varicose veins ultrasound explained

Overview

Varicose veins are swollen, twisted veins that usually appear on the legs. An ultrasound is a safe and painless test that uses sound waves to create pictures of the veins inside your body. It helps doctors see how blood flows and check for problems such as damaged valves or blood clots.

Yes, varicose veins are very common, especially in women and as people get older.

Varicose veins can affect anyone, but they are more common in women, people over 50, those who are pregnant, and individuals who stand or sit for long periods.

Symptoms

Common symptoms

• Visible swollen, blue or dark purple veins
• Aching, heavy, or tired legs
• Swelling in the ankles and feet
• Itching around the veins
• Muscle cramps in the legs, especially at night

Symptoms in children

• Varicose veins are uncommon in children. When they do occur, symptoms are usually the same as in adults, but less severe.

Symptoms in older adults

• For older adults, symptoms are the same as general common symptoms, but there is a higher risk of skin changes, ulcers, and bleeding from fragile veins.

Causes

Main causes

• Weakened or damaged valves inside the veins that allow blood to pool and stretch the vein walls.

Risk factors

• Age (getting older)
• Family history of varicose veins
• Pregnancy
• Hormonal changes (such as menopause)
• Being overweight or obese
• Long periods of standing or sitting
• Lack of exercise

When to see a doctor

See a doctor urgently if:

• If you have sudden swelling, redness, warmth, and pain in one leg (possible DVT)
• If a varicose vein bleeds heavily and does not stop with pressure

Book a routine appointment if:

• If you have bothersome symptoms like aching, swelling, or tired legs that affect daily life
• If you notice skin changes, such as discolouration or ulcers
• If you are worried about the appearance of your veins

Diagnosis

Varicose veins are usually diagnosed during a physical exam. A duplex ultrasound scan is the main test used to confirm the diagnosis and check how well your veins are working.

Tests that may be done

• Physical examination: The doctor looks at your legs while you stand, feels the veins, and checks for swelling or skin changes.
• Duplex ultrasound (venous ultrasound): This painless test uses sound waves to create moving images of your veins and measure blood flow. It shows if valves are damaged or if there are blood clots.

What to expect at your appointment

During the ultrasound, you will lie on a bed with your leg exposed. The technologist applies a cool gel to your leg and moves a small handheld device (transducer) over the skin. You may be asked to stand or change positions so the doctor can see how blood flows. The test takes about 30 to 45 minutes and does not hurt. After the test, you can go back to your normal activities. Your doctor will discuss the results and possible next steps with you.

Treatment

Treatment aims to relieve symptoms, prevent complications, and improve the appearance of your legs. Options range from simple self-care to medical procedures. A specialist will help you choose what is right for you.

Self-care at home

• Elevate your legs above heart level for 15–20 minutes several times a day
• Avoid standing or sitting for long periods – walk around every 30 minutes
• Exercise regularly, especially walking, to improve blood flow
• Maintain a healthy weight to reduce pressure on your veins
• Wear compression stockings if prescribed by your doctor

Medical treatments

Medical treatments include procedures such as endovenous laser treatment (EVLA), radiofrequency ablation (RFA), sclerotherapy (injection of a solution to close the vein), and phlebectomy (removal through small cuts). These are done by a specialist and often use local anaesthetic. Your doctor will explain which treatment may work best for your condition.

When is surgery considered?

Surgery (such as vein stripping) is less common nowadays, but may be recommended for very large or complicated varicose veins that do not respond to other treatments.

Living with this condition

You can live well with varicose veins by taking simple steps to care for your legs and watching for changes.

Lifestyle tips

• Wear compression stockings as advised by your doctor
• Elevate your legs when resting, especially after long periods of standing
• Avoid tight clothing around your waist, groin, or legs
• Stay active with low-impact exercise like walking or swimming

Diet and exercise

A healthy diet rich in fibre (fruits, vegetables, whole grains) and low in salt helps prevent swelling and constipation. Regular physical activity, especially walking, keeps blood moving and strengthens your calf muscles, which help pump blood upward.

Mental health and emotional wellbeing

Varicose veins can affect how you feel about your body and may cause worry or embarrassment. It is normal to feel this way. Talking to your doctor or a trusted person can help. Remember that treatment is available and most people manage well with simple steps.

Prevention

You cannot always prevent varicose veins, especially if they run in your family. But you can lower your risk by staying active, maintaining a healthy weight, eating a high-fibre diet, avoiding long periods of sitting or standing, and wearing compression stockings if recommended (for example, during pregnancy or long flights).

Complications

If left untreated

• Chronic leg swelling
• Skin discolouration and hardening
• Leg ulcers (non-healing sores)
• Bleeding from a burst varicose vein
• Inflammation of the vein (phlebitis)
• Blood clots (deep vein thrombosis)

Long-term outlook

With proper care and treatment, most people with varicose veins experience significant improvement in symptoms and quality of life. Serious complications are rare, and many people manage well with simple self-care and regular check-ups. There is a lot you can do to keep your legs healthy.

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