Varicose veins are twisted, enlarged veins. Any superficial vein may become varicosed, but the veins most commonly affected are those in your legs. That's because standing and walking upright increases the pressure in the veins of your lower body. For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.Treatment may involve self-care measures or procedures by your doctor to close or remove veins.

Medical treatment may include:

• Elevation of the legs. You may be instructed to elevate your feet above the level of your heart 3 or 4 times a day for about 15 minutes at a time. If you need to sit or stand for a long period of time, flexing (bending) your legs occasionally can help keep blood circulating. If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and relieve other symptoms.

• Compression stockings. These elastic stockings squeeze the veins and prevent blood from pooling. Compression stockings can be effective if they are worn every day.

• Sclerotherapy. Sclerotherapy is the most common treatment for both spider and varicose veins. A salt (saline) or chemical solution is injected into the varicose veins. They no longer carry blood. And, other veins take over.

• Thermal ablation. Lasers or radiofrequency energy may be used to treat varicose veins. A tiny fiber is inserted into a varicose vein through a catheter. The laser or radiofrequency energy is used to deliver heat that destroys the wall of the varicose vein.

• Vein stripping. Lasers or radiofrequency energy may be used to treat varicose veins. A tiny fiber is inserted into a varicose vein through a catheter. The laser or radiofrequency energy is used to deliver heat that destroys the wall of the varicose vein.

• Microphlebectomy. Special tools inserted through small cuts (incisions) are used to remove varicose veins. It may be done alone or with vein stripping.

What is chronic venous insufficiency? Chronic venous insufficiency occurs when your leg veins don’t allow blood to flow back up to your heart. Normally, the valves in your veins make sure that blood flows toward your heart. But when these valves don’t work well, blood can also flow backwards. This can cause blood to collect (pool) in your legs.

How is chronic venous insufficiency diagnosed?

Your provider will take your medical history and give you an exam. You may also have an imaging test called a Duplex ultrasound. This looks at blood flow and the structure of your leg veins. It checks the speed and direction of blood flow in the blood vessel.

Medical treatment may include:

• Improving blood flow in your leg veins. Keeping your legs raised (elevated) can reduce swelling and help increase blood flow. Wearing compression stockings may also help. Regular exercise can also improve blood flow.

• Medicines. Medicines that increase blood flow through the vessels may be used along with compression therapy to help heal leg ulcers. Aspirin can also be used to help ulcers heal. Medicines that draw excess fluid from the body through the kidneys (diuretics) are not often used. But they may be used if other conditions such as heart failure or kidney disease are also linked to the swelling.

• Endovenous laser ablation or radiofrequency ablation (RFA). This is a minimally invasive procedure. A tube (catheter) puts heat right into the affected vein. This closes the vein. Once the vein is closed, less blood pools in the leg. Overall blood flow is improved.

• Sclerotherapy.This may be used if your case is more serious. A chemical is injected into the affected veins. The chemical causes scarring in the veins so that they can no longer carry blood. Blood then returns to the heart through other veins. The body absorbs the scarred veins.

• Vein strippingLasers or radiofrequency energy may be used to treat varicose veins. A tiny fiber is inserted into a varicose vein through a catheter. The laser or radiofrequency energy is used to deliver heat that destroys the wall of the varicose vein.

• Surgery.This is done in severe cases. Ligation is a type of surgery that may be used. The affected vein is tied off so that blood no longer flows through it. If the vein or its valves are heavily damaged, the vein will be removed. This is called vein stripping.