Causes and Risk Factors

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Causes of Varicose Veins and Chronic Venous Insufficiency (CVI)

Our legs veins are designed to carry blood back to the heart.  When we are standing, or sitting with our legs down, that blood needs to go up, against the forces of gravity.  In order to help that process, there are one-way valves contained within those veins.  The purpose of those valves is to keep the blood flowing in the correct direction. 

However, for a variety of reasons detailed below, those vein valves can malfunction.  When this happens, the blood pools in the legs. This condition is called venous insufficiency, or venous reflux. In many people, it leads to the development large, unsightly varicose veins and can also cause leg pain, leg fatigue, leg swelling, and other symptoms. 

This is a condition that is known to progressively worsen.  Over time, the pressure in affected veins can increase leading to a more serious condition known as chromic venous insufficiency (CVI.)  CVI is a recognized, progressive medical condition causing the symptoms described below.  

Malfunctioning Vein Valves Causing Venous Reflux



Symptoms of Venous Reflux and Varicoe Veins

 The most common symptoms of varicose veins and venous insufficiency are:

  • Leg pain
  • Leg heaviness and fatigue
  • Leg restlessness
  • Leg swelling
  • Itching of the skin of the legs

In more advanced cases of CVI individuals may experience the following:

  • Discoloration and permanent damage to the skin of the legs
  • Open wounds or sores (venous leg ulcer)
  • Blood clots

    The most common risk factors for varicose veins and chronic venous insufficiency are:

    • Family history of varicose veins or other venous disease
    • Prolonged standing
    • Pregnancy
    • Increasing age
    • Obesity

    A doctor will take a detailed medical history to determine an individual’s risk factors for varicose veins. Physical examination may reveal certain finding or clues to suggest underlying venous reflux. A doppler ultrasound test, known as a venous duplex scan, is a noninvasive painless test that will evaluate the veins for clots, reflux (valve function) and other issues important in making a correct diagnosis and determining proper treatment. Other noninvasive testing may also be used to supplement doppler ultrasound results in certai situations.

    There are excellent, minimally-invasive treatment options for varicose veins and venous insufficiency detailed in the treatment section of this website. In some cases, wearing compression hosiery will be sufficient to relieve the symptoms. However, when stockings are not a practical solution or when cosmetic improvement is desired, minimally-invasive procedures can often be performed. These treatments are performed either in the office or another out-patient setting. Hospitalization is not required. All of the procedures that we perform for the treatment of varicose veins and venous reflux allow individuals to return to their usual activities within about a day.

    Spider veins are the small, purple or red “thread-like” veins seen on the surface of the skin. They may be associated with an early phase of venous insufficiency. The spider veins themselves are often a cosmetic issue. Affected individuals may also experience localized discomfort, itching or a burning sensation associated with them. In some cases, they may also be prone to bleeding, especially associated with shaving one’s legs. Spider veins can be treated with either sclerotherapy, laser, or other treatments minimally-invasive treatment options.

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