Bulging veins? When to seek help for leg problems

Arteries carry blood throughout the body, but veins are tasked with the more difficult, gravity-fighting job of transporting blood back up to the heart. Venous insufficiency is the main cause of leg vein diseases; meaning the valves in your leg veins aren’t working as efficiently as they should. If you’re experiencing leg vein issues, it’s a good idea to consult your doctor to determine just how serious the situation is and what the most appropriate treatment options are.

When to go for help

Early indications of a leg vein problem can include pain, heaviness, itching and swelling; in more advanced cases, patients may develop thrombophlebitis (inflammation of the vein walls), a rash-like condition called venous stasis dermatitis, venous ulcers or severe bleeding after scratching inflamed areas.

Dr. Jennifer Heller, director of the Vein Center at Greater Baltimore Medical Center, recommends patients seek help as soon as leg vein issues begin to limit your ability to do the things you want to do.

“The longer blood sits, the more likely the vein is to become inflamed or irritated,” Dr. Heller says.

“By the time some patients finally get around to making an appointment, they already have advanced vein disease because they’ve left issues untreated for so long and now they have complications.”

Who’s most at risk

People whose work requires them to spend long stretches of time on their feet — chefs, teachers, police officers and hairdressers, for instance — may find themselves at increased risk of developing leg vein problems. Other risk factors include advancing age, sedentary lifestyle, obesity, genetics, previous trauma to the leg or prior deep vein thrombosis (DVT).

“Women are at higher risk than men, especially if they’ve had multiple children,” Dr. Heller adds. “Hormonal changes, particularly progesterone, tend to exacerbate vein problems.”

Varicose veins vs. spider veins

Some patients confuse varicose veins with spider veins, but the two conditions are not one in the same.

Although often considered unattractive, flat pink or blue spider veins don’t pose any significant health risks. Injection sclerotherapy performed in a doctor’s office is the standard FDA-approved treatment, but because the procedure is considered cosmetic, it isn’t covered by insurance.

Varicose veins, on the other hand, have a visibly raised corkscrew or rope-like appearance. Doctors can perform a noninvasive ultrasound test to find out which veins are affected, and then determine the best treatment. If patients are experiencing minimal symptoms, the doctor may recommend measures such as increased physical activity, weight loss, better blood pressure control or wearing compression stockings.

“If there’s no improvement after that, the veins can be surgically removed during an outpatient procedure that usually takes about 30 minutes,” Dr. Heller says. “Most insurance companies do cover this treatment.”

Thrombophlebitis and DVTs

More serious in nature, thrombophlebitis can lead to DVT — a blood clot in the leg which, if left untreated, can grow, break off and travel to other parts of the body where it can cause a heart attack or stroke.

“Commonly, I’ll see patients in the summer who drive long distances for vacation and develop thrombophlebitis,” Dr. Heller notes. “It’s hot, they get dehydrated, they’re sitting in the car for long periods of time — it’s the perfect storm.”

Patients with a history of blood clots or DVT should be vigilant and seek help immediately at a doctor’s office or emergency room if their leg becomes swollen, painful, red or just doesn't feel right, particularly after traveling.

How to reduce your risks

There isn’t much you can do about your age or your sex, but patients can still take steps to reduce their chances of developing leg vein problems.

“Any exercise that activates the calf muscles helps, especially walking,” says Dr. Heller. “When taking driving trips, try to get out of the car every two hours to walk around and stretch, and wear compression stockings if needed. On airplanes, aisle seats make it easier to get up and down, and there are a lot of great calf muscle exercises you can do from a seated position.”