Heavy Legs — Is It a Vein Problem?

Why Do My Legs Feel Heavy?

The sensation of heavy, aching legs at the end of the day affects millions of people. While tired legs can have many causes, the most common medical explanation is chronic venous insufficiency — a condition in which the one-way valves inside the leg veins fail to close properly, allowing blood to pool in the lower legs.

Healthy vein valves push blood upward toward the heart against gravity. When valves weaken or become damaged, blood flows backward (reflux) and accumulates in the legs. The resulting increase in venous pressure causes the legs to feel heavy, full, and fatigued — especially after standing or sitting for prolonged periods.

Symptoms That Suggest a Vein Cause

• Legs feel progressively heavier and more tired as the day goes on
• Symptoms improve significantly after lying down with legs elevated
• Heaviness is accompanied by ankle swelling, itching, or nighttime cramps
• Visible varicose veins or spider veins are present
• Family history of varicose veins or venous disease

Who Is at Risk?

Venous insufficiency is more common in people who:

• Stand or sit for long hours (teachers, nurses, office workers, drivers)
• Are pregnant or have had multiple pregnancies
• Are overweight
• Have a family history of varicose veins
• Are over 40

Diagnosis: Venous Duplex Ultrasound

The gold-standard test for venous insufficiency is a venous duplex ultrasound — a painless, non-invasive scan that maps the veins and detects reflux in real time. Dr. Aronhime performs the duplex scan at the first consultation, so you receive a diagnosis and treatment plan at the same visit.

Treatment Options

When duplex confirms venous reflux, minimally invasive treatment is highly effective:

• EVLA (laser ablation) — available at Shamir Medical Center via kupat holim tofes 17; little or no out-of-pocket cost for eligible patients
• RFA (radiofrequency ablation) — at a private hospital; covered by supplemental private insurance
• VenaSeal (medical glue) — no tumescent anesthesia, no compression stockings post-procedure; ₪15,000
• Sclerotherapy — for smaller varicosities and spider veins