QA On Vein Symptoms – Aching Legs

with Dr. James L. Johnson, II Board Certified General Surgeon

My legs ache. Could it be my veins?

Yes! Leg pain or aching is a very common symptom of bad veins, aka chronic venous disease. Chronic venous insufficiency occurs when veins dilate preventing the valves in the veins from working right, and blood is allowed to flow towards the feet instead of the heart. Leg pain from bad veins is commonly described as an aching pain that is worse at the end of the day. It can be in one spot or all over the leg. However, leg pain from chronic venous insufficiency can be throbbing, a heaviness, sharp or burning. It can also occur all day or just part of the day.

How do bad veins make my legs hurt?

Veins are like a river system. They bring blood from small veins in the feet, to the bigger superficial veins, then to the biggest river, the deep veins. Blood flows from the deep veins to the heart. Veins, unlike arteries, have valves. These valves make sure blood flows in one direction, towards the heart. For various reasons, veins dilate and the valves get pulled apart. Then blood is allowed to flow in the wrong direction, away from the heart. This is called venous reflux. Eventually, the veins dilate enough that blood seeps out of the vein into the surrounding tissue (muscle, skin, fat, nerves, etc.). The oxygen poor blood in veins is irritating to the surrounding tissue and makes the legs hurt.

What are other symptoms of vein problems?

Bad veins can cause many symptoms. These symptoms are not limited to but include: leg tiredness, fatigue, cramping, restlessness, itching, swellings, change in skin color, varicose veins, spider veins and skin sores. Most of these symptoms tend to be worse at the end of the day or after sitting or standing for a long time. People with bad veins can have none or all of these symptoms.

What causes veins to go “bad”?

The most common cause of bad veins is genetics. If one parent has bad veins there is a 70% chance the children will have bad veins. If both parents have bad veins there is a 90% chance the children will have bad veins. Therefore, many people have a strong familial cause for the veins to stretch, dilate and not work right. Other causes include deep vein clots, any leg trauma, advancing age, jobs that require prolonged sitting or standing, obesity, sedentary life style and in women, pregnancy.

How do I know if I have bad veins?

Many, but not all, people with bad veins have varicose or spider veins on the legs. Some people have symptoms of bad veins but no blue veins showing on their legs. The best way to determine if leg pain is from bad veins is to perform a dedicated vein mapping. This is a painless ultrasound of the legs to measure vein size and more importantly if the vein blood goes in the wrong direction, or refluxes.

What can I do to make my legs stop hurting?

If the leg pain is caused by bad veins, there are many treatment options. Compression stockings, exercise, leg elevation, pointing and extending the foot, walking, warm soaks, ice, ibuprofen and/or Tylenol can help. Although these may make the symptoms better for a short time, they do not fix the bad veins. More permanent treatment of bad veins include minimally invasive outpatient procedures. These include closing the bad vein, to force the body use only the good veins, with heat or medicine.

For additional information on Chronic Venous Disease and its treatments, please visit:

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