Out.Back.Care for the whole route. — Dr. Farzad Moazeni

Most of the time there is no immediate danger, and the main problems are heaviness, swelling and appearance. Sometimes they cause complications: the skin of the lower leg turns dark and hard, an ulcer forms, or a surface vein becomes inflamed and painful. Any of these means you should be examined sooner. Bleeding from a varicose vein is urgent and is covered in the patient guide. Sudden swelling and pain in one leg only is a different matter, covered in the answer to "What is a clot?".

Tiny blue and red spider veins are mostly a cosmetic matter. But a bulging vein with heaviness, burning, swelling or night cramps may come from venous insufficiency. An examination and, if needed, a Doppler ultrasound show the difference.

Not every varicose vein needs an operation. Some can be kept under control with daily care, movement and, when needed, special stockings. What you need is clear after an examination and a look at how the blood flows.

The tendency lies in the person (family history, pregnancy, long hours on the feet). Even when one vein is treated, other veins may be affected in the years that follow, and no method can promise that this will not happen. That is why care and follow-up after treatment are part of the path.

Stockings press evenly on the calf, which helps blood move up more easily and eases swelling and heaviness. But the size and the amount of pressure differ from person to person, and in some conditions, such as severe narrowing of the leg arteries, they are not suitable. Ask your doctor before you buy.

It can be either, and there are other causes too. Swelling that builds up by evening and eases when the leg is raised points more to the veins. If it comes with breathlessness, tiring easily or swelling in both legs, the heart has to be checked as well. The answer comes from an examination, not a guess.

It means blood has clotted in one of the deep veins of the leg. It shows up as swelling and pain in one leg and sometimes redness and warmth. The danger is that a piece of the clot travels to the lungs. Sudden breathlessness or chest pain together with leg swelling means calling 115, not waiting for an appointment. Sudden swelling and pain in one leg should be seen the same day.

Pain alone cannot tell. Heart pain is most often pressure or heaviness behind the breastbone that gets worse with effort, eases with rest and may spread to the arm, neck or jaw. It is not always like that, especially in women and in people with diabetes. New or severe pain, or pain with breathlessness, cold sweat or fainting, cannot wait for an appointment: call 115.

New chest pain or pressure, sudden breathlessness, fainting, signs of a stroke (a drooping face, weakness on one side, sudden trouble speaking), and sudden swelling and pain in one leg together with breathlessness cannot wait for an appointment. Call 115. The full list is in the patient guide.

High blood pressure usually needs long follow-up, and some people need medicine for a long time, but the doctor decides this from several measurements and from your overall situation. Do not stop your medicine or change the amount yourself. If you have side effects, tell your doctor so the plan can be changed.

Earlier ECGs, echo reports, ultrasounds and test results, a list of the medicines you take (the name or a photo of the box), your home blood pressure notes if you have them, and, if your leg swells, a photo of it at the end of the day. If something is missing, come anyway.

The treatments for varicose veins (stockings, sclerotherapy, laser and radiofrequency, surgery) are explained in general terms on the varicose veins page. Which of them are done at this office will be announced after the doctor confirms.

The list of insurers will be announced soon.