Diagnosis

To diagnose varicose veins, a healthcare professional examines you. This includes looking at your legs while you're standing to check for swelling. You might be asked to describe the pain and aching in your legs.

Tests

To diagnose varicose veins, a healthcare professional might use a test called a venous Doppler ultrasound of the leg. It's a painless test that uses sound waves to look at blood flow through the valves in the veins. A leg ultrasound can help find a blood clot.

Treatment

Treatment for varicose veins may include self-care measures, compression stockings, and surgeries or procedures. Procedures to treat varicose veins are often done as outpatient procedures. That means you most often go home on the same day.

Ask your insurer if varicose vein treatment is a covered cost. If varicose vein treatment is done only to make your legs look better, this is called cosmetic. Your insurance might not cover it.

Self-care

Things you can do to help ease the pain of varicose veins include exercising, raising your legs when sitting or lying down, or wearing compression stockings. Self-care measures also might keep the veins from getting worse.

Compression stockings

Wearing compression stockings all day is often the first approach to try. The stockings squeeze the legs, helping veins and leg muscles move blood. The amount of pressure varies by type and brand.

You can find compression stockings at most pharmacies and medical supply stores. You also can get prescription-strength stockings. Insurance might cover the prescription ones if your varicose veins cause symptoms.

Surgeries or other procedures

If self-care steps and compression stockings don't work, or varicose veins are more severe, a healthcare professional might suggest surgery or other procedures:

  • Sclerotherapy. A healthcare professional injects the varicose veins with a solution or foam that scars and closes them. In a few weeks, treated varicose veins should fade.

    Some veins might need shots more than once. You don't need to be asleep for sclerotherapy. It can be done in a healthcare professional's office.

  • Laser treatment. Laser treatment sends strong bursts of light onto the varicose vein. This makes the vein slowly fade until it can't be seen. No cuts or needles are used.
  • Catheter-based procedures using radiofrequency or laser energy. This procedure is the treatment most used for larger varicose veins. A healthcare professional puts a thin tube called a catheter into an enlarged vein. Radiofrequency or laser energy heats the tip of the catheter. As the catheter is taken out, the heat destroys the vein by causing it to cave in and seal shut.
  • High ligation and vein stripping. This procedure involves first tying off a varicose vein before the place where it joins a deep vein. The next step is removing the varicose vein through small cuts. This is an outpatient procedure for most people.

    Removing the vein won't keep blood from flowing in the leg. That's because veins deeper in the leg take care of the larger amounts of blood.

  • Ambulatory phlebectomy (fluh-BEK-tuh-me). A healthcare professional removes smaller varicose veins through tiny pricks in the skin. Only the parts of the leg that are being pricked are numbed in this outpatient procedure. Most often there's not much scarring.

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Lifestyle and home remedies

Try these lifestyle and home remedies for varicose veins:

  • Get regular exercise. Walking is a great way to help blood flow in the legs. Your healthcare professional can suggest a good activity level for you.
  • Manage weight. Losing excess pounds takes pressure off the veins.
  • Avoid salt. Follow a low-salt diet to prevent swelling caused when the body holds in water.
  • Choose proper footwear. Don't wear high heels. Low-heeled shoes work calf muscles more. This is better for your veins.
  • Don't wear tight clothes. Tight clothes around your waist, legs or groin can reduce blood flow.
  • Raise your legs. To improve blood flow in your legs, take a few short breaks daily to raise the legs above the level of the heart. For instance, lie down with your legs resting on three or four pillows. You also can raise the foot of the bed six inches.
  • Change position often. Don't sit or stand for long periods. Moving helps blood flow.

Preparing for your appointment

Your healthcare professional needs to look at your bare legs and feet to diagnose varicose veins and find the treatment that might be best for your condition.

Your primary health professional might suggest that you see a doctor who specializes in vein conditions, called a phlebologist or vascular surgeon, or a doctor who treats skin conditions, called a dermatologist or dermatology surgeon.

Here are ways to prepare for your appointment.

What you can do

Make a list of:

  • Your symptoms, including any that may not seem linked to varicose veins, and when they began.
  • Important personal information, including a family history of varicose veins or spider veins.
  • All medicines, vitamins or supplements you take, including doses.
  • Questions to ask your healthcare professional.

Some basic questions to ask include:

  • What's the most likely cause of my symptoms?
  • What else could cause my varicose veins?
  • What tests will I need?
  • What treatment do you suggest?
  • How can I best manage varicose veins along with other health conditions I have?
  • Do I need to restrict any activities?
  • Are there any brochures or other printed materials I can have? What websites do you suggest?

What to expect from your doctor

Your health professional is likely to ask you questions, including:

  • When did you notice the varicose veins?
  • Do you have pain? If so, how bad is it?
  • What, if anything, seems to make your symptoms better?
  • Does anything seem to make your symptoms worse?

What you can do in the meantime

Before your appointment, you can begin self-care.

  • Try not to stand or sit in one position for a long time.
  • Raise your legs when you're seated.
  • Don't wear shoes that don't fit well or tight socks or stockings, other than compression stockings.
Feb. 06, 2024

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