One of the most common complaints we encounter is leg swelling. It is our job to determine if it is a vein related issue or not. If it is we give direction to the patient on what to do next. Swelling is usually multi-factorial (caused by more than 1 reason). Varicose veins due to venous insufficiency cause swelling by an increase in backflow pressure in the veins causing dilation. This is due to broken valves inside of the vein. This usually takes years to develop and an can cause symptoms of legs that ache, heaviness, fatigue, itching, and burning way before dilated bulging veins can be seen. The most common complaint to a vein clinic is “my legs ache and feel heavy, but I don’t see anything wrong”. Proper evaluation with duplex ultrasound will definitively tell you if a broken vein is present and where.
The flip side of this evaluation is that a patient and clinician can find out that the venous system is functioning normally. This would mean that there is another reason for swelling other than varicose veins. There are many other causes for the lower leg swelling. One reason is side effects from many routine medications, such as certain blood pressure pills. Others causes for swelling include a sedentary lifestyle, obesity, a standing occupation, hypertension, congestive heart failure, kidney problems, lymphedema, trauma, surgeries, and deep venous blood clots, to name a few. These are issues can be addressed with your primary care physician and usually improved.
Like venous disease, these other disease processes that cause swelling can be helped by using proper lower leg compression or wearing of support hose. It is important to get the right strength and size to fit. Please have your vein clinic or medical garment professional guide you to the proper type. Using the wrong size or type can result in worsening of the original problem.