What Causes Varicose Veins?
Your veins contain small valves that help keep blood moving in the right direction. When those valves become stretched or weakened and no longer close properly, blood can flow backward and pool in the legs. Over time, that added pressure can cause veins to enlarge, become more visible and lead to symptoms such as swelling, aching or heaviness.
Below, we’ll cover the most common risk factors, signs it’s time to have your veins evaluated and when treatment may qualify as medically necessary.
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How North Memorial Health Heart & Vascular supports vein symptoms
Vein disease is part of cardiovascular care. At North Memorial Health, vein conditions are evaluated and treated by board-certified cardiologists working alongside physician assistants who specialize in vein disease.
At your initial appointment, a heart and vascular specialist will review your symptoms, examine your veins and determine what’s causing them, typically with an ultrasound of your leg veins.
Treatment recommendations are tailored to each person and guided by ultrasound findings, vein anatomy, medical history, symptoms and treatment goals. Your provider will explain the options that fit your situation and help you decide on the approach that’s right for you. View treatment options we provide.
Appointments are available in Blaine, Maple Grove, Minnetonka, Monticello and Robbinsdale.
How varicose veins form
Veins move blood from your legs back toward your heart. They do that against gravity, which is why varicose veins most often develop in the legs. When the valves inside those veins stop sealing properly, blood flows backward and pools instead.
This backward blood flow is known as reflux, or venous insufficiency. The extra pressure created by pooled blood stretches the vein walls, causing veins to enlarge and become more visible beneath the skin. Varicose veins often appear twisted, raised or blue.
Varicose veins can be more than a cosmetic concern. Some cause no symptoms at all, while others lead to swelling, discomfort, heaviness, itching, burning or cramping in the legs.
What raises your risk
Several factors are associated with a higher risk of varicose veins, including:
- Family history of varicose veins
- Age
- Pregnancy
- Injury to the veins
- A history of blood clots, including clots that formed after surgery or a long hospital stay
- Prolonged standing
- Insufficient exercise
- Obesity, or a high BMI
- Cigarette smoking
- Prolonged, excess fluid retention
- Heart failure
- Liver disease
Having one or more of these risk factors does not mean you’ll develop varicose veins. However, they can increase the likelihood of vein problems over time.
When to have your veins evaluated
If you have bulging leg veins and any of the following symptoms, it’s worth having your veins evaluated:
- Leg pain, aching or heaviness
- Leg fatigue or nighttime leg cramps
- Restless legs
- Swelling in the ankles or calves
- Patches of skin that have darkened or turned purple
- Skin around the ankle or lower leg that has become thickened or hardened
- Skin that itches or feels like it’s burning
- Ulcers or open sores
- Pain that worsens when standing and improves when the legs are elevated
Is treatment medical or cosmetic?
Whether varicose veins are considered a medical condition or a cosmetic concern depends on your symptoms and what an ultrasound shows. Insurance plans typically consider treatment medically necessary when visible veins are accompanied by symptoms, nonhealing sores or other signs of vein disease, and an ultrasound confirms venous insufficiency. Coverage varies by plan, and many insurers require a period of conservative treatment before approving a procedure.
Spider veins without symptoms can be treated with sclerotherapy, but most insurance plans consider that treatment cosmetic and do not provide coverage. Because coverage decisions depend on your diagnosis, symptoms, insurance plan and recommended treatment, it’s a good idea to check with your insurer before moving forward.
Frequently asked questions
Are varicose veins hereditary?
Family history is a recognized risk factor for varicose veins. Genetics can affect the strength and structure of your vein walls and valves, which may influence how well they function over time. Having a parent with varicose veins can increase your risk, though it does not mean you’ll develop them.
How does standing for long periods cause varicose veins?
When you walk, the muscles in your calves help squeeze the leg veins and push blood back toward the heart. Standing still for long periods reduces that pumping action, which can increase pressure in the leg veins. Over time, that added pressure can stretch the vein walls and affect how well the valves function.
Are spider veins the same thing as varicose veins?
No. Spider veins and varicose veins are related but not the same thing. Spider veins are small red, blue or purple vessels that appear close to the skin’s surface, while varicose veins are typically larger veins that may appear raised, twisted or bulging. Spider veins without symptoms are often treated for cosmetic reasons, while varicose veins may require medical evaluation if they’re causing symptoms.
What test is used to diagnose varicose veins?
Venous duplex imaging is commonly used to evaluate varicose veins and venous insufficiency. Gel is applied to your leg, and your veins are scanned with ultrasound to show how blood is moving through them. This test shows how blood flows through the veins and helps identify valves that are not working properly.
Request an initial appointment
An initial appointment with our team can help determine whether your symptoms are related to varicose veins and what treatment options may be available.
Call 763-581-5400 or submit the following form to request an appointment.
We will contact you within 1-2 business days of receiving your form to schedule.