limbs depends on the severity of the condition, the symptoms and impact on quality of life. We list below some of the therapeutic approaches.

Conservative measures

These measures include the use of compression socks/stockings, leg elevation, regular exercise and  weight loss (when indicated).

Pharmacological treatment

Pharmacological treatment can be used to relieve symptoms such as pain, swelling and feeling of heaviness, especially in the early stages.

Sclerotherapy

Sclerotherapy is a highly effective procedure performed by a vascular surgeon, which involves injecting a solution into the affected veins, causing them to collapse. 

There are four types of sclerotherapy:
•    Conventional sclerotherapy: this is the most common technique, involving the use of a very fine needle to inject a sclerosing liquid directly into the vein; this procedure is usually painless.
•    Foam sclerotherapy: applies a solution of air and liquid to treat large veins, indicated for cases of recurrence or when surgery is not an option.
•    Laser sclerotherapy: uses heat to eliminate the veins, without needles, applying a jet of cold air (cryotherapy) for the patient’s comfort; this is ideal for spider veins.
•    Combined sclerotherapy (CLaCS): Cryo-Laser & Cryo-Sclerotherapy combines laser and the injection of a solution in the same session, providing faster and effective results in specific cases.

Laser therapy

Non-invasive techniques like laser therapy (a solution for eliminating spider veins and superficial vessels without needles), allow varicose veins to be treated effectively and with a quick recovery. 
We note the successful outcomes to treat reticular varicose veins and telangiectasias, commonly known as “spider veins”.

Treating larger varicose veins

This therapeutic approach is reserved for specific cases and involves ablation/correction of the affected veins by using an endovenous laser technique. This is an outpatient procedure performed under local anaesthetic, with or without sedation. Patients are discharged after a few hours and can go straight back to work, if they wish.

Precautions to take with varicose veins in the lower limbs?

Adopting some everyday precautions is essential to relieve the symptoms of varicose veins in the lower limbs, improve blood circulation and prevent progression of the condition.

1.    Avoid staying in the same position for long periods 

Spending too much time standing or sitting makes it difficult for blood in the legs to return to the heart, causing venous accumulation. Whenever possible, you should change position throughout the day, taking short breaks to walk or perform simple movements with your feet and ankles to help activate circulation.

2.    Regular exercise

Exercising regularly plays a key role in venous health, as muscle contractions in the legs act as a pump to propel the blood. Walking, swimming or cycling are examples of recommended exercises, which should be practiced regularly and adapted to each person’s fitness level.

3.    Wear compression socks/stockings (when recommended)

Compression socks help narrow the veins’ diameter and improve blood flow, reducing swelling and the feeling of leg heaviness. The use of these stockings should be advised by a healthcare professional, to indicated the right compression for each case.

4.    Maintain regular medical follow-up

Regular medical follow-up is essential to assess the progression of varicose veins and adjust treatment when necessary. This supervision ensures complications are detected early and guarantees personalised care, helping control symptoms more closely and protect venous health.

How to prevent varicose veins in the lower limbs?

Although there is no sure way to prevent varicose veins in the lower limbs, some habits help reduce the risk of developing this condition. 
•    Adopt an active lifestyle: regular exercise is essential for venous health;
•    Control weight: maintaining a healthy weight reduces pressure on the legs’ veins;
•    Elevate legs whenever possible: this simple measure helps blood return to the heart.

Take care of your wellbeing with Joaquim Chaves Saúde

With the right care, varicose veins in the lower limbs can be treated and controlled effectively, helping improve the quality of life of those who suffer from this condition. 

Joaquim Chaves Saúde features specialised teams and advanced diagnostic measures to guarantee comprehensive medical care, from the initial assessment to the right treatment. Schedule your consultation and protect your legs.