Aching that is improved with leg elevation is a symptom. You should get venous Doppler ultrasound to see if you have venous insufficiency. However, isolated reticular veins do occur, but published studies show that > 70% of those patients have associated venous insufficiency, whether it is axial or truncal or segmental or along perforator veins.

Published on Jul 11, 2012

Most isolated spider veins on the thighs are benign or not associated with significant underlying vein disease. Reticular varicose veins are often associated with underlying venous insufficiency. Small isolated reticular varicose veins are kind of in the middle.

Published on Jul 11, 2012

Spider veins, or telangiectasia, may be independent of venous insufficiency. I recommend treatment of patients who are symptomatic, or those seeking cosmetic improvement.

Published on Jul 11, 2012

Yes, it is possible to have surface veins without significant venous reflux. It is also possible that these veins are an early sign of relatively mild reflux that is not severe enough to cause the other leg symptoms, and your story about a long walk that caused aching (relieved by subsequent elevation) supports (but does not prove) that possibility.

Published on Jul 11, 2012

These can easily be isolated and benign. If you start having swelling, more veins, discoloration in you ankles, heaviness or tiredness daily, then I would consider a test for venous insufficiency. But if not, I would just treat the isolated veins.

Published on Jul 11, 2012

You can have underlying mild venous reflux with no symptoms such as swelling or aching. An ultrasound can check for the presence of venous reflux, and at our facility we provide free ultrasounds for screening purposes.

Published on Jul 11, 2012

You can have underlying mild venous reflux with no symptoms such as swelling or aching. An ultrasound can check for the presence of venous reflux, and at our office we provide free ultrasounds for screening purposes.

Published on Jul 11, 2012

To answer your first question, yes, spider and reticular veins are a sign of venous reflux with or without symptoms. Yet, it is more likely the cause if you have symptoms such as pain, swelling, aching, throbbing, itching, restless legs, fatigue, heaviness, hyperpigmentation and slow to heal ulcers. If you experience aching in your legs that go away with elevation, that is a symptom related to venous reflux. To answer your question as whether or not spider veins happen without venous reflux, that answer is also yes. But the only way to find out is to get an ultrasound of your legs to determine whether or not you have venous reflux.

Published on Jul 11, 2012

If you don't have symptoms, there is no need to look for or treat venous insufficiency.

You can get the spiders and reticulars treated and get venous Doppler ultrasound scans in 3-5 years or as you develop symptoms.

Reticular complexes in the lateral thighs occur from non saphenous systems that are fairly common. The lateral complex of Albanese.

Published on Jul 11, 2012

Typically, a few reticular veins and spider vein are, as you call it, benign. If you don't have classic symptoms as you mention daily, I would not be concerned. All pain/aching as you experience is not venous in origin. After a long walk you could have muscle aching and at times small tears in the fascia (lining over the muscles). We recommend low grade of compression for these during and after exercise. Rest, hydration and perhaps some over-the-counter pain medications will help. Often we see people who have specific aches like you and relate them the the veins as they can see them, something physical they can relate it to. Again, it can be what is going on below the surface, especially knees, which is actually aching. Be cautious in being evaluated.

Published on Jul 11, 2012