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Don’t mistake leg pain for fatigue or muscle soreness after physical exertion. The unpleasant sensations are often caused by invisible problems that have nothing to do with the muscles. If you feel heaviness, tingling, itching, or numbness in your legs without any apparent reason, varicose veins might be among the likely culprits.
The process is slow, and the appearance of visible traces such as bumps and bluish spots on the skin is a sign of an advanced stage, which may even be irreversible. This is why it is crucial to recognize the main symptoms and not ignore them.
Varicose veins, also known as “varicose,” are medically diagnosed as “varicosis” or “varices.” This condition should not be underestimated, as it is part of chronic venous disease (CVD), which encompasses all types of venous damage. Varicose veins are considered the initial stage of the disease, which inevitably leads to venous insufficiency and increases the risk of inflammation and blood clots (thrombosis) in the blood vessels.
Before reaching this stage, however, your body will send you numerous signals that something is wrong with circulation and that your veins need attention. The problem is that the initial symptoms are misleading – they don’t seem to be related to the veins at first glance, and people often attribute them to general discomfort and physical fatigue.
PAIN AND HEAVINESS
You’ve likely complained about these symptoms, especially if you've spent several hours standing or wearing high heels. Symptoms may also appear on hot days or after wearing uncomfortable shoes when we instinctively reach down to rub our tired legs. This urge has a physiological explanation – veins struggle to overcome gravity and “ask” for help. The brain receives the signal and “orders” us to massage the area where we feel pain and heaviness, thus stimulating circulation and supporting the veins' function.
As you may know, veins have special valves that push blood upward and then close to prevent it from flowing back down. When these valves do not function properly, blood circulation is disrupted, and over time, clear signs of trouble appear. Healthy veins work efficiently under all conditions, so any discomfort is a clear signal that something is wrong. Symptoms usually worsen at the end of the day, so if you regularly experience pain and heaviness after work, don’t be too quick to blame fatigue.
If the pain persists and returns in the morning, be sure to consult a vascular surgeon or angiologist.
SWELLING AND EDEMA
Many people say, "It's because of the heat!" or attribute it to water retention. However, the real culprit is often the veins and, more specifically, the increased pressure inside them. When blood flow is disrupted, blood accumulates in the veins, causing them to expand and lose elasticity. This weakens the vein walls, making it harder for the valves to function properly, resulting in inefficient upward blood movement. Blood typically pools in the lower limbs, particularly in the lower legs, leading to swelling.
As the condition worsens, blood vessel walls allow fluid to leak into surrounding tissues, causing noticeable swelling. For many, the swelling is subtle and subsides quickly. However, if the condition progresses, the swelling becomes more apparent, affecting the ankle, foot, and even the calf. Symptoms worsen with uncomfortable shoes and high temperatures and can even make walking difficult.
CRAMPS AND PULSATION
These are among the most common and definitive signs of venous problems. Painful muscle cramps may not initially seem related to veins, but in most cases, they result directly from venous dysfunction. According to official data, 67% of patients with varicose veins experience frequent muscle spasms. A study by the World Health Organization states that varicosis increases the risk of cramping.
Once again, the issue lies in the improper functioning of venous valves and blood stagnation in the veins. The problem is that this blood is oxygen-poor and toxin-rich, as it has not yet completed its recirculation process (oxygenation and return to circulation). When the distended and stretched vein walls begin to leak toxins, they inevitably reach the muscles. The accumulation of waste products makes muscles more susceptible to spasms.
SKIN DISORDERS
Unhealthy, poorly functioning veins affect all surrounding tissues, including the skin. Cells deprived of adequate water and oxygen lose their properties, and this eventually becomes visible. Initially, small brownish-gray spots appear, followed by more noticeable pigmentation. In advanced stages of varicosis, the upper skin layer thins, making it prone to injuries. Meanwhile, the underlying tissue thickens, disrupting natural regeneration processes. As a result, patients often experience trophic ulcers, open wounds (ulcerations), and varicose dermatitis (lipodermatosclerosis).
Severe skin conditions are complications of varicose veins, and if you have previously ruled them out, schedule a medical consultation. The issue is recognizable by reddish or brown skin discoloration around the ankle and foot. However, don’t rush to see a dermatologist—consult a vascular specialist!
VISIBLE DEFORMITIES
When veins protrude beneath the skin’s surface and you can not only see them but also feel them, you can be certain that there is a real problem. Varicosis usually affects only part of a vein, but it can also develop along its entire length. Only the sections close to the skin's surface are visible, while deeper ones can only be identified by the symptoms described above.
Varicose veins most commonly form on the legs but can also appear on other body parts (hands, face, neck, etc.). In some areas, entire clusters of varicose veins may develop, posing serious risks of thrombosis and thrombophlebitis. Ignoring the problem increases the risk of severe bleeding (due to a ruptured vein), varicose eczema, skin infections, and chronic venous insufficiency.
RISK FACTORS
Varicose veins develop over decades (typically 40-50 years) and may never become symptomatic. However, some factors accelerate the process and should not be ignored:
- Age: As we age, blood vessels lose elasticity and weaken. Valve function deteriorates, veins become overburdened, and venous hypertension is a common consequence.
- Pregnancy: Increases blood volume but alters circulation. Blood flow from the legs to the pelvis decreases as circulation prioritizes the growing fetus, often leading to varicose veins, typically forming during the first pregnancy and worsening with subsequent ones.
- Gender: Women are more prone to varicose veins due to hormonal fluctuations throughout life (pregnancy, menstruation, ovulation, menopause, etc.), which significantly impact venous health.
- Obesity: Excess weight makes it harder for veins to pump blood to the heart. Moreover, accumulated fat conceals problem veins, delaying diagnosis and treatment.
- Sedentary lifestyle: Lack of movement eliminates muscle contractions that assist venous circulation. If you spend eight hours a day sitting at a desk without movement, varicose veins are only a matter of time.
- Genetics: If your grandparents had varicose veins, your chances of developing them are high. However, proper prevention and lifestyle choices can mitigate serious complications.
PREVENTION
Even though we cannot control genetics, we can take steps to prevent discomfort and severe complications:
- Movement: Even simple activities at home or the office help circulation. Experts recommend at least 15 minutes of movement per hour.
- Healthy weight: Losing even 5-10% of body weight reduces the risk of varicosis and its complications.
- Rest: Elevating your legs reduces venous pressure and relieves heaviness.
- Wardrobe changes: Loose clothing and comfortable shoes improve circulation and reduce swelling.
If symptoms persist or worsen, don’t delay consulting a specialist.
