Leg and Ankle Swelling from Varicose Veins (Venous Edema)

Why do varicose veins make your legs swell?

Blood has to climb roughly a metre from your feet to your heart. Two things make that possible: one-way valves inside the veins, and the calf muscles, which squeeze the veins every time you walk. This is often called the calf muscle pump .

When valves weaken, blood falls back down the leg instead of moving up. This is venous reflux . The veins near the ankle then sit under constant high pressure. The smallest vessels respond by leaking fluid into the surrounding tissue, and the ankle swells. Gravity makes it worse the longer you stand or sit, which is why swelling builds through the day.

What does venous swelling feel and look like?

• Puffiness around the ankles and top of the feet, often with sock marks in the evening
• Shoes feeling tight by late afternoon
• A dent that stays for a few seconds when you press the skin (pitting)
• Heaviness, aching or a "bursting" feeling in the calves
• Improvement overnight or after raising your legs above heart level
• Often worse in hot weather, after saunas or long flights

Swelling may be in one leg or both. Many people also notice heavy, tired legs or night cramps at the same time.

What else can cause leg swelling?

Venous disease is a common cause, but not the only one. A good assessment considers:

• Heart failure – usually both legs, often with breathlessness
• Kidney or liver disease – swelling may also affect the face or abdomen
• Medicines – some blood pressure tablets and other drugs cause ankle swelling
• Lymphedema – a problem with lymph drainage, often including the toes
• Thyroid problems, pregnancy and long travel
• Deep vein thrombosis – sudden, usually one-sided, often painful

Seek same-day medical care if one leg suddenly swells and hurts, or the leg is hot and red. Call 119 in Korea (or your local emergency number) if swelling comes with chest pain or breathlessness. Read more about DVT and varicose veins .

How is the cause of swelling found at LEDAS?

At your first visit , Dr. Kim Byoung Joon asks when the swelling started, what makes it better or worse, and about your health and medicines. Then comes a duplex ultrasound on Philips EPIQ Elite equipment. You stand on an examination table designed by LEDAS for standing-position scans, because reflux shows most clearly when gravity is acting on the veins. The exam takes about 15–20 minutes, and results are explained on screen in real time.

If the scan shows no significant reflux, we will tell you that and suggest which kind of doctor to see next.

How is venous swelling treated?

Relief you can start today

1. Walk at a moderate pace every day to activate the calf pump
2. Raise your legs above heart level when resting
3. Avoid long periods in one position and very hot baths or saunas
4. Reduce salty, high-calorie food
5. Wear medical compression stockings , which apply the most pressure at the ankle

Treating the cause

Stockings ease swelling but do not repair the valves. If reflux is confirmed, LEDAS closes the faulty veins with EVLT and ultrasound-guided sclerotherapy under local anesthesia, with no incision and same-day discharge. Blood is then routed through healthy veins, which usually reduces the pressure that drives swelling.

Clues to the cause of leg swelling

Leg swelling and veins – frequently asked questions