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Most varicose veins do not cause medical problems. But you may decide to seek treatment because your veins are causing discomfort or you are unhappy with how they look.

Your doctor will ask you questions and may do some tests to find out the following:

• Whether you have varicose veins
• Which veins are affected and how badly
• Whether the veins are likely to cause other problems
• Whether the varicose veins are due to a problem in your deep veins. (See More serious problems in your veins.)

But keep in mind that most people's varicose veins are not caused by problems in their deep veins. In many cases, an office visit and an examination are all that you'll need to be diagnosed.

Your doctor will look at the pattern of veins in your legs, usually with you standing up. They may press the veins you're concerned about to see if they are lumpy.

There are other simple tests that you might have done by a specialist in the hospital. These tests can help your doctor figure out which of the valves in your veins are not working properly and where the blood is pooling.

• Your doctor may check that your ankle joints are moving well. These need to be working properly to help your calf muscles pump blood upward.¹
• Your doctor may look at your abdomen to check for any problems that might stop your blood from flowing upward. If you have this type of problem, the pressure of blood in your legs builds up and the valves in the veins may leak, causing blood to pool.
• Your doctor may also look for changes to the skin near your varicose veins, for example if you have an itchy rash. Skin changes like this could put you at risk of open sores on your skin (ulcers).
• Your doctor may also look for signs that you may have a problem in your deeper veins, such as brown patches on your skin.¹
• You might be asked to lie on a couch with one leg raised. The doctor will wrap a special cuff around your upper thigh to briefly reduce the blood flow in your leg. You'll be asked to stand and then the cuff will be taken off. The faulty area of the vein is the bit that bulges right away.¹ But this test isn't used much any more.

Your doctor will want to know whether you have diabetes. This condition can make problems with blood flow more likely.

Your doctor will also want to know if you or anyone in your close family has ever had a deep vein thrombosis. This is a blood clot that forms in one of your deep veins. It might signal more serious problems. Also, if you've had a clot in the past, you may have a higher risk of getting another clot if you have surgery for varicose veins.²

If you are a woman, your doctor may also check to see if you are taking birth control pills or hormone replacement therapy (HRT). Women on the pill or taking HRT may have a higher chance of having a deep vein thrombosis (DVT) if they have surgery for varicose veins.²

Your doctor may also ask these questions about your symptoms:

• How long have your veins been giving you problems?
• What sort of discomfort, if any, do your veins cause? Is the discomfort worse when you stand, exercise or do anything else?
• Do you worry about how your veins look?
• Do these veins come and go, or are they there all the time?

There are some other tests that specialists use to find out more about your varicose veins. They are called Doppler ultrasound, duplex ultrasound and venogram. To learn more, see Tests for varicose veins.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.