What are the biggest misconceptions about vein disease?

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Blog Misconceptions About Vein Disease

Medically reviewed by Dr. Peter Pappas on June 27, 2024

Vein disease describes a range of disorders that impact the veins in our circulatory system. The result of a progressive condition called chronic venous insufficiency (CVI), these weak, damaged leg veins have trouble returning blood to the heart, causing blood to pool and settle in the lower extremities.

These vein problems can manifest themselves as tired, heavy, achy legs, large, bulging varicose veins, skin discoloration, leg swelling, and, in worst-case scenarios, a venous leg ulcer.

Even though vein conditions are common (about 150,000 people are diagnosed with CVI each year, according to WebMD), there's a lot of misinformation about venous health. These myths can cause confusion and make it harder for people to recognize the signs, hindering the diagnosis and treatment of these issues.

For this blog, we had the privilege of interviewing Dr. Peter J. Pappas, a renowned vascular surgeon and Director of the Venous and Lymphatic Medicine (VLM) Fellowship Program at Center for Vein Restoration (CVR). CVR’s VLM fellowship is the largest graduate medical education training program in the country and is regulated under the auspices of the American Board of Venous and Lymphatic Medicine (ABVLM). Dr. Pappas is a national leader in venous medicine and a pioneer of minimally invasive treatments for chronic venous insufficiency, which have significantly enhanced patient outcomes.

What is the number one misconception about vein disease?

Dr. Peter Pappas: “People come into my office with cosmetic spider and reticular veins and think it's the cause of their leg symptoms. I want to make something very clear right now. Spider veins do not cause symptoms at all. They're usually associated with the problem underneath the spider veins.

Muscles and bones, not veins, cause ninety percent of leg pain in people without varicose veins. This is why many people come to me with injuries like sciatica and hamstring problems. In fact, I see about five or six patients a day who have a muscle or bone problem that was never correctly diagnosed, and they were never given instructions on how to treat it.

“As a leg pain doctor, I spend a lot of time educating patients on what is actually causing their leg pain and then telling them what they need to do to fix it. The astonishment on their faces is priceless! First, they're extraordinarily happy that somebody correctly diagnosed them and even happier that somebody told them what they can do about it. When they come back for follow-up visits, they're extraordinarily happy because their pain is gone, and they feel better. But 90% of leg pain patients that I evaluate have musculoskeletal pain, unrelated to vein disease.”
-Dr. Peter Pappas

Early intervention by a board-certified vein specialist can significantly improve the outcome of venous disease symptoms.

The correlation between weight and leg symptoms

Dr. Peter Pappas: “Most people don't understand the correlation between their weight and their leg problems. Patients know they're overweight, but they don't realize that that's what is causing their pain. I have long discussions with people regarding ways to achieve weight loss that don't necessarily involve bariatric surgery because most patients don't want surgery.

Once they lose that first 5 to 10 pounds, that's it; they're hooked, and they'll move on and lose the rest. After talking to me, about 10 percent to 15 percent go on to achieve their weight loss goals. It may seem like a low percentage, but that's 10 percent to 15 percent that wouldn't have done it had we not had the conversation. These are life-altering conversations. They get rid of their weight, and their pain is gone. Then, they start managing their overall health better.”

"So, you think, 'Why the hell is a vein doctor telling people about general overall health issues? Because patients come in with leg pain and don't know what the cause is. I can point them in the right direction.'” –Dr. Peter Pappas

Eight additional misconceptions about vein disease

  1. Venous disease is just a cosmetic issue
    One of the most common misconceptions is that venous disease is only an aesthetic concern. While varicose veins and spider veins can negatively affect the appearance of one’s legs, the underlying venous insufficiency can lead to significant health problems. Chronic venous insufficiency can cause symptoms such as tiredness, heavy, achy legs, pain, swelling, skin changes, restless leg syndrome, or nighttime leg cramps.
    Complications of untreated vein disease aren't just a bother; they could become serious health risks that shouldn’t be underestimated—and can result in severe complications such as venous leg ulcers and deep vein thrombosis (DVT).
  2. Only older adults get venous disease
    While the risk of venous disease increases with age, it is not exclusive to older adults. Young people, including athletes, can also develop varicose veins and other vein conditions. Factors such as genetics, pregnancy, obesity, prolonged standing or sitting, and a sedentary lifestyle can contribute to the development of venous disease at any age. For instance, pregnant women often experience increased venous pressure due to hormonal changes and the growing uterus, which can lead to varicose veins of the legs or vulvar varicose veins.
  3. Varicose veins are always visible
    Another misconception is that varicose veins are always visible on the surface of the skin. While many varicose veins are visible as bulging, twisted veins, others can be deeper and not visible externally. According to Dr. Pappas, these hidden deeper veins can cause swelling or aching throughout the leg, but more importantly, they can also increase your chance of developing blood clots. Diagnostic tools like duplex ultrasound are essential for detecting and assessing these deeper veins.
  4. Exercise makes varicose veins worse
    Many people believe that physical activity can worsen varicose veins, leading them to avoid exercise. In reality, regular exercise is beneficial for venous health. According toDr. Pappas, activities such as walking, swimming, yoga, cycling, or even simple calf raises improve circulation and can help prevent the progression of venous disease. These exercises strengthen the calf muscles, which act as a pump to help blood return to the heart, reducing venous pressure.
    While activities involving high-impact movement or heavy weightlifting do not cause varicose veins, the strain on the vena cava, a large vein in the abdomen that pumps blood back to the heart, could make vein bulging worse.
  5. Crossing your legs causes varicose veins
    Crossing your legs or wearing tight clothing is not a direct cause of varicose veins. External pressure from crossing your legs is minimal and unlikely to damage healthy veins. Prolonged periods of standing or sitting are well-established risk factors, and genetic predisposition and hormonal fluctuations do contribute to venous insufficiency. It's important to note that for individuals already experiencing varicose veins, crossing their legs may temporarily impede blood flow and exacerbate discomfort.
  6. Invasive surgery is the only treatment option
    Many individuals assume that invasive surgery, such as vein stripping, is the only way to treat varicose veins. Today’s advanced treatment options are safe, effective, and performed as outpatient procedures. They allow patients to return to normal activities immediately with fewer restrictions than traditional surgery. Vein stripping is rarely performed today, given the number of treatment options currently available.

Minimally invasive treatment options include:

7. Compression stockings cure venous disease
Compression stockings are often prescribed to manage symptoms of venous disease, but they do not cure the condition. These unique socks help by improving blood flow and reducing swelling and discomfort; however, they do not address the underlying cause: venous insufficiency.

Ultimately, minimally invasive treatments to close or remove the problem veins are usually necessary to provide lasting relief from problem veins.

8. Venous disease cannot be prevented
This statement is actually partially true. Studies are clear that genetics, advanced age, and being female—all unavoidable circumstances—are leading causes of vein disease. However, lifestyle changes can reduce the risk or slow the condition's progression. Maintaining a healthy weight, engaging in regular physical activity, avoiding prolonged periods of standing or sitting, elevating the legs, and wearing compression stockings can all help improve venous health.

    Beyond Misconceptions: Taking Charge of Venous Disease

    Center for Vein Restoration (CVR), America's largest physician-led vein center, boasts a 98 percent patient satisfaction rating and a team of 70+ active physicians nationwide with extensive experience treating chronic venous insufficiency. CVR prioritizes accessible and compassionate vein treatment and accepts various insurance, including Medicare and Medicaid.

    Scheduling a consultation with a CVR vein specialist is easy: Call 240-965-3915 to speak to a Patient Services Representative or book your appointment online at a CVR vein clinic location near you today.

    Find CVR Near You