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What could be causing a heavy feeling in my legs?

After standing for a short period of time, both of my legs always feel heavy and kind of achy. Someone mentioned it could be varicose veins, but I can't see anything that looks like varicose veins on my legs. Is it possible to have varicose veins that can't be seen? Could they be causing problems from inside my legs? What might be causing the heavy feeling in my legs?

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Doctors Answers (4)

A heavy aching feeling in the legs could be related to venous insufficiency or from a muscular-skeletal cause. If you have prominent varicose veins then this is likely the cause. If you do not see varicose veins then a physical exam of your legs by a physician would be helpful. If indicated, an ultrasound exam can evaluate the venous function in your legs. It is possible to have venous insufficiency with venous reflux and varicose veins that are not seen at the surface of the skin, but are easily seen with doppler or duplex ultrasound evaluation.

Tired, heavy, aching legs often are due to high pressures in the veins of the legs which get worse with sitting or standing still. Often, this improves with walking with a normal gait utilizing the ankles and calf muscles which pump venous blood out of the legs. The most common cause of these symptoms is failure of the valves in the veins of the legs which allows venous blood to run down the legs from the abdomen and pelvis. Varicose veins often are present due to the high pressures distending the veins, but it is not uncommmon for few abnormal veins to be visible on the surface. Detailed venous ultrasound examination to detect the valve failure is an essential diagnostic tool. Adbominal obesity may obstruct venous blood flow back to the heart and may cause similar symptoms. Often, valve failure (venous insufficiency) and abdominal obesity both contribute to the problem. See a venous specialist to evaluate your symptoms.

Varicose veins that are on the surface are typically caused by back flow in deeper veins (venous reflux). In some people there are not surface veins visible, although this is less common. Additionally, your type of symptoms can be part of getting older where the muscle support is not as good. Often a low 15-20 mmHg knee-length pressure sock can help with this. You might want to have a general check-up with your doctor first, watch your weight, diet/hydration and get regular exercise. If you try the socks, etc. and still have the symptoms, you may consult a Board Certified Vascular surgeon who specializes in treating veins. This will include an ultrasound examination to determine if your symptom is of venous origin.

Heaviness is a very common symptom in venous insufficiency causing varicose veins. Your physician or you can arrange a diagnostic ultrasound to determine which, if any, veins are a problem.

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