Many people experience leg heaviness, swelling, or visible varicose veins and assume it is simply part of getting older. In many cases, however, these symptoms are caused by a very common condition called chronic venous insufficiency, often referred to as venous reflux. The encouraging news is that this condition is easy to diagnose and highly treatable with modern, minimally invasive procedures.
What Is Venous Insufficiency?
The veins in our legs have an important job: they carry blood back to the heart. To help blood move upward against gravity, veins contain small one-way valves that prevent blood from flowing backward.
When these valves weaken or stop working properly, blood can begin to flow in the wrong direction. This backward flow is called venous reflux. Instead of efficiently returning to the heart, blood begins to pool in the veins of the legs. Over time, this increases pressure inside the veins, causing them to enlarge and leading to a variety of symptoms.
How Common Is It?
Venous disease is extremely common. In fact, about one in four adults has some form of venous insufficiency or varicose veins. The condition becomes more common with age, but it can affect adults of any age.
Risk factors include family history, pregnancy, prolonged standing or sitting, and occupations that require being on your feet for long periods of time. Despite how common it is, many people simply live with the symptoms without realizing there are effective treatments available.
Common Symptoms
Venous reflux often develops gradually. Many patients describe symptoms that worsen later in the day or after standing for long periods. Common symptoms include:
- A feeling of heaviness or fatigue in the legs
- Aching or throbbing discomfort
- Swelling, especially around the ankles
- Leg cramps, often at night
- Burning or itching around visible veins
- A sense of restless or tired legs
Many people notice that symptoms improve when they elevate their legs or walk, because the calf muscles help pump blood back toward the heart.
Signs You Can See
In addition to symptoms you can feel, venous insufficiency can also cause visible changes in the legs. These may include:
- Varicose veins, which appear as bulging or twisted veins under the skin
- Spider veins, small clusters of red or purple veins
- Swelling around the ankles that worsens throughout the day
- Skin discoloration near the ankles, often appearing brownish
- Thickened or hardened skin on the lower leg
These changes occur because increased pressure in the veins gradually affects the surrounding tissues.
How the Diagnosis Is Made
Fortunately, diagnosing venous reflux is simple. The most important test is a venous ultrasound, which is painless and noninvasive.
During the test, a small handheld probe is placed on the skin to create images of the veins. The ultrasound can show both the structure of the veins and the direction that blood is flowing. If blood is seen flowing backward through the valves, venous reflux can be confirmed.
The test usually takes less than an hour and does not involve needles, radiation, or downtime.
Modern Treatments Are Minimally Invasive
One of the biggest advances in vein care over the past two decades is the development of minimally invasive treatments that can correct the problem without major surgery.
Radiofrequency ablation (RFA) is one of the most common treatments. In this procedure, a thin catheter is inserted into the abnormal vein using ultrasound guidance. Gentle heat from radiofrequency energy closes the diseased vein. Blood is then naturally redirected to healthy veins.
The procedure is performed in the office using local anesthesia, and patients are typically able to walk immediately afterward.
Another treatment, microphlebectomy, removes bulging varicose veins through very tiny openings in the skin. Because the incisions are so small, stitches are rarely needed and scarring is minimal.
For smaller veins, physicians often use sclerotherapy, a technique in which a specialized solution is injected into the vein. The vein collapses and gradually fades as the body absorbs it.
Most patients return to normal activities quickly and notice improvement in symptoms over the following weeks.
Why Treatment Matters
If venous insufficiency is left untreated, the pressure in the veins can continue to increase over time. This can lead to more serious complications such as:
- Severe leg swelling
- Skin damage and discoloration
- Thickened or hardened skin around the ankles
- Venous ulcers, which are open wounds that can be difficult to heal
These complications can significantly affect mobility and quality of life. Treating venous reflux early helps prevent these problems and keeps the legs healthy.
The Bottom Line
Chronic venous insufficiency is one of the most common vascular conditions affecting adults. The good news is that it is easy to diagnose with ultrasound and highly treatable with modern, minimally invasive procedures.
For patients experiencing leg heaviness, swelling, or visible varicose veins, evaluation by a vein specialist can identify whether venous reflux is present. Treatment can relieve symptoms, improve the appearance of the legs, and prevent long-term complications.
Most importantly, addressing venous disease can restore comfort, mobility, and overall leg health—allowing patients to stay active and feel their best. Let us know how we can help!
Golden State Heart and Vascular, with offices in Los Gatos, Burlingame, Mountain View, Watsonville, Monterey, and Salinas, is the exclusive provider of heart and vascular editorial in Cypress Coast Living magazine. For more information, please visit www.gshav.com.
