Leg veins are equipped with one-way valves designed to prevent blood from flowing backwards in the vein. When those valves no longer function properly because of age, genetic, dysfunction or the distention of the veins, the blood will no longer be sufficiently pushed in the correct direction and can flow backwards (reflux) and pool up in the legs. The accumulated blood causes increased pressure in the veins, forcing them to dilate, bulge and leak fluid into the skin causing leg swelling. The circulatory and skin problems associated with this backup include symptoms identified with varicose veins. Those symptoms are heaviness, swelling, aching, pain, tiredness, burning, itching, throbbing, cramps at night, swelling, discoloration, rashes, blood clots, and even ulcers.
The dysfunctional veins locate underneath your skin and you cannot see them. The bulging veins and/or spider veins seen on your legs are usually a “tip of iceberg” Ultrasound test (DUS) will help to determine which veins have dysfunctional valves and cause blood flowing backwards (reflux).
There are several minimally invasive treatment options for leg veins (Endovenous Thermal Ablation, Ultrasound-guided sclerotherapy, Microphlebectomy, sclerotherapy, etc.). Generally, big veins are treated before smaller ones (spider veins). Think of a broken dam: if the dam is not fixed first, then the connecting streams below will continue to flood. Several sessions of vein treatments are spaced out over time. Your veins did not appear overnight and will not disappear quickly.
Insurance coverage for vein treatment differs greatly. Approval is more likely if you have leg swelling, significant symptoms that affect your quality of life and have tried compression stockings and conservative therapy for several months. Treatments (Sclerotherapy or laser) for spider veins and blue veins are not covered by insurance and are an out-of-pocket expense.