Varicose Veins

What are
Varicose Veins?

Blood travels away from the heart through arteries and then back to the heart through veins. In the legs most of the blood (85-90%) flows back to the heart through the many deep veins within the muscles and these veins rarely become varicose. Varicose means distended or enlarged.

To facilitate the flow back up to the heart the veins have one-way valves. Varicose veins usually occur in the superficial veins of the legs, are mostly visible and develop when these valves breakdown and become incompetent. Without properly functioning valves, the varicose veins are then unable to send blood back to up the heart. Blood  continues to travel back to the heart through healthy veins with normal functioning valves. See the animation below showing both normal competent valve function and abnormal incompetent vein valve function.

Varicose veins often become congested causing symptoms in the legs such as pain, aching, throbbing, tingling, heaviness, tiredness, burning, itching, rashes, swelling, restless legs and cramping. Most people only have one or two of these symptoms. Varicose veins can also cause skin discolouration, thickening of the skin and ulcers. Varicose veins can bleed and form bloods clots. Even small varicose veins can cause significant symptoms. Treating the abnormal varicose veins will lead to improvement of the symptoms in the majority of patients.  


In the lower half of the body blood has to flow against gravity, up through the legs & the abdomen back to the heart. The calf and thigh muscles act as a pump pushing blood up the many deep veins. The one-way valves prevent blood flowing backwards between muscle contractions.

Varicose veins occur when the valves become incompetent (stop working) and the veins bulge. Some of these varicose veins are visible on the surface of skin but some may not be visible. These varicose veins then become congested. The problem usually starts when one or more of the deeper superficial veins (out side the calf and thigh muscles) listed below become varicose:

  • In the Great Saphenous Vein up the inside of the leg.
  • In the Small Saphenous Vein up the outside of the calf.  
  • In Perforator Veins connecting surface veins to deep veins.

These varicose veins then put pressure on other surface veins in the leg causing them to become congested and varicose. These varicose veins can occur in any part of the leg but more commonly appear on the backs of the calves and the inside of the legs. When these veins stop functioning the deep system within the muscles is easily able to take over this function.

normal valves - - - - incompetent valves

Symptoms of Varicose Veins

Symptoms may be worse in hot weather, after prolonged standing or sitting , during exercise, after exercise or at the end of the day. Veins may appear or get worse during pregnancy. Some of these changes may improve after the pregnancy. Wearing compression stockings often relieves the symptoms of these varicose veins.

The symptoms in your legs may not necessarily be due to varicose veins, therefore it is necessary to consider and exclude other conditions. For example pain may be due to arthritis or sciatica. Swelling of the ankles may be a sign of fluid retention due to heart or kidney problems. An assessment at the Varicose Vein Clinic can generally clarify the cause of your symptoms.

Large varicose veins look like twisted cords that bulge the skin and run along your leg. You may also have fine clusters of veins on your skin that you can see but not feel. These are called spider veins. They tend to appear as fairly small patches on the legs and can be red or blue. They are usually caused by underlying larger varicose veins.  

  • Pain & Aching
  • Throbbing & Tingling
  • Heaviness & Tiredness
  • Burning & Itching
  • Rashes & Skin Thickening
  • Swelling & Cramping
  • Restless Legs
  • Skin Discolouration
  • Ulcers, Bleeding & Clots

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