What are varicose veins and why do they form?

Varicose veins are dilated, twisted veins from valve failure that allows blood to pool, increasing pressure and stretching the vessel wall.

What are common symptoms of varicose vein disease?

Visible bluish twisted veins, heavy or tired legs, swelling (sock indent), itching, burning, nighttime cramps, and skin discoloration in advanced stages.

How can I treat or manage varicose veins at home?

Daily exercise (30 60 min walking, cycling, swimming), compression stockings chosen by a professional, leg elevation, weight control, and home physiotherapy devices if needed.

When should I not use muscle stimulation or pneumatic compression devices?

Avoid EMS with implanted pacemakers, suspected active thrombosis, infected skin, malignancy, or pregnancy (abdomen/lower back). Avoid pneumatic compression in acute DVT or severe heart failure.

Back

Causes, symptoms and treatment of varicose veins – What can you do at home?

Are you on your feet all day? Or the opposite — sitting at a desk for hours? If by evening your legs feel heavy and tired, your ankle swells, and your sock leaves a mark in your skin, you may be experiencing the first signs of varicose vein disease. The good news: there’s a lot you can do to prevent worsening — and you don’t necessarily need to go under the knife.

What is varicose vein disease?

Varicose veins (medically called venous insufficiency or varicose veins) mean dilation and twisting of the veins, most often on the lower leg. Your veins contain small valves that prevent blood from flowing backward. When these valves are damaged or weaken, blood pools in the veins. With increasing pressure, the vessel wall stretches and becomes tortuous — this is how the characteristic bluish varicose veins appear.

It’s important to understand: varicose veins are not merely a cosmetic issue. In the early stages they can still be reversible, but without treatment they can progress quickly and lead to serious complications — leg ulcers, thrombosis.

Symptoms of varicose vein disease

Varicose vein disease usually develops gradually. Recognize the signs in time:

Visible varicose veins – Twisted, swollen, bluish-purple veins visible under the skin, most commonly on the lower leg and calf. This is the first visible sign, which many people consider only an aesthetic problem.

Heavy-leg sensation – Legs feel like lead, tired, especially after long standing or sitting. This is often the first symptom that draws attention to the problem.

Leg swelling – If the edge of your sock leaves a groove in your skin, that’s a warning sign. The foot, ankles, or even the lower leg can become edematous, especially by the end of the day.

Itching and burning – Itching in the affected area can indicate slowed circulation. Burning, throbbing sensations or nighttime muscle cramps may also occur.

Skin changes – In advanced stages the skin may discolor to a purplish-brown and thicken. This is a sign of hemosiderin deposition — you can read more about this in the article Reddish-brown spot on the lower leg – What is it?.

Ulcer – The most serious complication: a wound that does not heal or heals very slowly, usually around the ankle.

What causes varicose veins?

Several factors play a role in the development of varicose veins:

Heredity – If family members have it, your risk is higher. Weakness of connective tissue can be inherited.

Lifestyle – This is the most important factor you can influence! A sedentary lifestyle, prolonged standing or sitting directly leads to varicose vein disease.

Age – The older you are, the higher your risk. In the 60–69 age group, about 25% have varicose vein disease.

Sex – Women are twice as likely to be affected as men. This is due to weaker connective tissue and different vessel wall structure.

Hormonal factors – Birth control pills, pregnancy and hormonal changes increase the risk. During pregnancy the growing fetus can compress the pelvic veins.

Obesity and smoking – Both are significant risk factors that you can change.

Why is movement the key?

The natural motor of your venous circulation is the calf muscle pump. When you move — walk, hop while running, climb stairs — the rhythmic contraction of your calf muscles "pumps" blood upward toward your heart. This muscle pump effect is essential for venous return.

However, if you sit or stand still for long periods, the muscle pump doesn’t work — blood begins to pool in the veins. A sedentary lifestyle is therefore a direct path to varicose vein disease.

Scientific studies clearly show: structured physical exercise improves calf muscle pump function in chronic venous insufficiency. A randomized trial demonstrated significant improvement in muscle strength and venous hemodynamics after a 6-month training program (PubMed: 14718821).

Treatment of varicose vein disease — what you can do yourself

Regular exercise – the most effective method

For both prevention and treatment, regular physical activity is most important. Recommended activities:

Walking, brisk walking
Nordic walking
Cycling
Swimming
Running (if your condition allows)

The point: aim for at least 30–40 minutes daily. If you have a sedentary job, stand up every hour, walk for a few minutes and move your legs.

Lifestyle advice

Don’t use the elevator — take the stairs!
Wear flat, flexible-soled shoes (heels no higher than 5 cm)
Avoid heat: sunbathing, saunas, thermal baths
If your legs swell, elevate them frequently
Don’t sit with your legs crossed
High-fiber diet, reduced salt
Maintain a healthy body weight

Compression therapy

Compression stockings or bandages are a fundamental tool in treating varicose veins. Important to know: compression garments are most effective when you move while wearing them! If you sit motionless with a bandage on, its elasticity cannot take effect.

The appropriate compression strength should be selected by a professional. Don’t buy compression stockings by guesswork — the wrong strength can do more harm than good.

Home physiotherapy — if you can’t exercise

If your condition prevents regular physical activity — for example due to mobility limitations, severe joint problems, or advanced varicose vein disease — you can substitute the muscle pump effect at home with medical devices.

Muscle stimulator (EMS) device

The muscle stimulator device uses electrical impulses to trigger contraction of the calf muscles — exactly mimicking what happens while walking. During a 20–30 minute treatment the rhythmic contraction of the muscles "pumps" blood out of the veins.

This method is particularly recommended for:

Mild to moderate varicose complaints
If you are unable to perform active exercise
As a supplement to daily physical activity

Compression therapy unit (pneumatic compression)

The compression therapy unit (also called an intermittent pneumatic compression device) treats with air-chamber cuffs. The device sequentially inflates and deflates the air chambers, thereby "massaging" the leg from bottom to top — promoting venous and lymphatic return.

This method is particularly recommended for:

More severe varicose complaints
Significant leg swelling (edema)
Complications (ulcer, post-thrombotic syndrome)

Scientific studies show that pneumatic compression can positively influence venous circulation and relieve symptoms of chronic venous insufficiency (PubMed: 11700495).

Before you start treatment

To ensure safe use, know the contraindications.

When NOT to use a muscle stimulator?

If you have an implanted pacemaker or defibrillator
If there is a suspicion of active thrombosis
On infected or inflamed skin
Over malignant tumors
During pregnancy (on the abdomen and lower back)

When NOT to use the compression therapy unit?

In acute deep vein thrombosis
In severe heart failure
With acute skin infection, eczema, or open wounds on the treatment area
In decompensated heart disease

Important: For heart disease or high blood pressure, use lower pressures (max. 40–50 mmHg) and shorter sessions. If unsure, consult your treating physician.

Possible side effects

Treatments are generally well tolerated. Possible effects include:

Mild redness of the treated area (temporary)
Muscle fatigue after muscle stimulation
Mild discomfort during compression

When NOT to expect a miracle?

It’s important to understand: established varicose veins do not "heal" back to normal. A dilated, twisted vein will not regain its original shape. What you can achieve:

Relief of symptoms (pain, swelling, heavy legs)
Slowing the progression of the disease
Prevention of complications

Varicose vein surgeries (sclerotherapy, laser surgery, stripping) actually mean removing or closing the problematic vein — but if your lifestyle doesn’t change, another vein may dilate. Surgery should be considered when the disease severity (e.g., recurrent thromboses, non-healing ulcers) leaves no other option.

Which device should you choose?

For mild to moderate complaints: Muscle stimulator

Rehalito EMS muscle stimulator – Simple, affordable, 2-channel device. Designed especially for rehabilitation and circulation improvement. An ideal choice if you primarily need activation of the calf muscles.

Elite SII TENS/EMS device – A multifunctional device with 100 programs. In addition to EMS (muscle stimulation) it also has TENS (pain relief) functionality. If you need pain relief alongside varicose complaints, this is the better choice.

For more severe complaints, edema: Compression therapy unit

Power Q-1000 Plus leg treatment kit – A basic, easy-to-use compression therapy unit. Ideal for mild to moderate complaints at an affordable price.

Power Q-2200 leg treatment kit – A mid-range device with multiple treatment programs. Recommended for more severe complaints and frequently recurring edema.

The question of medicines and creams for varicose veins

Many creams and medicines are marketed for varicose veins. Important to know: alone they cannot eliminate varicose dilatation. Horse chestnut-containing products may relieve symptoms, but meaningful effects are achieved only together with exercise and compression therapy.

Summary – Quick overview

What is this article? A comprehensive guide to understanding varicose vein disease and home treatment options.

Who is it for? For anyone suffering from varicose complaints or who wants to prevent the disease.

Main message: The basis of treating varicose veins is regular movement, which activates the calf muscle pump. If you can’t exercise, home physiotherapy devices (muscle stimulator and/or compression therapy unit) can replace the muscle pump effect.

Main symptoms:

Visible bluish, twisted veins
Heavy-leg sensation, fatigue
Leg swelling (sock leaves a mark)
Itching, burning, nighttime cramps

What you can do:

30–40 minutes of daily movement (walking, cycling, swimming)
Wearing compression stockings (selected by a professional)
Lifestyle changes (take stairs, wear flat shoes, elevate legs)
Home physiotherapy: muscle stimulator and/or compression therapy unit

Scientific sources

Padberg FT Jr, Johnston MV, Sisto SA. (2004). Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg. PubMed: 14718821
Kakkos SK et al. (2001). Improved hemodynamic effectiveness of a new intermittent pneumatic compression system in patients with chronic venous insufficiency. J Vasc Surg. PubMed: 11700495
Araujo DN et al. (2016). Physical exercise for the treatment of non-ulcerated chronic venous insufficiency. Cochrane Database Syst Rev. PubMed: 37314059
Wójciak J et al. (2021). Compression therapy in venous diseases. Phlebology Review. PMC7874878

The information in this article is for guidance only. Home therapeutic devices are intended to complement medical treatment and do not replace specialist care. In case of complaints consult a vascular surgeon or angiologist. Read the device user manual before starting treatment.