What is the cause of pain in varicose veins?

Written by Zhang Xue Min

Vascular Surgery

Updated on September 23, 2024

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Varicose veins can sometimes cause localized pain, and there are several reasons for this pain.

One reason is the formation of blood clots in the varicose veins, which can cause very obvious pain. Additionally, the affected area feels harder, not soft. When we say soft, it's like the softness of one’s lips; if it feels like the tip of the nose or the forehead, then it's considered very hard. In such cases, it indicates that the vein is not empty but contains a solid blood clot, which can cause pain.

Another situation is if there is poor venous return in the proximal segment, causing the veins to fill significantly in a short time. This can also pull on the nerves outside the vein wall, leading to a sensation of pain.

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Can bilateral varicocele be cured?

After the occurrence of varicocele, some patients may experience a feeling of heaviness and pain in the scrotum, which is often more apparent after prolonged standing, sitting, or intense exercise, and gradually alleviates after lying down and resting. During physical examination, tortuous veins similar to earthworms can be felt inside the scrotum. A color Doppler ultrasound examination is needed for further clarification. For bilateral varicoceles, it is currently curable. The main treatment method is surgical intervention, such as laparoscopic high ligation of the spermatic veins on both sides. This surgical approach is a minimally invasive procedure and the surgical outcomes are quite definite. Generally, a recovery period of 3-6 months after surgery is expected before complete recovery.

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Vascular Surgery

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The difference between thromboangiitis obliterans and varicose veins

Firstly, these are two completely different diseases. Thromboangiitis obliterans is an inflammatory vascular disease involving the medium and small veins and arteries, causing migratory superficial phlebitis and leading to the obstruction of the veins, as well as some obstructions in the lower limb arteries. Thus, thromboangiitis obliterans includes some obliterative diseases of both arteries and veins, the cause of which is an autoimmune inflammation. Varicose veins are one of the most common vascular surgical diseases. They primarily manifest as tortuous, clustered, and dilated superficial veins of the lower limbs. This condition does not involve arterial changes, but varicose veins can progressively worsen and may lead to pigmentation and ulceration, which at that time necessitates differentiation from arterial ulcers. Generally, the ulceration in varicose veins is located in the "gaiter area," which is the area covered by a boot when wearing one, including the lower one-half to one-third of the lower leg. Most of the ulcers from varicose veins primarily appear above the inner ankle. The ischemia caused by thromboangiitis obliterans leads to a dry-type ischemia, where the limbs can gradually become dry, shriveled, atrophied, and blackened, with ulcers typically beginning from the extremities.

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Urology

58sec

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Symptoms of varicocele in the right spermatic cord

If it is a mild varicocele, most patients have no discomfort symptoms and it is not easily detected. If the varicocele reaches a moderate or even severe level, the patient may experience a sensation of dragging pain in the right testicle and a lax scrotum, especially after long periods of sitting, standing, or intense exercise. The pain and dragging sensation in the testicle will become more pronounced. However, the symptoms will gradually ease after lying down and resting. If varicocele persists for a long time, it can lead to a decline in sperm quality, causing male infertility, and can even result in testicular atrophy. If the above symptoms are present, it is necessary to promptly go to the hospital for an ultrasound examination to determine the diameter of the spermatic vein. A routine semen analysis may be necessary if there is a decline in semen quality. If needed, surgery may be required for treatment.

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Written by Chen Feng

Urology

49sec

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Can varicocele heal itself?

Varicocele generally cannot be cured, and most patients with varicocele do not have any symptoms and only discover their condition during physical examinations. Such patients can temporarily be under observation, but they should regularly have their varicocele rechecked and also have their semen quality tested. If there are abnormalities in semen quality, timely surgical treatment is necessary. Clinically, a small number of varicocele patients exhibit significant symptoms, typically presenting as discomfort and pain on the affected side of the scrotum, especially after long periods of walking or standing, with pain becoming more pronounced. In such cases, prompt surgical intervention is generally necessary, and surgery can also improve the quality of the patient's semen.

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Vascular Surgery

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What happens if varicose veins worsen?

Varicose veins, when they worsen, can lead to changes in the skin, including thickening of the skin which feels woody to the touch. Additionally, the skin may exhibit pigmentation that can be severe enough to resemble the black color of a belt. More seriously, ulcers can develop, typically near the inner ankle, though they occasionally appear in other locations. These ulcers are referred to medically as “boot ulcers” and are commonly known among the general population as “continuous sore legs.” In extreme cases, these ulcers may persist for many years without healing and could potentially become malignant.