For many people, varicose veins and spider veins — a common, mild and medically insignificant variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes the condition leads to more serious problems. Varicose veins also may signal a higher risk of other disorders of the circulatory system. Approximately 40 million Americans have varicose veins. Women are twice as likely as men to have the condition.

You may have symptoms even before varicose veins appear. Signs and symptoms may include:

An achy or heavy feeling in your legs and burning, throbbing, muscle cramping and swelling in your lower legs. Prolonged sitting or standing tends to make your legs feel worse.  Enlarged veins readily seen under the skin of your legs.  Brownish-gray discoloration on your ankle.  Itching around one of your veins. Skin ulcers near your ankle, which represent a severe form of vascular disease and require immediate attention.

Occasionally, veins deep within your legs are involved. In such cases, your limbs may swell considerably. Any sudden leg swelling that may or may not be accompanied by pain and redness warrants urgent medical attention, as it may indicate a blood clot.

Varicose veins occur when the valves in your veins malfunction. As you get older your veins can lose elasticity, causing them to stretch out. When that happens, blood that should be moving toward your heart may flow backward.

Blood pools in your veins, and your veins enlarge and become varicose.

In making a diagnosis, your doctor will examine your legs while you're standing and look for swelling. You doctor may also ask you to describe the pain and aching in your leg.

Finally, your doctor may perform an ultrasound test to see if there's any evidence of a blood clot.

Sometimes, extremely painful ulcers may form on the skin near varicose veins, particularly near the ankles. Ulcers are the result of long-term "waterlogging" of these tissues as the result of increased pressure of blood within affected veins. Brownish pigmentation usually precedes the development of an ulcer. Ulcers require urgent medical attention.

There's no way to prevent varicose veins. But, improving your circulation and muscle tone can reduce the risk of getting varicose veins or getting additional ones. To improve circulation and muscle tone, follow these tips:

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.

Control your weight. Shedding excess pounds takes unnecessary pressure off your veins.

Watch what you wear. Avoid high heels. Low-heeled shoes work calf muscles more, which is better for veins. Don't wear tight clothes around your calves or groin. Tight panty-leg girdles, for instance, can restrict circulation.

Elevate your legs. To improve circulation, take three or four 10- to 15-minute 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.