Varicose Veins FAQs

Frequently Asked Questions

Arteries carry oxygenated blood away from the heart to your tissues. Veins return deoxygenated blood back to the heart and lungs to obtain oxygen again. Arteries have a thick wall with muscles that generate blood pressure. Veins have relatively thin walls and low pressure.

When muscles in the arms or legs contract, they squeeze veins and push the blood within them. Veins contain valves that allow blood flow one direction. Therefore, when muscles contract and squeeze blood through the veins, the vein valves prevent blood from flowing backwards, away from the heart.

The three different types of veins are deep, superficial, and perforating veins. Deep veins run between muscles or within muscles. Superficial veins run between the muscles and the skin (i.e. above the muscular fascia). Perforating veins connect deep veins and superficial veins.

Chronic vein disease, venous stasis, or venous insufficiency, is a pooling of blood within the veins. In chronic vein disease, valves within veins do not work properly, which allows blood to pool and/or flow away from the heart (i.e. venous reflux). Pressure within the veins is abnormally high. Unfortunately, this elevated venous pressure does not effectively push blood back to the heart. Instead, it causes varicose and other abnormal veins to form.

Varicose veins and spider veins are visible forms of chronic vein disease, also called venous insufficiency. There are several risk factors for chronic vein disease including pregnancy, obesity, older age, smoking, trauma to the vein, prior clot within the vein, and a sedentary lifestyle. Genetics may also play a role, since vein disease tends to run in families.

The most common symptoms of varicose veins are a tired or heavy feeling in the legs, pain, and swelling. The pain of varicose veins may be localized or diffuse. Localized pain means it occurs at or near the site of the abnormal vein, in a specific location. Diffuse pain, which is more common, is felt through the affected area. Severe vein disease can cause a rash, skin ulcers, and changes to the color of the skin.

Varicose veins can be treated with compression stockings and minimally invasive procedures. Varicose veins and spider veins are treated differently.

In most cases, yes, varicose vein treatment is covered by medical insurance. If you have chronic vein disease that causes symptoms, treating them or removing them is a medically necessary procedure. The treatment of spider veins is a cosmetic procedure, however, and is not covered under most insurance plans. Talk with your vein specialist about insurance coverage and out-of-pocket costs.

A numbing solution, that is, local anesthetic with additional saline, is often used prior to ablation. This numbing solution makes thermal ablation virtually painless and reduces the risk of burns.

Your vein specialist will use ultrasound to identify the abnormal vein and provide treatment.

Compression stockings help prevent or treat chronic vein disease, including varicose veins and venous stasis. Many insurance companies require people with vein disease to try compression stockings first before approving payment for other vein treatments such as thermal ablation, sclerotherapy, or surgical removal (phlebectomy).

Thermal ablation is not used to treat veins that you can see. Thermal ablation treats the diseased veins that caused the varicose and spider veins. See the dandelion animation.

Once the diseased blood vessels are removed, blood will flow through healthy vessels more easily. Your vein specialist may perform tests to determine that you have other, healthy veins nearby before treating the diseased vein.

Most vein specialists will recommend compressions stockings for up to two weeks after thermal ablation, sclerotherapy, or endovenous (within the vein) laser treatment. You may experience some soreness in the treated area that may feel like a pulling or tugging in the leg. It is important to walk every day after the procedure for at least 30 minutes. Also, avoid prolonged sitting or standing without walking. When seated, elevate the legs. You may need to return to your vein specialist for a follow-up ultrasound.