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Managing and Treating Varicose Veins

Are your varicose veins causing leg pain or swelling? Treatment is available.

Almost 15 percent of people in the United States have varicose veins—enlarged or swollen veins caused by a lack of circulation that bulge through the top layer of the skin, typically in the legs. Although varicose veins rarely indicate a larger underlying condition or serious health risk, they can cause pain and discomfort,

To learn more about diagnosing and treating varicose veins, we spoke with Danielle M. Pineda, MD, FACS, vascular and endovascular surgeon, and S. Yedida Goldman, MD, interventional radiologist at Abington – Jefferson Health.

Q: What is the difference between varicose veins and spider veins?

Dr. Pineda: Spider veins are generally a cosmetic problem where you have dark veins that are usually flat, but can occasionally be slightly raised, and are often related to hormones. That is why we more commonly see spider veins in females, especially during pregnancy, but you can get them at any time.

Varicose veins are actually a symptom of venous insufficiency and are related to problems with the underlying veins in your legs. These are traditionally the big, ropey veins you see in your legs that stick out, and they will more commonly cause symptoms. While both types can be hereditary, varicose veins are almost always related to family history.

Q: Are varicose veins dangerous? What if you let them go untreated?

Dr. Goldman: Varicose veins are usually not dangerous in and of themselves. Even if a varicose vein were to bleed, if you hold gentle and consistent pressure on it, you’ll have the bleed under control.

Chronic varicose veins can cause leg ulcers. While ulcers are not fatal, they could be painful and debilitating, especially when the skin begins to break down to form small craters. If your varicose veins are causing symptoms that make it difficult to get through your daily activities, that would be an appropriate time to seek treatment.

Q: How can someone relieve pain and swelling caused by varicose veins?

Dr. Pineda: The first line of treatment for varicose veins is purchasing compression stockings, which are available at any medical supply store. Compression stockings are tight socks that provide compression from the foot up to the knee. They prevent the veins from swelling, and subsequently, prevent the leg from swelling. They do not treat the swelling long-term, but can provide temporary relief. Surgery is recommended when the compression stockings don’t work, or if you cannot wear them for any reason.

Q: What surgical options exist for varicose veins? What is the recovery process like?

Dr. Goldman: We like to think of surgical options as procedure options because we can treat varicose veins without major surgery—unlike the old-fashioned vein stripping surgical method. One procedure we offer in the office is radiofrequency ablation, which is a catheter procedure where we give you numbing medication, insert a catheter into your vein and close the vein by heating it from the inside.

Additionally, we offer stab phlebectomy, a minor surgery that can be performed either in the office or in the operating room. Here, we make tiny incisions and physically close the vein by removing it with hooks or other surgical instruments. We may also inject fluid to surround and insulate the vein as we heat it up so that no adjacent tissues are harmed in the process. With all of these minimally invasive procedures, recovery may include light bruising post-procedure, but the recovery period is generally very quick.

Learn more about venous disease

Our experts discussed venous disease and available treatment options.

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To watch specific venous disease related topics, see the appropriate time stamp and fast forward to that spot in the video.

2:33 - Varicose & Spider Veins
26:32 - Leg Swelling and Pain
43:30 - Additional Questions

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Experiencing Leg Pain or Swelling? It Could be Venous Disease.

Experiencing Leg Pain or Swelling? It Could be Venous Disease.

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