Five Star Vein and Wellness Blog

Why Do My Legs Ache, Swell, and Look Ugly?

Posted by Robert W. Ruess MD | Jun 6, 2013 5:02:59 PM

Varicose veins and other vein conditions don’t always manifest the same symptoms. For example, you and a friend may both suffer from seemingly similar spider veins. Nonetheless, your friend may not experience the same pain that you feel on a regular basis.

Let’s look at some of the explanations behind such differences.

What Causes Vein Problems?

Very simply, almost all vein problems have only 2 main causes: 1- What you were born with; in other words, “How tough are your veins?” and 2: Gravity.

Blood that supplies oxygen and nutrients to your feet [in the arteries] has to return to the heart in order to complete the circulation. It does this from the day you are born. And the earth’s gravity tries to force the blood to the earth since the day you were born.

The main reason that the blood in the veins can return to the heart is that there are a series of one-way valves in our veins that prevent the blood from going backwards [toward the earth]. Unfortunately, over time, gravity’s pressure can breakdown the valves and render them incompetent. Once this happens the blood can run backwards. This results in an increased pressure in the system. It is this increased pressure that leads to varicose veins and the other problems of venous disease.

Effects of Improper Vein Blood Flow

As you might imagine, an increase in pressure in the venous system can create swollen, dilated, tortuous veins—these are called “varicose veins”. When the walls get stretched enough, patients can have varying amounts of aching and pain. When the pressure gets high enough, fluid can get pushed out into the tissues, resulting in swelling that typically gets worse as the day wears on.

Microscopic amounts of tiny red blood cells can be pushed out of the circulation and into the tissues where they breakdown forming brownish spots or discoloration [No these are not age spots that you automatically get as you grow older].

Over time the high pressure + swelling causes dysfunction at the cellular level and the skin breaks down and painful ulcers occur. If the veins get dilated enough, the blood begins to move more and more slowly and blood clots can occur. There are other symptoms that can occur as well; e.g. fatigue, restless legs, and night cramps.

What Should I Do If I am Worried About My Veins?

Interestingly, not all those who have large, dilated, swollen veins have symptoms. Nevertheless, these symptom-free patients DO have high pressure in their veins [Venous Hypertension]. So in spite of being pain-free, the forces that are at work in their veins are, in time, going to result in swelling, ulceration, blood clots, and destruction of the valves in the deep venous system [which can’t be repaired].

The bottom line: if you recognize that you might have a vein problem you should seek out a vein specialist. Now that you recognize what is going on, you should do this regardless of whether you have symptoms or not.

How to find a vein expert? That is a completely different subject, as there are many self-appointed vein experts out there.  The best way to find a vein expert is to go to: and click on the find a Board Certified Physician.

Schedule your appointment with vein specialist Robert Ruess, MD of Five Star Vein Institute. Visit for sockets more information.

Topics: Dr. Robert W. Ruess, Five Star Vein Institute, Leg Pain, Vein Health, Spider Veins, Telangiectasia, Varicose Veins

Written by Robert W. Ruess MD