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Varicose veins and venous insufficiency may cause symptoms less obvious than the commonly noted spider veins, bulging lumps, bleeding veins or leg ulcers. Other symptoms may include swollen achy legs, a feeling of heaviness or fatigue of the legs, or itchy and discolored legs. Patients usually complain of increased swelling and aching toward the end of the day and often note improvement with elevation of the legs or after a night of sleep. Other patients may be under treatment for conditions thought to be related to the heart (congestive heart failure), kidneys (renal failure or diabetic kidney disease), excess salt intake, lymphedema (swelling after leg incisions) or for neurologic conditions such as neuropathy or restless leg syndrome (RLS). Restless leg syndrome has been strongly correlated with venous insufficiency, so patients who have been diagnosed with RLS are encouraged to seek further vein evaluation.