Hypersensitivity to cold—especially ice-cold feet—and a sensation of heaviness in the legs may be important, yet under-recognized indicators of varicose veins, according to a new large-scale study published in the journal Open Heart.
The research, which analyzed data from the Taiwan Biobank, reveals a significant correlation between self-reported cold sensitivity in the lower limbs and the presence of moderate to severe varicose veins—particularly when coupled with feelings of leg heaviness.
What Are Varicose Veins?
Varicose veins are enlarged, twisted veins, typically occurring in the legs, caused by malfunctioning valves within superficial or deep venous systems. When blood flow becomes inefficient, it pools in the veins, leading to bulging, discomfort, and—in severe cases—ulcers or chronic swelling.
Symptoms can include:
- Aching, throbbing, or itching
- Swelling and fluid retention
- Leg cramps
- A sensation of heaviness
- Restlessness
- In extreme cases, skin ulcers
While more common in women, varicose veins affect both sexes, with prevalence rates ranging between 2% and 30% in adult populations globally.
READ MORE: New Study Uncovers Surprising Link Between Body Fat and Anxiety
Key Findings of the Study
The researchers examined data from 8,782 adults aged 30–70, collected between 2008 and 2020. Among them, 676 individuals were diagnosed with moderate to severe varicose veins.
Participants were asked whether they:
- Experienced hypersensitivity to cold in their feet
- Felt heaviness in their legs
They also provided information on lifestyle and health factors, such as age, weight (BMI), smoking habits, alcohol consumption, exercise frequency, job type, education level, and the presence of diabetes or high blood pressure.
Cold Hypersensitivity and Varicose Veins: The Numbers
5,888 participants reported no cold sensitivity; among them, 5.8% (340 people) had varicose veins.
1,535 participants reported moderate cold sensitivity; 9.4% (144) had varicose veins.
1,359 participants reported extreme cold sensitivity; 14.1% (192) had varicose veins.
Statistical analysis showed that those with moderate to severe cold hypersensitivity had a 49% to 89% higher likelihood of having varicose veins compared to those without cold sensitivity.
Leg Heaviness Amplifies the Risk
The prevalence of heavy legs was found to be four times higher in participants with varicose veins than those without.
Participants who reported both heavy legs and cold feet had significantly greater odds of having varicose veins:
- 90% higher with moderate cold sensitivity
- Over 3 times higher with extreme cold sensitivity
Moreover, people who experienced heaviness in their legs without cold hypersensitivity were 7 times more likely to have varicose veins than those who did not report leg heaviness.
Jobs That Involve Standing Increase Risk
The study also found that prolonged standing at work significantly raised the risk of developing varicose veins—by about 45%, supporting existing knowledge about occupational risk factors.
Study Limitations
The authors cautioned that this was an observational study and cannot definitively establish cause and effect. Other limitations included:
- Self-reported symptoms, which may be influenced by individual perception and not confirmed clinically
- Lack of data on varicose vein treatments or severity assessments beyond basic classification
Despite this, the findings underscore the importance of listening to subjective patient experiences, particularly those involving cold sensitivity and heaviness, which may have been previously dismissed or deprioritized in clinical assessments.
Clinical Implications: Time to Rethink Screening?
The authors emphasize that cold sensitivity in the lower extremities has been traditionally underestimated in connection with venous disease:
“In clinical practice, the sensation of coldness is usually relegated to a secondary position among varicose vein symptoms… However, our study shows that moderate-to-severe cold hypersensitivity is significantly associated with varicose veins.”
They suggest that the co-occurrence of cold feet and heavy legs should raise clinical suspicion and prompt further vascular examination, especially in patients reporting both symptoms concurrently.
The Takeaway
For healthcare providers, this research adds a compelling dimension to symptom-based screening for varicose veins. It signals that patients complaining of cold feet and heavy legs—particularly those in standing jobs—deserve more careful evaluation for venous disease.
And for patients, it offers an important message: If your legs feel heavy and your feet unusually cold, especially during the day, it may be more than discomfort—it could be a sign of an underlying vascular issue worth checking out.
