Varicose veins and venous insufficiency may cause symptoms less obvious than the commonly noted spider veins, bulging lumps, bleeding veins or leg ulcers. Other symptoms may include swollen achy legs, a feeling of heaviness or fatigue of the legs, or itchy and discolored legs. Patients usually complain of increased swelling and aching toward the end of the day and often note improvement with elevation of the legs or after a night of sleep. Other patients may be under treatment for conditions thought to be related to the heart (congestive heart failure), kidneys (renal failure or diabetic kidney disease), excess salt intake, lymphedema (swelling after leg incisions) or for neurologic conditions such as neuropathy or restless leg syndrome (RLS). Restless leg syndrome has been strongly correlated with venous insufficiency, so patients who have been diagnosed with RLS are encouraged to seek further vein evaluation.
Complications of Vein Disease
The natural history of untreated venous insufficiency is the development of progressive edema and swelling in the affected extremity, leading to insidious onset of skin changes, including thickening of the skin and eventual discoloration from the deposit of red blood cells in the skin. Most of the severe skin changes seen in patients with venous insufficiency are reversible, and once the underlying superficial leaky veins have been treated the skin often returns to a more normal color and texture. Over time, after successful endovenous treatment of severe superficial venous insufficiency, the risk of bleeding and ulceration is also lowered significantly. In summary, most severe appearing skin changes seen in patients with chronic venous insufficiency are secondary to superficial venous dysfunction and once the underlying problems have been treated (with endovenous closure) the skin changes can be halted at the least and reversed in many patients.