Living with bulging, achy or heavy legs can make everyday activities uncomfortable. Spending long hours standing or sitting may increase your risk of varicose veins – the visible veins that can leave your legs tired or sore.
Varicose veins are common, affecting about 23% of American adults. Usually more cosmetic than medical, they can still impact how you feel day to day.
“Varicose veins are more likely if your job keeps you on your feet most of the day,” says Alex Westerband, MD, a Scottsdale-based vascular surgeon and independent member of the HonorHealth Medical Staff. “Sitting too long can also affect your veins, causing them to enlarge or even increasing the risk of blood clots. Move around regularly, and when seated, elevate your legs on a stool or cushion if you can.”
How varicose veins form
Tiny valves inside the veins in your legs help blood flow back to your heart. Over time, these valves can weaken or become damaged from standing, sitting or other risk factors. When the valves fail, blood can pool in the veins, causing swelling and the bulging appearance of varicose veins. In some cases, skin changes or ulcers can develop.
Common risk factors
- Family history: Raises your chances, though it’s not a certainty.
- Age: Most people who develop varicose veins are 40–80.
- Gender: Women are more likely than men to develop them.
- Pregnancy or obesity: Extra weight puts more pressure on your legs.
- Crossing your legs: Doesn’t cause varicose veins but can worsen symptoms.
- Leg trauma: Injuries can damage veins or their valves.
Symptoms to watch for
- Veins that bulge or look ropey under the skin
- Legs that feel heavy, achy or itchy, especially after standing
- Nighttime leg cramps or pain when standing
Spider veins
Spider veins are tiny, superficial veins that usually present a cosmetic concern rather than a medical one.
When to seek treatment
Contact your doctor if you notice:
- Swelling, discoloration, inflammation or breaks in the skin
- Worsening leg pain or cramping
- Veins that bleed and don’t stop with elevation and pressure
- Chest pain or difficulty breathing, which could signal a serious blood clot
- Painful veins that interfere with your daily life
Treatment options
“Support hose help keep veins supported, relieve symptoms and can slow progression, though they won’t change your genetics or hormones,” Dr. Westerband says.
Other treatments include:
- Compression stockings: Improve blood flow by gently squeezing the legs.
- Leg elevation: Helps reduce pressure and swelling.
- Minimally invasive procedures: Catheter ablation uses radiofrequency or laser energy to close problem veins. Chemical ablation is another option.
- Superficial cosmetic procedures: Surface lasers or injections can improve appearance.
“Our goal is to stop abnormal circulation in affected veins, prevent swelling or skin changes and help you feel like your best self again,” Dr. Westerband says.
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