Symptoms of Vein Disease

En Español

Vein disease can come with a variety of symptoms, many of which are painful or debilitating.

If you experience significant, persistent symptoms such as those mentioned here, seek physician evaluation and treatment as soon as possible. Left untreated, these conditions will progress and worsen over time. Early treatment prevents  pain progression and further damage to your legs, as well as other medical complications.

Read more about these common symptoms of vein disease:

Vein Treatment Options


Leg pains and aches

Including burning and itching sensations

Leg pain is caused by venous reflux (insufficiency) in many patients. Over time, patients 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 must stand for long periods. 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. Symptoms may also  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, and 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 of more serious conditions, such as blood clots. 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 occurs in the buttocks, calves, and thighs. It happens 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 diagnostic ultrasound 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 vein doctors can help determine the true cause.

Skin Changes

Including darkening, rashes, and dry itchy skin

Significant changes on your lower leg skin 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 that look like 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 many patches of  tiny red bumps. They may come together 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 skin darkening (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. It causes the tissues below the calf to shrink and  harden. Patients may notice a caliber change in the diameter of their lower legs. That means they may narrow  from the lower calf down to the ankles.

The skin changes caused by venous insufficiency are often misdiagnosed as a dermatological problem. This can prevent us from discovering its true cause, 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.

Swollen legs

edema and lymphedema in leg

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 doesn’t function properly. It is not the same as edema caused by vein disease, although vein disease can progress into a combined venous and 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. Lymphedema requires medical attention as soon as possible.



Venous Ulcers

venous ulcer

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 an inflammatory reaction that leads to swelling. That’s caused by fluid leaking out into the tissues of the lower legs. A brown, rust-colored discoloration can begin around the ankle. It is crucial to seek medical treatment immediately for ulcers or pre-ulcerous conditions.


Visible varicose or spider veins

varicose veins on leg

Varicose veins occur when veins become stretched out or enlarged over time, leading to non-functioning valves. These leaky valves cause the blood to pool and stagnate 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.

spider veins on legs

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.


Restless legs

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

Spontaneous bleeding from superficial veins in the leg can occur due to untreated vein disease. The bleeding results from high pressure in superficial veins due to venous insufficiency (reflux). And that reflux comes backwards flow of blood when your leg  veins can’t handle 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 your 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’ve experienced spontaneous bleeding, contact us to schedule an appointment.

Recurrent Cellulitis (skin infection)

cellulitis on leg

Cellulitis is an infection that affects the skin making it red, painful, tender, and warm to the touch. Cellulitis is treated with antibiotics.

Patients with chronic vein disease have damaged fragile skin with decreased oxygen levels. That 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 condition (not an infection) that leads to a red rash on the lower legs. It 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’ve had a leg ulcer or been diagnosed with cellulitis, schedule an appointment with us.

Varicocele Pain

A varicocele is an enlarged vein in the scrotum. It  can cause pain and decrease sperm production. Varicoceles develop over time and often don’t need treatment. However, if you experience symptoms, including pain that worsens with physical exertion or throughout the course of the day, learn about non-invasive treatment options. Texas Endovascular specializes in varicocele embolization.

Request Appointment

Meet the Doctors

Request an AppointmentRequest Appointment