Aching and pain in the legs can be caused by many conditions including Varicose Veins. Most leg pains are caused by wear and tear to the joints, muscles, ligaments or tendons in the leg. Some types of leg pain can be due to lower spine problems or inflammation of nerves (neuropathy) or muscles (myalgia). Leg pain can be caused by blood clots, Varicose Veins, Spider Veins or poor arterial circulation. In some people there can be multiple causes occurring at the same time such as pain in the groin from hip arthritis and also from a faulty Varicose Vein in the groin.
It is important to appreciate that many patients with Varicose Veins have no specific symptoms such as aching or pain. Also the severity of Varicose Veins does not directly correlate with the severity of symptoms that a patient might experience. Some patients with very large Varicose Veins have no symptoms whilst other patients with quite small Varicose or even Spider Veins can have quite severe symptoms such as pain.
It is important to determine if leg pain or aching is due to Varicose Veins, especially if the only reason for considering treatment is to alleviate symptoms. If for example a patient with Varicose Veins requests treatment because of calf pain, but the calf pain is actually due to knee arthritis, then whilst the Varicose Veins might be very effectively removed it would not fix the calf pain.
To help determine if leg pain or aching is due to Varicose Veins the history of the characteristics of the pain or aching are very important:
- Whilst pain from Varicose Veins can occur in both legs typically one leg is more severely affected than the other. Pain in one leg usually indicates a local problem as the presumption is that a systemic illness that might cause leg pain would affect both legs.
- Pain associated with Varicose Veins is usually described as a dull ache rather than sharp or stabbing. It is usual for the aching to vary in intensity over the day tending to worsen towards the end of the day.
- Certain situations and activities are typically associated with making symptoms due to Varicose Veins worse. Prolonged periods of being stationary, either standing or seated, can cause symptoms to increase, thought to be due to the lack of muscular contractions, which are important for promoting blood flow through the legs. Many patients give a history of symptoms being more severe in hot weather, thought to be due to heating of the body which results in a shifting of blood flow to the surface of the skin to dissipate heat. Some women complain of increased symptoms in the premenstrual period, presumably because of increased blood flow and venous congestion.
- Certain situations and activities are typically associated with alleviating symptoms due to Varicose Veins such as elevating the legs, massage and the use of support stockings. All these measures are thought to encourage the return of the blood in the veins back towards the heart.
- Leg aching and pain due to Varicose Veins can be associated with other symptoms of Varicose Veins such as heaviness, burning, throbbing, swelling, tiredness, cramps, restless legs or itchy skin.
In certain situations, even after a thorough history and examination, it may still be unclear whether leg aches or pains are due to Varicose Veins. In this situation a common strategy is to use a ‘Trial of Stockings’. This is where a patient is instructed to strictly wear 20-30 mmHg compression stockings for a period of 2 weeks. Should leg pain and aching improve significantly then it makes it very likely that the symptoms are due to Varicose Veins and that treating the Varicose Veins will result in a similar level of symptom improvement.