“How do I know if I need varicose vein treatment?”  If you have pain, swelling, heaviness or achiness in your legs, ankles, or pelvis you may have varicose veins (venous insufficiency.) Typically, those with varicose veins also suffer from pain and achiness while sitting, standing or walking for long periods of time. You may experience the achiness and pain in the evening or when you are laying down in bed for the night. The pain and achiness may be something that you experience occasionally or on a daily basis. The use of Ibuprofen and Tylenol may give you some relief of the pain and achiness. Venous insufficiency is a disease and should be treated by professionals who specialize in comprehensive varicose vein management including diagnosis and treatment.