Varicose Veins Treatment

Blood returns from the leg against gravity, pushed upward by the calf muscles and stopped from falling back by one-way valves inside the veins. When those valves fail, blood drops back down the vein between steps and pools in it.

The pooling stretches the vein, and a stretched vein holds its valves further apart, so more of them fail. That is the loop that makes the problem progressive. The visible ropey veins at the surface are the end of the chain, and the failure that produced them usually lies in a deeper trunk vein feeding them.

Pregnancy, long hours standing and a family history all make it more likely. The valves do not repair themselves, and no tablet or cream restores them.

The examination is done standing, since the veins only fill against gravity. A surgeon looks at the pattern of the veins down the leg and at the state of the skin around the ankle, which is what shows how long the pressure has been raised.

The test that decides everything is a duplex ultrasound, again standing. It follows each trunk vein, measures how long blood takes to fall back when the calf is squeezed and released, and maps exactly which segments have failed and which are still competent.

Any plan is built on that map, since treating the surface veins while the failing trunk above them is left alone leads straight back to where you started.

Treatments that close the vein from within are day procedures, and walking immediately afterwards is part of the treatment.

You wear a compression stocking for one to two weeks and walk for half an hour or more each day. The treated vein can be felt as a firm tender cord along the thigh for two to three weeks while it scars down and is absorbed, and that is expected.

Office work resumes within a day or two. Long-haul flights and heavy gym work wait a fortnight. The leg tends to look worse before it looks better, with bruising along the line of the vein that clears over a month.