Varicose Veins: Symptoms, Causes and Treatment Options

Varicose veins are enlarged, twisted veins most often in the legs. “In healthy veins, blood only goes up in one direction,” says Laura Garvey, MD, vascular surgeon at Emory Healthcare. “There are multiple one-way valves along the course of a vein that prevent the blood from leaking back down. A varicose vein is one where the wall and the valve has been damaged, so now blood can run back down. The veins don't empty properly, so you get pooling and bulging veins on the leg.”

Varicose veins that you see on the surface are usually a sign of a deeper problem. While these bulging veins are visible, they are often caused by a larger vein underneath the skin that isn’t working properly. When the valves in that deeper vein fail, blood flows backward and creates pressure that shows up as varicose veins on the surface.

That’s why an ultrasound is important — it helps identify the root cause, not just what you can see. Think of it like a tree: the visible veins are the branches, but the problem often starts in the trunk below the surface. Treating that deeper vein is key to fixing the issue.

It’s important to see a specialist when varicose veins start to affect your quality of life or appear to worsen visually.

While many people think varicose veins are just a cosmetic issue, untreated vein disease can become an underlying problem. “If pressure continues to build, it can lead to skin changes or even ulcers near the ankle,” Dr. Garvey says.

Signs it’s time to see a varicose vein specialist:

• Persistent leg swelling
• Daily heaviness or fatigue
• Skin discoloration around the ankle
• Non-healing wounds
• Large, bulging veins

Michael managed his symptoms for years. After work, he elevated his legs. He wore compression socks. He stayed active. But the fatigue and swelling persisted.

“I’d come home and just need to get off my feet,” he says.

His physician had circulation concerns and referred Michael for further evaluation. Because of prior care at Emory, Michael chose to return — this time to see Dr. Garvey at the Emory Vein Center. Patients across metro Atlanta turn to the Emory Vein Center for advanced, minimally invasive vein care.

For Michael, Dr. Garvey recommended radiofrequency ablation, a minimally invasive procedure that closes the damaged vein. “It’s done in the office. Patients walk in and walk out,” says Dr. Garvey.

Michael even watched the procedure on the ultrasound screen. “It was fascinating,” he says. “I could see exactly what was happening.”

Michael’s treatment took about four weeks, with minimal disruption to his routine. “I went back to work the next day each time,” he says.

The biggest change? How his legs feel now. “I have so much more energy,” he says. “The swelling and fatigue are gone.”

Today, he still takes preventive steps — like wearing compression socks — but his daily discomfort has improved dramatically. “I feel the difference every day,” he says.

Varicose veins are common — but they don’t have to be something you live with. With today’s minimally invasive vein treatments, patients can find relief from symptoms like swelling, fatigue and discomfort — often with little downtime.

For Michael, getting treatment meant more than improving how his legs looked. It meant getting back to feeling like himself again.