Vein Health

Understanding Vein Health

What are varicose veins and what are the causes?

Varicose (VAR-i-kos) veins are swollen, twisted veins that you can see just under the surface of the skin. These veins usually occur in the legs.  That's because standing and walking upright increases the pressure in the veins of your lower body. However, they also can form in other parts of your body.

The primary predisposing factor for varicose veins is heredity. Other causes of varicose veins include aging, prolonged standing, obesity, leg injury or prior deep or superficial vein thrombosis. Women are more likely than men to suffer from varicose and spider veins and have a 50 percent chance of developing them in their lifetime. Varicose veins may result from increased hormone levels, blood volume and pressure from the enlarged uterus during pregnancy. Varicose veins that develop during pregnancy generally improve without medical treatment within 3-12 months after delivery.

What are symptoms of varicose veins?

Varicose veins are a common condition. Some symptoms include leg swelling, aching, pain, and itching over the vein area. Severe varicose veins can lead to wound formation.
Signs you may have varicose veins include:

  • Veins that are dark purple or blue in color
  • Veins that appear twisted and bulging; often like cords on your legs
  • When painful signs and symptoms occur, they may include:
    • An achy or heavy feeling in your legs
    • Burning, throbbing, muscle cramping and swelling in your lower legs
    • Worsened pain after sitting or standing for a long time
    • Itching around one or more of your veins
    • Bleeding from varicose veins
    • A painful cord in the vein with red discoloration of the skin
    • Color changes, hardening of the vein, inflammation of the skin or skin ulcers near your ankle, which can mean you have a serious form of vascular disease that requires medical attention

How are varicose veins treated?

Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.

Medical procedures are done either to remove varicose veins or to close them. Removing or closing varicose veins usually doesn't cause problems with blood flow because the blood starts moving through other veins. Fortunately, treatment usually doesn't mean a hospital stay or a long, uncomfortable recovery. Thanks to less invasive procedures, varicose veins can generally be treated on an outpatient basis.

What are the long term effects of varicose veins?

Leaving varicose veins untreated can lead to a variety of serious medical conditions. Most patients with varicose veins report symptoms of itchiness, fatigue, pain and discomfort in the legs, and swelling of the skin. In most cases, these symptoms will only get worse if the patient chooses not to see a medical professional. Individuals that suffer from the condition should schedule a consultation with a board certified Vascular surgeon to learn more about their specific condition, treatment options and recommendations.

Once these varicose veins are removed what is going to happen to my overall health?

Since none of the treatment methods involve large incisions, there are no sutures to worry about. Patients will need to wear bandages and/or compression stockings for a few days following the treatment, but there is very little downtime involved. Most people are back at work within several days. Though there are few activity restrictions after varicose vein procedures, your board certified vascular surgeon will give you specific instructions about how to care for yourself properly following treatment. Your physician may have short term lifting, exercise, or travel limitations based on your history and procedure(s) performed. Click here for post-surgery FAQ

What should I expect when I come in for a consult at the CSA Vein Center of Mid-Missouri?

You can expect to be seen by one of the surgeons who trained in the area of vein diagnosis and treatment. For the office examination, you might also see our Nurse Practitioner who has been trained in the evaluation and diagnosis of vein problems. Our initial goal in is to identify and understand the causes of a patient's leg pain and swelling, and to inform them of the available treatment options. Whether or not you are bothered by the cosmetics of varicose veins, you should schedule a consultation to learn about all of your treatment options by a board certified and skilled vascular surgeon. Sometimes tests, such as an ultrasound, are done to find out the extent of the problem and to rule out other disorders.


First make sure any patient forms including medical history are filled out to the best of your ability before your scheduled appointment begins.

Physical Examination
During your appointment, our board certified vascular surgeon or nurse practitioner will examine specific areas of concern. This initial screening focuses on your family and vascular history, leg and vein symptoms, and to identify the affected areas. In order to properly examine problem areas, we will have you wear a pair of shorts or change into a hospital gown we provide.

The ultrasound is an important step in gathering information about the extent of the damage to your veins. This highly specialized examination provides our physicians with a precise map of your venous insufficiencies (i.e. damaged veins, blood clots and incompetent valves so we can tailor procedures specifically for you. This exam allows us to be able to pinpoint the exact cause of your vein related concerns and any leg pain you may be having.  A portion of this exam will be done with you standing.

Physician Interpretation
Lastly, our board certified specialist will review the ultrasound findings and customize a treatment plan that will have you feeling better as quickly as possible. During this doctor visit, you'll discuss your diagnosis, treatment options, procedures and post-procedure instructions if applicable. One of our office staff can also walk you through details of cost, insurance criteria and answer any questions you may have.

What should I expect during my varicose vein procedure?

Before the procedure starts, we will obtain a set of vital signs. Your entire leg will be prepped or cleaned with a cold orange solution that smells a bit like rubbing alcohol. Your leg will then be covered in sterile drapes. Depending upon your preference, we will talk to you as much or as little about what to expect and when to expect it throughout the procedure. If you are having a laser procedure, the surgeon will start by using an ultrasound and cool gel to view your veins. During this time the room lights are turned down and most patients respond well to the calming environment this creates. Once the vein has been studied and accessed, the surgeon will insulate the vein with numbing medication, usually from around the knee to the groin. This process usually takes several minutes. Once this is completed, the laser is used to close down the vein. Most patients do not feel anything during the laser treatment, which takes about 2 minutes. This procedure is performed through a tiny incision in the leg

Once the laser portion of the procedure is completed, we will start performing the microphlebectomies if required. (For patients who do not require a laser treatment, this paragraph will describe the microphlebectomy portion of the procedure.) The microphlebectomies will interrupt portions of the visible varicose veins that sit just under the skin. The surgeon will inject numbing medication in the area of the incision(s) and then remove portions of the vein through a very small incision. You should not expect to feel anything painful once the area is numb, but it is common to feel pressure and "tugging." The incisions are too small for a suture, so steri-strip or butterfly bandages will be applied over each tiny incision. The number of microphlebectomies required will depend upon your specific situation. You may have anywhere from 1 to over 30 tiny incisions, but most patients will have somewhere between 10-15. 

At the conclusion of the microphlebectomies, dressings will be placed on your leg and then your leg will be wrapped in an ace bandage, usually from the toes to the groin.

What are my sedation options for varicose vein procedures and what is the recovery process?

The choice of anesthesia is a decision made between the patient and the surgeon based upon your individual preference. In general, medical care and surgery is designed to be minimally invasive, including reduction of risks and down time. This is very much the case in vein procedures which most often can be performed fully ambulatory under local anesthesia. Click here for sedation options.

Once my varicose veins are treated can they return?

The same varicose veins will not return once removed. However, new varicosities can form. Patients who have venous disease are prone to future vein problems. Therefore, even though we remove the symptomatic veins you have today, that underlying propensity for new symptomatic varicose veins to develop over time is still there. 

What makes the CSA Vein Center of Mid-Missouri different?

At the vein center of Mid-Missouri, you will be evaluated and treated by a Board Certified Vascular Surgeon, which is not an option at every vein center. You will be greated by friendly and highly qualified staff throughout your experience including the certified technicians in our Vascular lab and skilled crew in the ambulatory surgery center. Our entire team, including our billing specialists, are prepared with the experience and know how to help you every step of the way. 

Will my insurance pay for varicose vein procedure?

Ask the billing team at the Vein Center of Mid-Missouri if insurance will cover any of the medical cost for your treatment. If done purely for cosmetic reasons, the treatment may not be covered. However, insurance companies do recognize that varicose veins are a medical condition that requires medical treatment.  Some insurances may require a trial of conservative management such as use of compression stockings, usually for around three months. If this therapy does not improve your symptoms and you choose to move forward with a surgical treatment, our staff will help handle the insurance requirements for you, including any prior authorizations and letters of medical necessity. Every effort will be made to work with your insurance company to arrange your procedure as soon as possible. For your planning, you can expect around 4-6 weeks for this process to be completed prior to insurance approval to schedule the procedure.

To Make an Appointment
Your initial consultation gives you the opportunity to meet our team, learn more about our services and find out which treatment options will best meet your needs. To schedule a prompt appointment with one of our board-certified vascular surgeons, please call Vein Center of Mid-Missouri at 573-256-1541

Dr. Salinas
Dr. Humphrey
Dr. Adams
Dr. Sanford