Normal veins bring blood from the extremities back to the heart. The valves in these veins must close properly so that blood travels in the right direction. If these valves become damaged or weak and do not close properly, the blood moves backwards down the leg (called venous reflux), causing an abnormally high volume and pressure of blood to build up in the veins. The veins cannot tolerate the high pressure of this additional blood, so they expand and begin to dilate and protrude. When they bulge against the skin surface, they are called varicose veins and frequently have a tortuous or worm-like appearance.
Patients seen by vein specialists typically have symptomatic veins. Most often, symptomatic veins include both the varicose veins and the underlying “feeding” vein (great and small saphenous veins.) These feeding veins may be the true cause of the bluish, dilated, swollen varicose vein. The backward flow of these refluxing veins also result in the achiness, leg fatigue, restless leg sensations and the many other common symptoms in vein diesease.