The term "varicose veins" has nothing to do with a cramp, but with the Old High German word for bending.
With varicose veins, the superficial veins are visible under the skin as curved, tortuous blood vessels. Varicose veins most commonly occur in the legs, but varicose veins can also develop in the abdominal area and in men in the testicular area (so-called varicoceles).
The overloaded vessels not only become visible in the form of varicose veins, but are usually also accompanied by symptoms. The following symptoms are typical:
- Pain in the legs
- Legs may feel heavy, tight and itchy
- Calf cramps, especially at night
- Brownish discoloration and hardening of the skin, especially on the shins
The symptoms often worsen in warm temperatures and in the evening, as well as in women before menstruation.

Varicose veins appear as visible thickenings under the skin © zlikovec / Fotolia
The veins transport blood from the blood vessels back to the heart. This process demands a great deal of strength from the veins in the legs in particular, as they have to transport the blood against the force of gravity.
Breathing as well as foot and leg muscles serve as natural pumps. The muscles compress the veins during movement so that the blood reaches the heart. Each vein also has dozens of venous valves that prevent the blood from flowing back into the vein when the muscles relax. The venous valves therefore act as valves.
Varicose veins occur when the veins are overloaded and the venous valves no longer function properly. This causes the blood to back up in the vessels. As a result, the congestion expands the veins and makes them visible under the skin. Varicose veins are therefore the visible sign of venous insufficiency.
There are many causes for the development of varicose veins:
- hereditary predisposition to weak veins
- Lack of exercise and generally predominantly standing or sitting activities without variety
- being overweight
- smoking
- Pregnancy (higher weight and hormonal changes)
The hormone oestrogen is generally associated with venous disorders. It is therefore not advisable to take the contraceptive pill after the age of 30.
If the above-mentioned signs of varicose veins occur, you should consult a vein expert (phlebologist) or vascular expert (angiologist). The earlier varicose vein treatment begins, the more likely it is that the disease will not get worse.
To diagnose varicose veins, the doctor will first carry out a physical examination. Varicose veins usually occur on the legs, especially the lower legs. The expert will therefore first look at the legs and feel them for any abnormalities. This examination is carried out while standing, sitting or lying down.
Various methods are available for a more detailed examination of the veins. These include color ultrasound (color-coded duplex sonography). This gives the doctor an insight into the veins. This allows him to see whether and where the blood is actually pooling.
If the deeper leg veins are affected by varicose veins, the doctor will also use phlebography to make a diagnosis. This is an X-ray examination using a contrast medium. A contrast agent is injected into the patient's dorsal vein under local anesthetic. It makes all leg veins visible, which can then be examined for varicose veins.
Phlebography is generally only used to diagnose varicose veins if the leg veins are difficult to reach or deeper.
With the help of light reflection rheography (LRR) or photoplethysmography, it is possible to check the pumping function of the leg veins. A measuring device sends infrared rays to the affected areas and the red blood pigment in the vein reflects the infrared light through the skin.
If the patient performs simple movements of the leg, the veins empty due to muscle tension and then refill when the muscles relax. The fluctuations in vein volume lead to changes in the reflection of the infrared light, which are then analyzed. This allows the expert to draw conclusions about the refilling time of the vein.
The shorter the refill time, the more damaged the vessel is. The refill time is normally 25 seconds.
Although varicose veins cannot be cured, the right therapy can counteract a worsening of varicose veins. Relief is also possible.
If varicose veins remain untreated, permanent symptoms can occur. These include
- severe leg swelling
- Reddened and painful veins that feel warm to the touch
- bleeding
- ulcers
- open wounds ("open leg")
- thrombosis
Medicine offers those affected various treatment options for varicose veins. These include
- Treatment with compression stockings(compression therapy),
- various sclerotherapy procedures including laser therapy and
- surgical methods.
For optimal treatment of vein problems, consult a phlebologist.
Compression therapy is carried out with the help of compression stockings, which exert targeted pressure on the veins. They extend from the ankle over the knee joints to the thighs.
The pressure on the damaged, dilated veins can reduce the diameter of the veins. This also causes the venous valves to close better. As a result, the blood flow in the legs improves.
The pressure exerted by compression stockings is greatest at the ankle and decreases towards the thigh. For this reason, compression stockings should not be confused with support stockings, which distribute much less pressure evenly over the leg.
Compression stockings are adapted to the patient's needs and made to measure. There are different compression classes or strengths depending on the severity of the varicose veins. The stockings must be replaced after six months at the latest.
However, compression stockings only alleviate the varicose veins, the actual problem remains.

How compression stockings work on the veins © antaya / Fotolia
Sclerotherapy is used for lighter varicose veins. The doctor injects a liquid or foam into the patient's veins, which artificially causes inflammation of the veins. The vein walls stick together and slowly break down as a result, so that surgery is not necessary.
Modern procedures use microfoam, which can be applied precisely to the desired area of the vein under ultrasound guidance.
Compression stockings must then be worn to promote the breakdown of the sclerosed veins. A lot of exercise is also necessary to stimulate the blood flow in the remaining veins.
The procedure is performed on an outpatient basis and under local anesthesia. It can be repeated as often as required, which is usually necessary to achieve solid results in the long term.
Laser therapy is also a varicose vein treatment that leads to the obliteration of the vessels. The doctor inserts a laser probe into the vessel via a small incision and uses it to generate targeted heat. This heats the blood and is transferred to the vessel wall, causing it to stick together.
The vein then slowly breaks down and, as with sclerotherapy, does not need to be removed.
Medical lasers are precisely matched to their intended use so that treatment can be carried out with pinpoint accuracy. Laser therapy for varicose vein removal is then painless and produces impressive results.
Laser therapy is usually performed on an outpatient basis and under local anesthetic. After the procedure, the patient must wear compression stockings for around four weeks.
In contrast to sclerotherapy and laser therapy, varicose veins are completely removed in a surgical procedure. Varicose vein operations are generally used to treat varicose veins in the large veins (truncal veins).
This varicose vein therapy is particularly recommended for complications such as an "open leg", severe pain or inflammation. The most frequently used varicose vein operations include
During stripping , the varicose veins are removed from the leg using a probe inserted into the veins. The doctor inserts the small, flexible probe into the vessel via an incision in the groin, where it ties itself into a knot. The doctor then pulls the vein out of the leg.
In the case of partial stripping, only the pathologically altered part of the vessel is removed, while the healthy part remains intact. Different types of probes can be used, such as a Babcock probe (Babock operation) or a cryoprobe (cryostripping).
During a crossectomy, the connections between the superficial and deeper vein systems are severed. This procedure often takes place before stripping or partial stripping. The doctor can then use partial stripping to remove only the pathologically altered part of the vein from the leg.
A phlebectomy is mainly used to remove smaller side branches of larger vessels. The doctor makes micro-incisions (1 - 2 mm) along the affected veins and inserts a small hook into the subcutaneous fatty tissue. The expert uses this to pull out the diseased vein and remove it piece by piece.
He then closes the incision with a fine suture, a strip of plaster or a skin adhesive.
Further information on varicose vein treatment can be found in the linked specialist article Varicose vein treatment - with foam, light or steel?
As a rule, varicose veins cannot be prevented. However, you can still do something for your vein health and thus reduce the risk of the disease:
- Exercise: especially endurance sports such as jogging, cycling, swimming
- give up smoking
- Reduce excess weight
- Avoid standing or sitting for long periods of time
- Alternate showers to improve blood circulation in the legs
- Avoid wearing high heels
- Eat a high-fiber diet with reduced sugar and fat content