Varicose Veins are often misunderstood—even by healthcare providers.

Brought on by a condition known as Chronic Venous Insufficiency (CVI), varicose veins can cause aching, tiredness, restless leg syndrome, and other symptoms—whether they are visible or not.

Varicose veins are just the tip of the iceberg.

A common myth is that you don’t have bulging veins, you don’t have vein problems. The truth is, bulging veins are just the tip of the iceberg- a sign that a larger problem is lurking underneath. An ultrasound can reveal veins beneath the surface that can cause symptoms.

When valves weaken, gravity wins.

Veins in your leg carry blood upward to the heart, against gravity. They achieve this feat using one-way valves. Varicose veins occur when these valves weaken and do not close properly, causing blood to pool in the veins.

Common Symptoms of Varicose Veins

Dull, throbbing, aching, or pain in the legs

Especially felt at the end of the day – who doesn’t this describe as you get older? People classically describe this as a background annoying pain, pressure, or cramping/tingling-type feeling that is tolerable during the day/at work when you’re busy as you don’t think about it but is really felt at the end of the day when you get home and relax. It can become quite debilitating.

Leg heaviness

Again progressive throughout the day, but really pronounced if you are stationary, such as a movie or a long flight; patients with a strong condition say it feels like they have “lead” in their shoes or socks.

Tired legs/leg fatigue

Always feeling like your legs are tired and lethargic, which again describes many people.


Progressive swelling as the day goes on, usually at the foot and ankle level, telling as it usually leaves a “sock line.” Swelling can happen for many other reasons, but younger patients and/or patients who have no history of heart disease or other causative factors should get an appointment to see if chronic venous insufficiency can be ruled out.


The superficial veins which cause chronic venous insufficiency help drain the skin of the leg. When this circulation is poor due to incompetent veins, the skins can become very dry and scaly, especially in the shin, calf, and ankle regions. Many patients claim to use up to one bottle of lotion per day to constantly keep their legs from being so dry. Obviously, many dermatologic issues can present in the same way.

Burning sensation over legs/prickly feeling

People have trouble describing this, but relate a heat or burning feeling or feeling of “creepy crawlers” underneath the skin of the leg, oftentimes near a bulging varicose vein.

Restless legs

Traditionally, this has been thought of as a neurological issue; however, many patients with chronic venous insufficiency/varicose veins relate symptoms of restless legs as well – this manifests as a constant need to move or shake your legs, especially at night. People also describe that they “just can’t get their legs comfortable” in any position, so they constantly shift their legs, put a pillow between their legs, or elevate their legs on a pillow.

Charlie horses or leg cramping

Similar to restless legs at night, many people with varicose veins relate waking up in the middle of the nights with severe cramps or Charlie horses, for which they usually jump out of bed and have a ritual to stop the pain and cramping.

Easy bruising

Constantly get bruises over the legs, usually from minimal injuries or bumps, which tend to last a lot longer than other bumps or bruises on the body.

Skin darkening and/or hardening

Usually over the shin and calf region, this starts as darker spots and progresses to a reddish brown skin discoloration, oftentimes accompanied by a hardening of the skin in the same region.

Bleeding varicose vein

Classically, women will relate shaving the leg over a small bulging vein and then see severe bleeding; men will also describe excessive bleeding after a small bump and scrape over a bulging vein; although still only veins, varicose veins that bleed are under pressure and can take significant time and pressure to ultimately stop.

Skin breakdown/ulcer

This is one of the worst complications, usually occurring after decades of poor venous skin circulation from venous insufficiency and usually after many of the previous signs and symptoms. This refers to an open wound or sore in the leg; the varicose vein causing this is almost always underneath the skin and the ulcer. These can be difficult to treat given that wound care and covering it only treats the problem superficially – patients need to have the underlying vein problem treated to actually have this symptom cured.

Who suffers from CVI and varicose veins?

Varicose veins are a common condition that affects people from all backgrounds. It is estimated that up to 40% of the U.S. population has venous insufficiency. Up to 25% of women and 15% of men will have visible varicose veins. However, many people have symptoms without visible varicose veins.

Advanced Treatments

Our Vein Institute physicians treat varicose veins with Radiofrequency Ablation (RFA), Endovenous Laser Ablation Treatment (EVLT), ambulatory microphlebectomy, and ultrasound-guided foam sclerotherapy. These are outpatient procedures that generally require no sedation and little or no interruption to your daily life.

You can contact Rochester Radiology by phone at 585-336-5000 or by e-mail through our secure and confidential contact page.

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