varicose veins with fatigue

Overview

Varicose veins are swollen, twisted veins that you can see just under the skin, usually in the legs. They happen when the valves inside the veins weaken, allowing blood to pool and the vein to stretch. Fatigue refers to a heavy, tired feeling in the legs that often comes with varicose veins because blood isn't pumping back to the heart as efficiently.

Yes, varicose veins are very common. Many adults have them, and they become more common with age.

Varicose veins can affect anyone, but they are more common in women, people over 40, those who are pregnant, and people who stand or sit for long periods. Having a family history of varicose veins also increases your chance of getting them.

Symptoms

Common symptoms

• Visible swollen, twisted veins – often blue or dark purple – on the legs.
• A heavy, aching, or tired feeling in the legs, especially after standing or sitting for a long time.
• Mild swelling of the ankles and feet.
• Itching or burning around the veins.
• Muscle cramps in the legs at night.

Symptoms in children

• Varicose veins are rare in children. If a child has them, it may be linked to a genetic condition or previous injury. They may have similar symptoms like visible veins or leg pain.

Symptoms in older adults

• Older adults are more likely to have varicose veins. Symptoms like leg fatigue, swelling, and aching can be more noticeable. The skin over the veins may become thin and easily damaged, increasing the risk of sores or bleeding.

Causes

Main causes

• Weak or damaged valves in the veins. Normally, valves keep blood flowing toward the heart. When they weaken, blood can flow backward and pool, stretching the vein.
• Increased pressure in the leg veins from standing or sitting for long hours, pregnancy, or being overweight.

Risk factors

• Age – valves naturally weaken over time.
• Being female – hormonal changes during pregnancy, menopause, or from birth control pills can weaken vein walls.
• Pregnancy – increased blood volume and pressure from the uterus.
• Family history – varicose veins often run in families.
• Obesity – extra weight puts more pressure on leg veins.
• Job or lifestyle that involves long periods of standing or sitting.
• Previous blood clots or vein surgery.

When to see a doctor

See a doctor urgently if:

• If you have symptoms of a blood clot (DVT): sudden, severe leg pain, swelling, warmth, or redness.
• If a varicose vein bleeds and does not stop with pressure.
• If you have signs of infection: spreading redness, warmth, fever.

Book a routine appointment if:

• If varicose veins cause persistent leg fatigue, pain, or swelling that affects your daily life.
• If you develop skin changes near the veins, like rashes, sores, or thickening.
• If you are worried about the appearance of your veins or they are causing discomfort.

Diagnosis

A doctor can usually diagnose varicose veins by looking at your legs while you are standing. They will ask about your symptoms and medical history. Sometimes they may recommend an ultrasound to check the blood flow and see if the valves are working properly.

Tests that may be done

• Physical exam – the doctor examines your legs visually and feels for any swelling or tenderness.
• Duplex ultrasound – a painless test that uses sound waves to create images of the veins and evaluate blood flow. This is the main test to confirm the diagnosis and assess the severity.

What to expect at your appointment

The exam is simple and usually done in the doctor's office. For the ultrasound, you will lie down while a gel is applied to your leg. A small device is moved over the skin to capture images. The results can help determine if you need treatment and what type might be best.

Treatment

Treatment for varicose veins depends on how severe your symptoms are and whether they affect your quality of life. Many people manage with self-care, but there are medical procedures available if needed. The goal is to relieve symptoms, improve the appearance, and prevent complications.

Self-care at home

• Elevate your legs above heart level for 15–30 minutes several times a day to help blood flow.
• Move and stretch your legs regularly, especially if you sit or stand for long periods.
• Wear compression stockings – these provide gentle pressure to support the veins and reduce swelling and fatigue. You can buy them at many pharmacies or get a prescription from your doctor.
• Exercise regularly – walking, swimming, or cycling helps improve circulation in your legs.
• Maintain a healthy weight to reduce pressure on your veins.

Medical treatments

If self-care isn't enough, your doctor may suggest minimally invasive procedures. These include laser or radiofrequency treatment, where heat is used to close off the affected vein. Another option is sclerotherapy, where a special solution is injected into the vein to make it scar and close. These treatments are usually done in a clinic and have a short recovery time. Your doctor can explain which option might be suitable for you.

When is surgery considered?

Surgery for varicose veins is less common now but may be recommended for very large or complicated veins. Procedures like vein stripping or ligation involve tying off and removing the affected vein. Your doctor will only suggest surgery if other treatments have not worked or are not appropriate.

Living with this condition

Many people with varicose veins live normally with only mild discomfort. Simple habits like taking breaks to walk and elevating your legs can make a big difference. Avoid sitting or standing still for too long. If you have a desk job, try to stand up and move every 30 minutes.

Lifestyle tips

• Stay active – aim for at least 30 minutes of brisk walking most days.
• Avoid tight clothing that restricts blood flow around your waist or legs.
• When resting, put your feet up on a stool or cushion.
• Wear compression stockings during the day if your doctor recommends them.
• Avoid prolonged sun exposure on your legs, as it can damage the skin over varicose veins.

Diet and exercise

A balanced diet rich in fibre can help prevent constipation, which can strain leg veins. Include plenty of fruits, vegetables, whole grains, and lean protein. Drink enough water. Regular exercise like walking, swimming, or cycling helps pump blood through the legs and reduces fatigue. Try to exercise daily, even if only for a short time.

Mental health and emotional wellbeing

Varicose veins can sometimes affect how you feel about your appearance, leading to embarrassment or self-consciousness. Leg pain and fatigue can also be frustrating. It's normal to feel this way. Talking to your doctor about treatment options or joining a support group can help. Remember that many people have them and effective treatments are available.

Prevention

You cannot always prevent varicose veins, especially if you have a family history or other risk factors. However, you can reduce your risk or slow the progression by staying active, maintaining a healthy weight, avoiding long periods of standing or sitting, and elevating your legs when resting.

Screening programmes

There is no routine screening for varicose veins. However, if you have a family history or notice symptoms, it's a good idea to mention it to your doctor during a regular check-up.

Complications

If left untreated

• Mild complications include chronic leg swelling, skin changes (brown discolouration, eczema), and itching.
• More serious complications include leg ulcers (open sores that are slow to heal), phlebitis (inflammation of a vein), and bleeding from a burst varicose vein.
• In rare cases, a blood clot (DVT) can form in a deep vein, which is a medical emergency.

Long-term outlook

For most people, varicose veins are not a serious health problem and symptoms can be managed well with self-care and, if needed, treatment. With proper management, complications are rare. If you have varicose veins, you can still lead an active, comfortable life. Many treatments are very effective and have good outcomes.

Find support

International organisations

• Circulation Foundation

Local organisations

• NHS Health A–Z: Varicose veins ↗ · United Kingdom

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