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What causes painful varicose veins to harden?

This question was asked in Bino, Pennsylvania and has 4 answer(s) as of 04/12/2016.
I have had a varicose vein right on my left knee cap since I was 14. I am now 23 and for the last year or so the bulge has not only increased, but has also been painful. In recent months, it has also begun to harden. The moment I press down on it, pain is elicited and it feels as though there is a pebble trapped within the bulge. I am not sure if this is a blood clot or a symptom of chronic distension of the vein walls. What causes hardening of varicose veins?

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Doctors Answers (4)

You probably are describing superficial thrombophlebitis, which is the formation of clots in the veins within the fatty tissues of the leg. Superficial thrombophlebitis usually forms in varicose veins where the velocity of blood flow slows down in the enlarged vein. It is wise to seek evaluation by a specialist in the management of venous disorders to determine what you can do to prevent this in the future. About 10 percent of cases of superficial thrombophlebitis can extend into the veins in the muscle. Clotting in veins in the muscle is deep vein thrombosis which is a much more serious condition and can lead to clots traveling to the lungs (pulmonary embolism).

It is possible you have developed a superficial thrombus (clot) in this vein, which should remain localized. The vein becomes inflamed and painful, hard and reddened. The best treatment is compression hose (best) or a firm acewrap at least; take an anti-inflammatory medication such as ibuprofen, aspirin or naproxen twice a day, and apply low heat often. It should resolve on its own. If you find the hardened area is extending upwards, you should see your doctor and have an ultrasound exam. It would be advisable to be evaluated anyway by a vascular surgeon who specializes in the treatment of varicose veins to see if there is an underlying cause for the varicose veins.

Varicose veins do not typically get hard or develop hard spots. However, a local area of superficial vein clot (called phlebitis) may be experienced as a firm and tender area in the varicose vein. It may also be the result of many previous episodes of phlebitis resulting in scar tissue developing which may feel like a "pebble" when you press down over the area. A physical exam and possibly an ultrasound evaluation may be helpful to determine the cause of your symptoms.

A full and complete evaluation is a covered service of most insurances. This can be a significant issue - superficial blood clotting that can lead to bigger problems. Contact your doctor today.

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