A patient with symptoms may or may not have visible varicose veins in their legs. An ultrasound examination of the major veins inside the leg is essential to assess for vein reflux disease or detect varicose veins present beneath the skin. This is the most common cause or source for varicose veins as well as the associated symptoms. Any treatment of varicose veins and its associated symptoms must begin with addressing the source. Getting an ultrasound is non-invasive and painless.