This fact sheet helps you to gain an understanding of venous disease (problems caused by poor blood flow) and what you can do to help yourself.
Blood flows from the feet and legs towards the heart through veins. As the blood flow is going against gravity, blood can sometimes pool in the lower legs and feet. This pooling increases the pressure in the veins which can cause damage, resulting in venous disease.
The chances of getting this vein damage is increased by many things including:
- Being overweight
- Standing or sitting for long periods
- Air travel for longer than three hours can increase the risk of a blood clot in the leg (deep vein thrombosis or DVT)
What can I expect to happen?
Early on, you might notice:
- Tired, aching legs – Legs feel sore and heavy as blood stretches the veins in the legs.
- Spider veins – Tiny blood vessels which have stretched to become visible.
- Swollen ankles – Puffiness from blood and fluid pooling in the legs, often caused by standing or sitting for long periods (the swelling in the ankle reduces once you have put your feet up)
- Ankle flare – Blood vessels are enlarged by blood pooling in the feet
Later on, you may develop:
- Varicose veins – Bulging veins caused by blood not returning to the heart efficiently leading to stretched vein walls and damaged valves.
- Phlebitis – Damage to vein walls or small clots can cause a vein under the skin to become red (‘inflamed’) and develop painful hard lumps but without any discharge. It should not prevent you from walking.
- Leg problems in pregnancy – Changes during pregnancy can cause the blood vessel walls to relax. This can cause discomfort, swelling and even varicose veins.
- A venous leg ulcer – An open, often painful, sore in the skin that takes more than two weeks to heal. They usually develop on the inside of the leg, just above the ankle. Ulcers are unlikely to get better on their own, and usually require specialist medical treatment.
- Skin changes – Itchy, dark, hardened or leathery skin.
What can I do to get myself better now and in the future?
- Regularly moisturise your legs
- Walk and exercise regularly
- Eat a balanced diet and watch your weight
- Put your feet up
- Check your legs and feet regularly
- Get treatment for any knocks and sores on the lower leg, particularly if you have diabetes
- Try to give up smoking
- Cross your legs for long periods
- Stand still or sit for long periods without moving around
- Ignore any sores or irritations
- Assume that your legs will just get better by themselves
- Remain inactive for extended periods, eg long journeys. Even journeys of three hours can put you at risk of a blood clot in the leg. Wearing flight socks can help prevent them if you’re at an increased risk. They are available through your pharmacist.
Compression hosiery helps to push blood back out of the legs but should always be prescribed by a nurse or doctor to make sure it is safe for you to wear. If you are advised to wear compression hosiery, it is important that you wear it regularly, ideally every day.
When should I seek medical attention?
When to see your GP routinely
- If you think you may have problems with your vein Speak to your doctor or nurse, who may give you a more thorough examination. This may include a full health check and a review of the circulation in your lower legs, which will indicate whether the veins in your legs are working well or not and whether you need further treatment.
- If you have any concerns about the condition of your legs, even if you do not have the same symptoms as described in this leaflet, it may be appropriate for your legs to be professionally assessed.
- If you think you might have a leg ulcer. If you have a break in the skin or a sore that takes longer than two weeks to heal up, book in to see your practice nurse or GP immediately for advice and next steps in managing your leg health.
- If you think you have phlebitis It is not usually serious and usually dies down in a few weeks but other conditions may have to be ruled out.
- Leg problems during pregnancy Contact your GP or midwife to see if compression stockings would be suitable to help reduce swelling or discomfort.
When to seek urgent help from your GP
If you think you might have an infection
Cellulitis is an infection that spreads through the skin.
The skin is red, hot and painful (it may also be swollen and blistered).
You can also have swollen, painful glands.
Infected leg ulcer
if you have been diagnosed with a venous leg ulcer and have symptoms that suggest it could be infected.
Symptoms of an infected leg ulcer can include:
- worsening pain
- a green or unpleasant discharge coming from the ulcer
- redness and swelling of the skin around the ulcer
- a high temperature (fever)
- an unpleasant smell coming from the ulcer
When to seek immediate help from your GP or NHS111in England and Wales, the Phone First service in Northern Ireland or NHS24 in Scotland.
If you have a bleeding varicose vein
Varicose veins near the surface of your skin can sometimes bleed if you cut or bump your leg. You should lie down, raise your leg and apply direct pressure to the bleeding point. Seek immediate medical advice if this does not stop the bleeding.
If you think you might have infection and
- your symptoms are rapidly getting worse
- you have a weakened immune system – for example, because of chemotherapy or diabetes
- a young child or elderly person has possible cellulitis.
- Early treatment with antibiotics can stop the infection becoming more serious.
If you think you might have a deep vein thrombosis (DVT)
DVT is a blood clot in a vein, usually the leg. DVTs can be dangerous. Ask for an urgent GP appointment or call 111 (in England and Wales, or the Phone First service in Northern Ireland or NHS24 in Scotland) if you think you have a DVT.
Symptoms of DVT in the leg are:
- throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
- swelling in 1 leg (rarely both legs)
- warm skin around the painful area
- red or darkened skin around the painful area
- swollen veins that are hard or sore when you touch them.
Call 999 or go to A&E now if you have cellulitis or infected leg ulcer with:
- a very high temperature, or you feel hot and shivery
- a fast heartbeat or fast breathing
- purple patches on the skin
- feeling dizzy or faint
- confusion or disorientation
- cold, clammy, pale skin
- unresponsiveness or loss of consciousness.
These are symptoms of sepsis, which can be very serious and potentially life threatening.