Vein disease may present with a variety of symptoms, many of which are painful, even debilitating.
If you begin to experience significant, persistent symptoms such as those mentioned here, it is best to seek evaluation and treatment by a physician as soon as possible. Left untreated, these conditions will progress and worsen over time. Early treatment prevents the progression of pain and further damage to your legs, as well as other medical complications.
These symptoms can occur at any age, but are most common in people over 40. While people often attribute some of these symptoms to “getting old,” they are not inevitable! Certain conditions may develop as a person ages, but modern medical science has produced new treatments that can improve quality of life as one ages.
- Leg pains and aches, including burning and itching sensations
- Leg cramping, including nighttime cramps
- Tired, heavy legs
- Skin changes, including darkening, rashes, and dry itchy skin
- Swelling / Lymphedema
- Varicose or spider veins
- Restless legs
- Spontaneous bleeding
- Recurrent cellulitis (skin infection)
- Loss of hair on feet, ankle, and/or lower leg
Leg pains and aches, including burning and itching sensations
Leg pain is caused by venous reflux (insufficiency) in many patients. Over time, patients often experience the gradual onset of leg pain in one form or another. Some describe their leg pain as a dull ache or throbbing. Others describe a pressure sensation in the lower leg. Many experience muscle cramping, especially at night. Some describe their leg pain as heaviness.
Leg pain and associated symptoms are usually worse when a patient is subjected to periods of prolonged standing. Many occupations such as teaching, health care, retail, and law enforcement require long periods of standing which can worsen symptoms. These symptoms usually worsen at the end of the day and improve when a patient can elevate their legs. These symptoms usually worsen with warm weather and improve in colder climates. Leg pain due to vein disease is usually worse with standing and lack of activity and improves with walking or exercise.
Leg pain can also be caused by other problems not related to veins. Diseases affecting the arteries limit the amount of blood and oxygen that can reach the legs. Leg pain due to arterial disease is usually brought on with exertion is quickly relieved by rest. When walking, patients can experience muscle cramping in the calves, thighs, or buttocks.
Leg pain can also be caused by back or nerve disorders not related to vein or arterial disease. The pain also may be a sign that a more serious condition, such as blood clots, could be present. All vein diseases will continue to worsen without treatment. Early detection and intervention can help you avoid developing more serious health issues.
Leg cramping, including nighttime cramps
Leg cramping is commonly caused by venous reflux (chronic venous insufficiency). Many patients experience muscular tightening or painful cramping at night. The relationship between venous insufficiency and leg cramping is poorly understood. It is sometimes difficult to predict which patients with leg cramping will respond favorably to treatment for vein disease.
There are other causes of leg cramping in addition to venous disease. Muscular cramping due to vein disease is usually worsened by prolonged standing or inactivity. Cramping at night is also commonly due to vein disease. Calf cramping with exercise may be due to arterial disease, and unrelated to venous insufficiency. With arterial disease, the cramping, most often occurring in the buttocks, calves, and thighs, occurs after walking, exercise, or exertion and is alleviated quickly with rest. If leg cramping is causing you discomfort or keeping you awake at night, a medical examination can help determine the cause.
Tired, heavy legs
One of the symptoms patients with vein disease commonly experience is a tired, heavy feeling in the legs. This feeling may or may not be accompanied by aches and pains. However, this is not just caused by needing rest. In fact, the tired, heavy feeling often intensifies after periods of rest or inactivity. If that is the case, tired leg muscles are not the problem—vein disease may be to blame. The most likely culprit in these situations is venous insufficiency, or the dilation of superficial veins with incompetent valves, which leads to a gravity-dependent retrograde flow of venous blood.
If you are experiencing these symptoms, a medical examination by one of our expert physicians can help determine the true cause.
Skin Changes, including darkening, rashes, and dry itchy skin
Significant changes in the skin of the lower leg may be a sign of vein disease, most commonly superficial and deep vein insufficiency (when superficial veins with broken valves become dilated) or arterial occlusive disease (when narrow arteries disrupt blood flow), though other conditions may be at fault. Skin changes may include:
- Darkening of the skin, typically to a reddish-brown, dark-brown or rust color
- Rashes, manifesting as tiny, usually itchy bumps around the lower calf or ankle
- Cellulitis or similar skin infections
- Painful, hard, dark-red or brown plaques (lipodermatosclerosis) around the lower calf and/or ankle
- Venous ulcers around the inner or outer ankle
- Thin, easily torn skin
- Loss of hair on lower legs and feet (also a sign of arterial disease)
- These changes may also be accompanied by aches and pains and/or heavy, tired legs.
The inflammatory changes caused by chronic venous insufficiency often leads to skin rashes that cause intense itching and redness. If this rash is due to vein disease it is usually referred to as venous eczema or venous stasis dermatitis. This usually affects the lower legs with patches of numerous tiny red bumps that may coalesce into diffuse red rashes covering the lower legs and ankles. The rash is usually very itchy and is often misdiagnosed as an infection of the skin called cellulitis.
Chronic venous insufficiency also frequently leads to a darkening of the skin called hyperpigmentation. Chronic inflammation damages the tiny blood vessels called capillaries. Fluid and red blood cells leak out, causing swelling and skin discoloration, respectively. The substance in red blood cells that carries oxygen is called hemoglobin — an iron-based pigment. When leaky capillaries allow red blood cells to escape into the skin and subcutaneous tissues, this iron-based pigment is deposited in the skin, causing the brownish, rust-colored discoloration that starts around the ankle and progresses up the lower leg in a gaiter distribution.
More advanced skin changes lead to lipodermatosclerosis, a dark-red or brown, plaque-like thickening of the skin that can be painful. This is usually associated with scarring and fibrosis of the underlying subcutaneous tissues and causes the tissues below the calf to shrink and become hardened. Patients may notice a caliber change in the diameter of their lower legs and narrowing of the lower legs from the lower calf down to the ankles.
The skin changes caused venous insufficiency are often misdiagnosed as a dermatological problem. This can prevent its true cause from being discovered, allowing the condition to get progressively worse over time. If vein disease is left untreated, the patient risks developing worsening skin changes leading to a stasis ulcer or open wound on the skin.
Swelling / Lymphedema
When the valves in leg veins begin to weaken or fail, the blood cannot be pumped out of the leg properly. This causes fluid to become trapped in the leg. When the fluid begins to build up, the leg may begin to swell. Swelling due to fluid accumulation in the body is called edema.
The swelling may be accompanied by other symptoms, such as pain, cramps, or a heavy, tired feeling in the legs. Any swelling in the lower leg should be considered abnormal, and patients must visit a physician immediately to diagnose and begin treating the underlying problem. Swelling can also be a symptom of other, non-venous conditions such as heart disease, heart failure, obesity, high blood pressure, liver disease, or kidney disease, so it’s important to seek medical attention immediately.
Lymphedema is a form of long standing or chronic edema that occurs when the body’s lymphatic system does not function properly. It is not the same as edema caused by vein disease, although vein disease can eventually progress into a combined venous/lymphatic disorder. Lymphedema can be congenital, primary, or secondary. The cause of primary lymphedema is unknown, while secondary lymphedema can be the result of cancer, prior radiation treatment, certain tropical diseases, trauma, or surgical treatment. As with swelling in the lower legs, lymphedema requires the attention of a healthcare professional as soon as possible.
Venous ulcers usually develop around the ankle and can vary in size from very small to several inches in diameter. While usually not very painful, venous ulcers can occasionally be quite painful or become infected.
Chronic vein disease causes a progressive inflammatory reaction that damages the capillaries and lymphatic ducts and leads to swelling caused by fluid leaking out into the tissues of the lower legs. The pigment hemoglobin inside of red blood cells is deposited in the skin and tissues of the lower leg. This iron-based pigment causes the brown, rust-colored discoloration that commonly begins around the ankle.
Damage to capillaries caused by chronic vein disease leads to low oxygen levels in the soft tissues of the lower leg. This leads to poor wound healing and chronic venous stasis ulceration. Treatment for venous ulcers in the past relied on compression therapy and wound care. While effective for healing ulcers, compression therapy alone was associated with high recurrence rate of venous ulcers. The standard of care now relies on closure of the abnormal veins causing venous insufficiency AND compression therapy. In addition to improving the rate of ulcer healing, state of art vein treatment drastically lowers the recurrence rate of venous ulcers. The ulcers heal more quickly and are much less likely to come back.
An ulcer is a very severe condition, requiring treatment of both the open wound and the underlying vein disease. If left untreated, the condition will progress, allowing the ulcer to get larger and possibly become infected.
There are three types of ulcers to consider if you believe you might be suffering from vein and vascular disease:
- Venous ulcer: Moist, weepy, or wet lesions on the inside or outside ankle, which may or may not be painless
- Arterial ulcer: Dry, “punched out,” and painful lesions that usually appear on the toes or feet
- Diabetic (neurotrophic) ulcer: Located on the pressure points of the foot, like the ball or the heel
It is crucial to seek medical treatment immediately for ulcers or pre-ulcerous conditions.
Varicose or spider veins
Varicose veins occur when veins become stretched out or enlarged over time, leading to non-functioning valves. These leaky valves allow the blood to flow in the wrong direction and back into the legs, a condition known as venous insufficiency. The blood pools and stagnates in the vein, causing it to stretch over time.
A varicose vein will appear swollen and rope-like, bulging out from the surface of the skin. They are most commonly found on the thighs or calves. The varicose vein may be the same color as the skin, or it may appear blue or red.
Varicose veins can cause the legs to swell or feel achy, heavy and tired. A person with varicose veins also may experience itching, burning, numbness or tingling. Varicose veins also cause nighttime leg cramps and restless leg syndrome. In extreme cases, varicose veins may result in skin changes, rashes, swelling, and ulcers or open sores on the legs if left untreated. Some patients can experience clotting of varicose veins, which can be quite painful.
Certain lifestyles and work requirements, such as prolonged sitting, can worsen venous disease. Teachers, police officers, and retail associates are all at risk for developing venous insufficiency and varicose veins.
Spider veins are tiny, dilated veins that are visible on the surface of the skin. Spider veins are typically not painful, but some patients do complain of burning or itching. When numerous spider veins are visible at the skin’s surface, they may be an indicator that venous insufficiency of larger veins are present under the skin.
Approximately 15 percent of Americans are affected by restless leg syndrome. When it occurs, patients experience a constant urge to move their legs due to uncomfortable sensations. The symptoms usually appear while sitting or lying down, and tends to occur more often at night.
Restless leg syndrome in most patients is the result of vein disease. More than 90 percent of patients with restless legs suffer from venous insufficiency. When the valves in the leg veins weaken and fail to function properly, blood flows backwards into the legs, leading to venous congestion. In addition to causing significant leg discomfort, venous congestion in the legs presumably triggers a reflex to move the legs to clear the blood and fluid out of the muscles.
Studies have shown that 80 to 85 percent of patients have significant or complete resolution of restless leg syndrome following treatment of vein disease. If you have been diagnosed with restless leg syndrome, experience the frequent urge to move your legs while at rest, and you feel as if this condition is negatively impacting your work and life, contact us to set up an appointment. One of our doctors will examine you, review your medical history, and make the appropriate treatment recommendations.
Spontaneous bleeding from superficial veins in the leg can occur due to untreated vein disease. The bleeding results from high pressure in superficial veins caused by venous insufficiency (reflux) caused by backwards flow of blood into the veins of the legs under the force of gravity. The veins and skin weaken over time, and if the affected area receives even a slight injury, the vein may rupture and bleed a substantial amount. This also may occur after bathing in warm water, which softens the skin and dilates the veins close to the skin surface. If spontaneous bleeding occurs from a vein in the leg, immediate actions must be taken to stop the bleeding. Patients should elevate the leg, apply pressure, and seek medical assistance immediately.
Vein disease will progress without treatment, and spontaneous bleeding is a serious warning sign of deeper problems. If you have experienced spontaneous bleeding, contact us to schedule an appointment.
Recurrent Cellulitis (skin infection)
Cellulitis is an infection that affects the skin making it red, painful, tender, and warm to the touch. Cellulitis is treated with antibiotics to eradicate the infection.
Patients with chronic vein disease have damaged fragile skin with decreased oxygen levels which can lead to repeated episodes of cellulitis.
Many patients with chronic vein disease are often misdiagnosed with recurrent cellulitis when they actually suffer from venous eczema (stasis dermatitis), an inflammatory (not infection) condition leading to a red rash on the lower legs that is usually very itchy. If you have been diagnosed with chronic, recurrent cellulitis and antibiotics don’t seem to help, you may be suffering from venous eczema (stasis dermatitis) caused by vein disease.
Treating the underlying vein disease can help prevent the physical conditions that increase the risk of recurrent cellulitis. If you have had a leg ulcer or have been diagnosed with cellulitis, schedule an appointment with us.
Schedule Your Appointment
Please contact us with any questions you might have about vein disease, or if you would like to schedule an appointment with us to have your vascular disease diagnosed and treated.
Texas Endovascular provides the most advanced and minimally invasive vein treatments for the Greater Houston area without the risks of surgery or the expense and hassle of going to the hospital. Intervening early helps prevent the escalation of pain and suffering.