Vascular Surgeon Questions Varicose Veins

Why does my leg swell if I have varicose veins?

I have varicose veins in my legs. They aren't bad (not all bulgy). But if I stand for any length of time my legs swell up. Is this related?

13 Answers

it is possible it could be. You would need to have a special ultrasound test called a venous insufficiency study which could help determine this.
The answer to your question is yes. I tell my patients that arteries carry blood away from the heart to the body. Arteries Supply oxygen and nutrients to the body's organs and tissue. The body needs nutrients and oxygen therefore the arterial blood is pumped to the body. Once oxygen and nutrients have been extracted from the arterial blood it enters the venous system starting at the skin level. The sole purpose of veins is to bring the blood back to the heart. This is done through one-way valves in the venous system. Only 10% of your venous blood should be in your superficial system. This is the skin and fatty tissue. 90% of your venous blood should be in the Deep system. Deep system veins run between your muscles. Every time your muscles contract it pushes blood back to the heart where it can receive more oxygen to be pumped to the body. When the valves in your superficial system fail to close and hold the blood in the Deep system, deep system blood backs up into the superficial system which is your fatty tissue and skin. When this happens the Superficial veins will become large and overtime they will become diseased and leak out protein which draws water into the fatty tissue and hemosiderin which begins to tattoo the skin. These are the skin changes that many people will see along with varicose veins and large spider veins. So in the morning after you have been lying down all night your legs will look the best. Because the blood has been able to flow back to the heart. In the upright position your valves are required to hold the blood in the deep system. When you go to work and sit all day or stand all day, blood will pool in your legs because the valves are not holding that blood in the Deep system where it can be pumped back to your heart. This leads to swelling in the legs. Depending on how many valves are not working will determine how quickly you develop swelling. Some people will develop it immediately after getting out of bed, some will develop it in the early afternoon and some will develop it at night. Additionally people will complain of dull aching pain at night time, restless leg syndrome, itching, burning, numbness, heaviness in the legs and fatigue as the day goes on. When you complain of swelling to your primary care doctor most of the time you will be evaluated for heart disease, lung disease ,liver disease and kidney failure. These are other causes of swelling in the legs and are more detrimental to your health. Venous disease often does not kill you it is just debilitating. Venous disease has a slightly higher increase risk for deep Venous Thrombosis. Most patients if they present with swelling will often be sent for venous duplex to rule this out. This is because a deep Venous Thrombosis has the potential to move up the venous system into the lungs and cause a pulmonary embolus which can be lethal. If you have swelling regardless of external findings the easiest thing to do is wear graded compression stocking (20-30 mmhg) when you are working, sitting, standing for long periods of time, long car rides or plane ride. Finally get a vein mapping of your legs which will diagnose the problem and allow it to be treated. When you have symptoms it is not considered cosmetic. When it is worked up properly treatment is covered by most insurances including medicare.
Your legs swell because the valves which are causing your varicose veins are allowing the blood to pool in the leg. This allows the water component of blood to leak out into the tissues and that is what is causing the legs to swell. These need to be properly evaluated by a special type of ultrasound to determine where the problem is as that will dictate both care and what your insurance will and will not pay for. At a minimum, you need to be in proper support stockings and at the proper amount of compression. A vascular surgeon will guide you through this.
Indeed it could be! Varicose veins are usually the result of valves in the superficial veins of your legs not working properly. As you know veins carry blood from the feet to the heart so when the one-way valves in them don't work correctly, blood can pool in the lower legs and create those bulges. This can cause swelling in the veins themselves and in the lower legs and ankles that usually spares the feet. The longer you stand or sit, the more you'll swell; the more your calf muscle contracts as with walking or the more you elevate your legs above your heart, the less you'll swell. If your symptoms are severe, consider wearing gradient compression socks of 20-30mmHg and getting evaluated by a vein specialist at an accredited vein center.
Yes, for sure. Leg swelling is the next level up on the venous insufficiency/valvular reflux scale.
It could be. If the valves in your veins are not working well, then you can get swelling in the legs from prolonged standing.
Varicose veins are a visible SIGN of venous insufficiency as is swelling.

Venous insufficiency is a treatable disease where blood does not flow properly back from the feet to the heart and lungs. This can present as visible signs such as spider veins or varicose veins. It can also present as symptoms including heaviness or fatigue in the legs at the end of the day, nighttime urination, nighttime leg cramps or even restless legs.

Blood is mainly water and when blood pools in the legs, this extra water can lead to swelling.
Perhaps. The veins You see may be an indication of an underlying problem, or could be unrelated. A venous ultrasound exam answer the question. see a board certified vascular surgeon, avoid cardiologists and radiologists masquerading as vein specialists. They tend to tell everyone they see that their veins need treatment, whether they need them or not.
Dear Patient,
Your legs may get swollen if you have varicose veins because Varicose veins are associated with a condition called venous insufficiency which  causes a build up of back pressure within your veins at the ankle and high pressure in those veins. This causes fluid within your veins to seep out into the surrounding tissues which manifests as "swelling". This condition can be easily diagnosed using an ultrasound scan and can often be treated by a special type of compression stockings or minimally invasive out patient procedures. Left untreated this condition may progress to more severe presentations with pigmentation or ulceration of skin at the level of the ankle. Please discuss this with your doctor on your next visit. Let us know if we can help you in any way.All the best.Shubha Varma MD
"Bad veins" means their main function of sending blood back to your heart by your leg veins is decreased. Additionalstress to them, such as prolonged standing, makes them work even worse and cause leg swelling.
Varicose veins can contribute to leg edema. They are usually visible and frequently painful.