If you suffer from painful, bulging varicose veins, you may have found yourself thinking about varicose vein treatment options.

That's what happened for one of our former editors Melanie. Whenever Melanie went for a run, she noticed that her legs would start to hurt before she felt the burn in her chest. She didn't think much of it until she went to see a doctor for her spider veins. The Midwest Vein Center specialist explained to Melanie that in addition to spider veins, the reddish-purple veins that form in web-like scribbles on the legs, she had potentially problematic varicose veins.

What are varicose veins?

Varicose veins are characterized by a bulging, rope-like appearance, and they may appear dark purple or blue. They often hurt, a pain that is commonly described as an achy, burning sensation. In less severe cases, they may not be as noticeable. Melanie, for instance, had issues with her left calf, her right upper back thigh, and the front side of both of her legs from groin to ankle.

"I started to put two and two together and wondered if that's why my legs hurt before my heart and lungs did while running," she says.

Other symptoms include itchiness and skin discoloration around the veins, muscle cramping and swelling in your lower legs, and pain after sitting or standing for a long time.

What causes varicose veins?

Veins send blood to the heart, where it gets recirculated throughout the body. In order to do this, the veins in the legs must work against gravity, so they use a system of one-way valves to direct the flow of blood upward. When these valves don't function properly, the blood flows in the opposite direction, which causes the blood to back up and increases pressure in the veins. As a result, the veins become inflamed, protrude from the skin, and cause pain.

But what causes the valves to stop working? In a nutshell, things like age, pregnancy, and plain old genetics. Melanie says hers are likely the result of "genetics and bad luck!" So what can be done about them?

How to get rid of varicose veins

Varicose vein treatment options are a lot like spider vein treatment options. Patients typically opt for either sclerotherapy (injecting a medication into the veins to seal them) or surface-level laser therapy without incisions (according to the Mayo Clinic, it may not be effective on certain veins). Although, for some patients with sever varicose veins, minor surgery with a local anesthetic may be the best option.

To determine a treatment for her veins, Melanie underwent an intensive ultrasound appointment to "basically create a road map ... and determine exactly where things are compromised," Melanie explains. This step typically occurs after the initial consultation.

Based on the size and location of Melanie's veins, her doctor recommended endovenous laser treatments. These use a laser to shut down and seal off unhealthy veins below the skin's surface.

Melanie decided to go for it. "Even though I'm on the young side, I decided to take care of this now to prevent them from getting more painful," she says. "And because left untreated, they can eventually start to form ulcers and generally become more of a problem. I figured the recovery would be easier while I'm young and active too." 

What happens during a treatment?

Melanie's doctor recommended a series of four laser treatments. Here's what happened during each one-hour "lunchtime appointment":

1. Melanie's doctor applied a local anesthetic into the problem vein. "It's a lot of pressure and a weird sort of discomfort, and is the worst part of the whole thing," Melanie says.

2. Her doctor inserted a laser fiber into the vein through a tiny incision, using an ultrasound to guide the thin fiber to the correct area. The fiber then closed and sealed the vein.

3. Her doctor applied Steri-Strips to the incisions and helped Melanie get into a compression stocking, which Melanie wore for the rest of the day. She was encouraged to wear it as long as she experienced pain, but says she never needed to wear it after that first day.

Pro Tip: The compression stockings patients have to wear post-treatment tend to be tight and can become uncomfortable in hot weather. So if you can, wait until the fall or winter to treat your veins.

Recovery period and follow-up

Depending on the severity of the veins, most patients can return to normal activities in 2–5 days; however, the treatment area can take a month to heal completely.

"I was surprised by how tired my legs felt the first couple of days and the amount of bruising that occurred," Melanie says. "It went away quickly, though (after about a week)."

Additionally, Melanie experienced a swollen ankle and some numbness, which is not uncommon. Patients typically regain feeling, though it can take up to 12 months. Melanie's ankle started to wake up again a few weeks later.

"I also still have the incision marks right now but those should fade over the next year, too."

During her follow-up appointments, which occurred one week after the treatment, the doctor would use ultrasound technology to check for blood clots. She would then perform the next laser treatment. Now that all four treatments have been completed, Melanie says her veins are "much smaller." And while certain areas will take longer to go away completely, the doctor is confident they will disappear.

So, was it worth it?

The laser treatments are designed to permanently rid the body of the veins they treat, but if other varicose veins developed, Melanie says she "definitely stand[s] behind this choice."

Plus, she adds, "My legs don't seem to hurt anymore! I might be getting stronger because I'm also doing some resistance training, but it definitely seems to have helped. Overall I do feel better!"