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Why Do Varicose Veins Hurt?

For many, varicose veins are just cosmetic. For others they cause mild, moderate or sometimes severe symptoms. Tender and painful varicose veins may indicate that you have a serious medical complication called phlebitis.

Symptoms of Varicose Veins

Have you ever wondered why your varicose veins cause your legs to ache? If you have varicose veins and they don’t hurt, is that OK? This 5 minute read gives you the answers.

Varicose Veins can cause the legs to feel heavy, to throb and to ache. Varicose Veins can also cause the ankles to swell, the skin to feel tight and to itch

Symptoms are usually worse towards the end of the day, especially after sitting or standing for long periods. Varicose veins can also cause pain, restlessness or cramps in the calf muscles, particularly at night.

In general, warm-weather aggravates the symptoms.

"Symptoms include heaviness, throbbing, itch , restlessness and ache"

Strangely, the appearance of the varicose veins themselves doesn’t always match how bad the symptoms are.

So, for example, some varicose veins may not look very bad, but they may cause quite a great deal of discomfort.

On the flip side, big large lumpy veins may not cause any symptoms at all.

Even stranger, it is possible for you to develop the complications of Varicose Veins without any varicose veins actually being visible at all.

"You can have the symptoms and the complications of Varicose Veins without any varicose veins to see. That's why a vein scan is so important"

So what actually causes varicose veins to hurt? It is now clear that the underlying problem is Superficial Vein Reflux and that people with Varicose Vein Symptoms should have a vein scan, even if there aren’t any varicose veins to be seen.

Superficial Vein Reflux is a progressive condition that inevitably deteriorates and which can cause complications such as phlebitis, varicose eczema and leg ulcers.

"The Real Cause of Varicose Veins Symptoms is Superficial Vein Reflux"

Tender, Hard, Painful Varicose Veins

If your varicose veins actually become hard, painful and tender to the touch, you may have a serious medical complication called superficial vein thrombosis (sometimes referred to as phlebitis, thrombophlebitis or superficial thrombophlebitis – they all mean the same thing).

The cause of  phlebitis is a clot within the vein. The clot leads to inflammation which in turn is responsible for the symptoms of pain and tenderness. 

what does varicose phlebitis look like

 The reason why phlebitis is serious is that the clot may grow and extend into the deep veins causing a deep vein thrombosis (DVT).

Deep vein thrombosis can seriously damage the circulation to your leg and it can cause leg ulcers. The deep vein thrombosis may break off and travel to the lungs (pulmonary embolism).

Self-help Remedies For Varicose Veins Symptoms

There are a number of things you can do for yourself to relieve many of the symptoms of varicose veins:

Avoid standing or sitting for a long period of time. This may be easier said than done. For example, if your job involves sitting at a desk, perhaps working at a computer, it may be difficult for you to avoid sitting for a long time. If that is the case, you may wish to set the timer on your phone to remind you to get up and walk around every 30 minutes or so.

If you work in a shop or as a hairdresser, for example, it may be very difficult for you to sit down and put your feet up. If that is the case, you might wish to perform a set of calf raises every 30 minutes or so. Calf muscle contractions empty the leg veins and ease discomfort.

Keeping Hydrated. Adequate hydration is necessary for a properly functioning circulation. Drinking water throughout the day helps the blood vessels to work efficiently and may help reduce leg cramps and calf muscle aching.

Keep active as much as you can. Regular activity particularly of the calf muscles helps  pump blood out of the leg veins back towards the heart. In this way, the veins are less distended and more comfortable.

Avoid hot baths. Hot baths will cause enlargement of the leg veins with extra blood. The  stretching will aggravate the symptoms of varicose veins.

Between periods of activity put your legs up. When you sit, elevating your legs will help drain the blood from the legs veins back to the heart. Empty veins ache less.

Adopt a healthy lifestyle. By keeping active, watching your weight and eating well (which may be risk factors for varicose veins getting worse), you should keep varicose symptoms under control.

Compression Socks

Medical grade, graduated compression socks are designed to encourage the flow of blood, and many people find that they help their symptoms.

Unfortunately, many people find compression socks difficult to put on and take off.  

 They often feel tight and uncomfortable and for these reasons people often are reluctant to wear them. In addition, medical compression socks are not a permanent solution. 

Referral to a Specialist For Varicose Veins Symptoms

If you have severe symptoms, in line with guidance from the National Institute for Health and Care excellence (NICE), you may wish to consider getting referred to a vascular specialist. Of course, if you have a hard tender lump on your varicose vein then you might have phlebitis and urgent referral is always appropriate.

Accurate diagnosis of varicose veins and their complications requires a duplex ultrasound scan, also referred to as a doppler scan.

A duplex ultrasound scan can confirm the diagnosis of superficial vein reflux and it will distinguish between Superficial Vein Thrombosis (phlebitis) that might lead to a pulmonary embolus and other less serious conditions.

All assessments and treatments should be based on a venous duplex ultrasound scan. 

Treatments for Painful Varicose Veins

It used to be the case that surgical stripping was the only option available to treat superficial vein reflux and varicose veins.

This involved admission to hospital, treatment in an operating theatre under general anaesthetic and major surgical incisions and scars. In our opinion surgical stripping is outdated and should no longer be performed.

There are much better treatments available now which do not involve general anaesthetic and which have better cosmetic results. What’s more, these newer treatments have a much lower risk of the varicose veins returning.

These newer treatments can be performed in a clinic rather than a hospital, on a walk in walk out basis under local anaesthetic.

The recovery after these new treatments is much more comfortable and far quicker.

Most people can return to driving, work and social activities within a few days


  1. Varicose Veins cause ache, throbbing, swelling, itch and restless legs
  2. Severe varicose veins may cause no symptoms
  3. You can have symptoms and complications with no varicose veins
  4. The cause of symptoms and complications is superficial venous reflux
  5. Tender painful lumps need checking for phlebitis
  6. Scans are needed to make a diagnosis

Want to Know More About Varicose Veins Symptoms and Treatments?

If you would like more information about varicose veins, please get in contact and one of our advisors will be happy to help you.