Varicose veins are swollen, twisted, painful veins that have filled with an abnormal collection of blood.

In normal veins, valves in the vein keep blood moving forward toward the heart. With varicose veins, the valves do not function properly, allowing blood to remain in the vein. Pooling of blood in a vein causes it to enlarge.

This process usually occurs in the veins of the legs, although it may occur elsewhere. Varicose veins are common, affecting mostly women.

Causes include congenitally defective valves, thrombophlebitis, and pregnancy. Prolonged standing and increased pressure within the abdomen may increase susceptibility to the development of varicose veins or aggravate the condition.

Primary varicose veins occur because of congenitally defective valves, or without a known cause. Secondary varicose veins occur because of another condition, such as occurs when a pregnant woman develops varicose veins.

• Pain in the legs: fullness, heaviness, aching
• Visible, enlarged veins
• Mild swelling of ankles
• Skin at the ankle discolored brown
• Skin ulcers near the ankle

The diagnosis is based primarily on the characteristic appearance of the legs when the patient is standing or is seated with the legs dangling. At times a physician may order a duplex ultrasound exam of extremity to see blood flow and characterize the vessels, and to rule out other disorders of the legs. Rarely, an angiography of the legs may be performed to rule out other disorders.