11.10.14 Dr. Garth Rosenberg Varicose Veins

Leg Pain Without Varicose Veins

At my Leesburg, Virginia office last week I saw a 42-year-old nurse who has being feeling achy, heavy legs for well over 5 years. Her symptoms become more notable toward the end of the day and she needs to elevate her legs at work and at home. Her sister and mother have significant varicose veins and had vein stripping many years ago. Genetics are a prime factor in determining who will develop varicose veins, as most patients have a close relative with venous insufficiency.

Even without visible varicosities, her history was significant enough that I felt a duplex ultrasound exam was necessary to investigate venous reflux. As I anticipated, her great saphenous vein was incompetent in both legs, allowing backflow of blood down the legs. The pooling of blood in the lower legs, accentuated by gravity, leads to the common symptoms of aching, heaviness and fatigue. Even swelling and restless legs can be caused by this problem. My patient is a perfect example of how venous insufficiency can lead to very significant and debilitating symptoms, even in the absence of visible varicose veins.

The optimal method of treating this condition is the Venefit Procedure (VNUS Closure), which allows us to place a small wire in the vein through an IV access near the knee. After a small dose of local anesthesia, the problematic vein is painlessly heated, leading to its collapse and elimination of backflow of blood. Normal veins in the leg take over and bring blood up the correct direction, improving circulation. This eliminates leg symptoms in the matter of a few days. This office-based procedure allows normal activity immediately afterward.

The key instructive point of this patient's experience is that venous insufficiency can most definitely cause very real symptoms, even in the absence of varicose veins. When patients experience heavy, achy tired legs, a thorough investigation with a venous duplex ultrasound is a reasonable and recommended option. Seeking the advice of an experienced vein professional is key to getting the help you need.

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