Varicose Veins

Key points

• • The veins of the legs carry blood upward against gravity, helped by one-way valves and the squeezing of the calf muscles.
• • When these valves fail, blood flows backward and pools, so the surface veins become swollen, twisted and visible.
• • Symptoms include aching, heaviness, swelling and itching of the legs, often worse after long standing.
• • Long-standing disease can cause skin changes, brown staining and, in time, a venous ulcer near the ankle.
• • The cause is judged by testing which valves have failed, using clinical tests and ultrasound.