In making a diagnosis, your doctor will examine your legs while you're standing and will look for swelling. He or she may also ask you to describe the pain and aching in your legs. Finally, your doctor may perform an ultrasound test to see if the valves in your veins are functioning normally or if there's any evidence of a blood clot. Your primary care doctor may recommend that you see a doctor who specializes in vein conditions (phlebologist) or a doctor who treats skin conditions (dermatologist or dermatology surgeon).

Fortunately, treatment usually doesn't mean a hospital stay or a long, uncomfortable recovery. Less invasive techniques generally allow varicose veins to be dealt with on an outpatient basis. Self-help measures — such as exercising, losing weight, not wearing tight clothes, elevating your legs and avoiding long periods of standing or sitting — can ease pain and prevent varicose veins from getting worse. Varicose veins that develop during pregnancy generally improve without medical treatment within three months after delivery.

If you don't respond to self-help or if your condition is more severe, your doctor may advise one of these varicose vein treatments:

• Sclerotherapy. In this procedure, your doctor injects small- and medium-sized varicose veins with a solution that scars and closes those veins. In a few weeks, treated varicose veins should fade. Although the same vein may need to be injected more than once, sclerotherapy is effective if done correctly. Sclerotherapy doesn't require anesthesia and can be done in your doctor's office.
   
• Laser surgeries. Doctors are using new technology in laser treatments to close off smaller varicose veins and spider veins. Laser surgery works by sending strong bursts of light onto the vein, which makes the vein slowly fade and disappear. No incisions or needles are used.
   
• Catheter-assisted procedures. In one of these treatments, your doctor inserts a thin tube (catheter) into an enlarged vein and heats the tip of the catheter. As the catheter is pulled out, the heat destroys the vein by causing it to collapse and seal shut. This procedure is usually done for larger varicose veins.
   
• Vein stripping. This procedure involves removing a long vein through small incisions. This is an outpatient procedure for most people. Removing the vein won't affect circulation in your leg because veins deeper in the leg take care of the larger volumes of blood.
   
• Ambulatory phlebectomy (fluh-BEK-to-me). Your doctor removes smaller varicose veins through a series of tiny skin punctures. Local anesthesia is used in this outpatient procedure. Scarring is generally minimal.
   
• Endoscopic vein surgery. You might need this operation only in an advanced case involving leg ulcers. Your surgeon uses a thin video camera inserted in your leg to visualize and close varicose veins, and then removes the veins through small incisions.

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There's no way to completely prevent varicose veins. But improving your circulation and muscle tone can reduce your risk of developing varicose veins or getting additional ones. Traditional, common-sense approaches include:

• Exercise. Get your legs moving. Walking is a great way to encourage blood circulation in your legs. Your doctor can recommend an appropriate activity level for you.
   
• Watch your weight, and your diet. Shedding excess pounds takes unnecessary pressure off your veins. What you eat makes a difference, too. Follow a low-salt, high-fiber diet to prevent the swelling that may result from water retention and constipation.
   
• Watch what you wear. Avoid high heels. Low-helled shoes wor calf muscles more, which is better for your veins. Don't wear tight clothes around your waist, legs or groin. Tight panty-leg girdles, for instance, can strict circulation.
   
• Elevate your legs. To improve venous circulation, take several short breaks daily to elevate your legs above the level of your heart. For example, lie down with your legs resting on three or four pillows.
   
• Avoid long periods of sitting or standing. Make a point of changing your position frequently to encourage blood flow. Try to move around at least every 30 minutes.
   
• Don't sit with your legs crossed. This position can aggragate circulation problems.

Wearing compression stockings is often the first approach to try before moving on to other treatments. Compression stockings are worn all day. They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently. The amount of compression varies by type and brand.

Stockings today come in a variety of strengths, styles and colors. With the variety offered, you're likely to find a stocking that you're comfortable wearing.

You can buy compression stockings at most pharmacies and medical supply stores. Prices vary. Prescription-strength stockings also are available.

When purchasing compression stockings, make sure that they fit properly. Using a tape measure, you or your pharmacist can measure your legs to ensure you get the right size and fit according to the size chart found on the stocking package. Compression stockings should be strong but not necessarily tight. If you have weak hands or arthritis, getting these stockings on may be difficult. There are devices to make putting them on easier.

Evidence suggests that horse chestnut seed extract may be an effective treatment for chronic venous insufficiency (CVI), a condition associated with varicose veins in which leg veins have problems returning blood to the heart. The herb may help improve swelling and discomfort caused by varicose veins. Talk with your doctor before trying horse chestnut seed extract or any other herb or dietary supplement.