Understanding Varicose Veins
Why they develop, what they mean for your health, and how today's minimally invasive treatments can relieve symptoms — usually with no hospital stay and little downtime.
What are varicose veins?
Varicose veins are enlarged, twisted veins just beneath the skin, most often in the legs. They appear as bulging, rope-like cords — blue, purple or skin-colored — and are a visible sign of a circulation problem called chronic venous insufficiency: blood that should be flowing back to the heart is instead leaking backward and pooling in the leg.
Spider veins
Fine red, purple or blue lines (telangiectasias) in a web or sunburst pattern. Mostly a cosmetic concern, though they can itch or burn.
Reticular veins
Flat, blue-green "feeder" veins visible under the skin, often behind the knee or on the thigh. They frequently supply nearby spider veins.
Varicose veins
Raised, bulging, twisting veins. Often linked to faulty valves in a larger "trunk" vein deeper in the leg — which is what treatment targets.
Explore the stages of venous disease
Why do varicose veins develop?
Your leg veins carry blood uphill to the heart, against gravity. They rely on two things: the squeezing of your calf muscles as you walk, and dozens of tiny one-way valves that snap shut to stop blood from slipping back down.
- Over time, vein walls can stretch and valves can weaken so their leaflets no longer meet.
- Blood flows backward (venous reflux) and collects in the lower leg, raising pressure inside the veins.
- The extra pressure stretches surface veins further — they bulge, twist and become varicose. Left untreated, it can lead to swelling and skin damage.
Who is at higher risk?
What are the symptoms of varicose veins?
Some people only notice how their veins look. Many others feel them — symptoms are typically worse at the end of the day or after standing, and better when the legs are raised.
Quick symptom check — tap any that apply to you
When should you see a vein specialist?
Varicose veins are rarely an emergency, but they are a medical condition — not just a cosmetic one. Consider an evaluation if any of the following apply.
Symptoms affect daily life
Aching, heaviness, swelling, cramping or restlessness that limits work, sleep, exercise or standing.
Veins are painful or enlarging
Bulging veins that are tender, getting bigger, or spreading over time.
Skin changes near the ankle
Brownish darkening, itching, rash-like eczema, or skin that feels hard and tight.
A sore that won't heal
An open wound on the lower leg or ankle, or a varicose vein that has bled.
A hard, red, tender cord
Possible superficial thrombophlebitis — inflammation with a clot in a surface vein.
Self-care isn't enough
Stockings, elevation and exercise haven't relieved symptoms — or you simply want answers about how your veins look.
Seek urgent care for
- Sudden swelling, pain or warmth in one leg — this can signal a deep vein thrombosis (DVT). Get medical attention the same day.
- Chest pain or sudden shortness of breath — call 911 immediately.
- A bleeding varicose vein — lie down, raise the leg above heart level, and press firmly on the spot with a clean cloth. Call 911 if bleeding does not stop.
What is involved in the evaluation?
A thorough evaluation finds the source of the problem — not just the veins you can see. Select a step to learn more.
What are the treatment options?
Most patients do best with a combination: conservative care for everyday comfort, plus a procedure that closes the faulty vein at its source and clears the visible veins. Current national guidelines from the Society for Vascular Surgery, the American Venous Forum and the American Vein & Lymphatic Society favor minimally invasive endovenous treatment over traditional surgery for most patients.
At a glance
| Option | Best for | Where & anesthesia | Typical downtime |
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Frequently asked questions
Is treatment covered by insurance?
Often, yes. When varicose veins cause symptoms and an ultrasound documents venous reflux, most insurance plans — including Medicare — cover medically necessary treatment. Some plans require a period of compression stocking use first; our team reviews your plan's criteria and handles the paperwork. Treatment of spider veins for appearance alone is usually considered cosmetic.
If a vein is closed, where does the blood go?
The treated vein was already failing at its job — carrying blood the wrong way. Once it is closed, blood naturally reroutes through healthy veins, chiefly the deep veins, which normally carry the large majority of blood out of the leg. Circulation typically improves.
Do the procedures hurt?
Most patients describe mild discomfort. In-office procedures use local anesthesia — there is a brief pinch from the numbing medicine, then pressure. Afterward, tenderness similar to a bruise for several days is common and is usually managed with walking and over-the-counter pain relievers when appropriate.
How soon can I get back to work and exercise?
Most people walk out of the office and return to desk work within a day or two. Walking is encouraged immediately. Strenuous exercise and heavy lifting are usually paused for about a week — your post-procedure instructions will be specific to you.
Can varicose veins come back?
Treated veins rarely reopen, but the tendency toward vein disease is often inherited, so new varicose veins can develop over the years. Staying active, managing weight, wearing compression when advised and periodic check-ups help keep legs healthy.
I'm pregnant — should I be treated now?
Elective vein procedures are generally postponed during pregnancy. Many pregnancy-related veins improve within months after delivery. Compression stockings and leg elevation can help in the meantime; we are happy to re-evaluate after your baby arrives.
Healthier legs start with the right answers.
Dr. Satish Tadepalli, MD, MPH, DABVLM, evaluates every patient with an in-office duplex ultrasound and builds a treatment plan around your symptoms, goals and insurance — in a calm, private setting in Sparta, New Jersey.
Sparta, NJ 07871
About this guide. The topics in this guide follow the patient education series on venous disease and varicose veins developed by the American Venous Forum's Patient Education Committee. Clinical content reflects the 2022–2023 Society for Vascular Surgery, American Venous Forum and American Vein & Lymphatic Society Clinical Practice Guidelines for the Management of Varicose Veins of the Lower Extremities.
This information is educational and does not replace individual medical advice. Treatment options, risks and coverage vary by patient; please discuss your situation with your physician.