Knee Pain and Varicose Veins
Patients over age 50 often develop two very common causes of leg pain: venous insufficiency and osteoarthritis of the knee. There is some overlap of symptoms with these diagnoses and the magnitude of the discomfort often limits activity for work or recreation. Pain in the knee or the area surrounding the knee that is worse with weight bearing or change in position is often from osteoarthritis. This pain is often worse in the morning with the initiation of walking. Pain from venous insufficiency can be felt around the knee and down into the calf and is often associated with a sense of muscular fatigue, heaviness or leg swelling. The presence of dilated veins or skin discoloration suggests venous disease but vein problems can produce symptoms before enlarged veins are detected on the skin. Leg swelling is often associated with venous insufficiency but also can be secondary to the diminished physical activity experienced with arthritic knee pain.
It is a misconception that eventually we all have to tolerate leg pain. Both venous insufficiency and osteoarthritis are progressive diseases that should be actively managed to improve function and comfort of the legs. Because these diseases are common they may co-exist. Orthopedic evaluation and treatment is beyond the scope of this writing. However, when symptoms overlap with venous disease and knee issues, correction of the symptomatic venous insufficiency can improve the status of the leg and clarify the severity of the arthritis. Also, prior to any orthopedic intervention it is prudent to correct significant varicose veins to reduce the risks of getting a blood clot with the orthopedic treatment.
The treatment of varicose vein problems is done with local anesthesia in the office setting. There is minimal downtime and almost no discomfort with the vein treatments. See our website for a discussion of VNUS Closure and microphlebectomy. Both procedures permit immediate return to normal activity and require only a three-day period of limiting vigorous exercise while wearing support hose. Most patients return to work the day after treatment. Getting those legs back in shape by healing the vein issues and managing the arthritis will keep you moving and healthy!