Achy ankles, a complaint that affects nearly one in five individuals over 55, could be a sign of an often-overlooked condition: hidden varicose veins. While many attribute ankle pain to age, injury, or even weather, experts suggest that deeper, unseen venous issues may be the culprit.
Varicose veins occur when valves within blood vessels malfunction, causing blood to pool and preventing its efficient return to the heart. Research indicates that genetic factors play a significant role in their development. While commonly perceived as a women's health issue, studies show that varicose veins affect men and women equally.
Professor Mark Whiteley, a varicose vein expert at The Whiteley Clinic, explained that a common misconception is that all patients develop visible, bulging veins. "There’s a misconception that all patients get visible varicose veins, but for many, these are hidden," Whiteley stated. "The condition typically starts off with stiff and painful ankles. Many patients report that the pain tends to get better when they elevate their feet."
Over time, some individuals may experience itchy skin or sores around the ankle. Visible varicose veins may eventually appear, but this is not always the case. To diagnose the condition, experts recommend a specialized scan, known as a venous duplex ultrasound, which can assess the functionality of the valves in the leg veins.
However, access to these scans and subsequent treatment can be limited through the National Health Service (NHS) in the UK. NHS treatment for varicose veins is typically only offered if patients report severe pain or complications, leading to a limited number of operations performed annually relative to the number of people affected. This often leaves patients facing significant out-of-pocket expenses for treatment.
While varicose veins are a potential cause, other factors can also lead to ankle pain. Dr. Naomi Potter, a menopause expert, noted that hormonal changes during mid-life, particularly the decrease in estrogen, can contribute to joint stiffness and achiness. However, she added that menopause-related joint pain is usually accompanied by other common symptoms like brain fog and sweating.
Experts also emphasize the importance of distinguishing ankle pain caused by muscle injury. Signs of an injury typically include redness, swelling, and tenderness to touch. Nevertheless, the consensus among specialists is that a significant number of achy ankle cases are linked to hidden varicose veins, and they urge individuals experiencing such pain to seek medical evaluation for potential venous issues.