What Causes Leg Pain from Varicose Veins

Most patients tend to be amazed by the symptoms that can be explained by vein disease. Venous insufficiency represents the underlying condition for many patients with symptomatic spider and varicose veins.

First and foremost, not all patients with varicose veins have pain. Instead, common complaints are leg heaviness, leg swelling, restless legs. These symptoms occur daily and often worse by the end of the day. Importantly, not every patient with venous insufficiency has visible varicose veins. This probably explains why very few patients are ever referred to a vein clinic for expert evaluation.

Diagnosing Varicose Veins?

Spider and varicose veins represent the issue at the very surface, however venous insufficiency is happening underneath. A vein specialist needs to consider all your symptoms and findings on physical examination to determine the possibility of venous insufficiency. Preventing long-term issues requires more than eliminating spider veins at the skin surface.

To begin, your vein expert may consider a duplex venous ultrasound to evaluate the anatomy, flow and size of your leg veins. This provides the necessary information to your vein doctor on what is causing your symptoms. A duplex ultrasound should only be performed by a certified vascular tech and interpreted by vascular imaging experts.

Minimally Invasive Varicose Veins Treatments

Modern vein treatments are more comprehensive and non-surgical. Vein stripping or surgical procedures have been replaced by more straightforward, faster, and more effective treatments that require no downtime or anesthesia. Our favorite techniques:

  • Radiofrequency ablation: Catheter-based technology that delivers radiofrequency-generated heat to the blood vessel walls. The procedure is done with only small amounts of local anesthetic and can be completed in less than 30 minutes.
  • VenaSeal: This is the latest innovation in vein treatment and is equally effective as RF ablation. VenaSeal is also a catheter-based technology. However, unlike ablation, the catheter is used to inject a medical adhesive that fuses the diseased vein closed. As such, it requires no tumescence for anesthesia.
  • Sclerotherapy: A medicated solution is injected in either liquid or aerated form (foam sclerotherapy). This medication acts as a sclerosant and disrupts the walls of diseased veins causing them to collapse and eventually be absorbed.
  • Ambulatory Phlebectomy: This requires the most skill and patience, but still is minimally invasive. Tiny incisions are made over large, protuberant veins so that they can be directly removed. Unlike stripping, these procedures are done within the office and patients do not require any downtime. The best part, any large visible varicose veins are immediately removed leading to dramatic skin improvements.
  • Clarivein: Another catheter-based technique with some special uses in certain varicose vein anatomy. In this case, mechanical force and sclerosant are used to eliminate diseased veins. Interesting fact, our very own Dr. Brotman was present for the first ClariVein® procedure on humans in the United States.


What Is The Best Treatment For Varicose Veins?

Your dermatologist or local med spa may offer spider vein treatment, however it is likely limited to sclerotherapy or laser vein removal.

Patients with common presentations of spider and varicose veins are separated into 3 common categories:

  • Cosmetic: Patients without underlying venous insufficiency or symptoms. The primary treatment goal is the elimination of spider and reticular veins using sclerotherapy or laser vein removal.
  • Symptomatic Venous Insufficiency: Patients will benefit from treatment of the underlying condition. Early treatment includes exercise, weight loss (if needed), and fitted medical stockings. If conservative measures have not controlled symptoms, then medical treatments are considered.
  • Advanced venous insufficiency: These patients present with advanced signs of vein disease (CEAP 3-6) which includes leg edema, stasis dermatitis, skin discoloration, or venous leg ulcerations. Bleeding varicose veins are also a sign of advanced vein disease and compression stockings alone are unlikely to be sufficient.

Vein Specialist Centers of Long Island

Our Vein Specialist Center is a comprehensive diagnostic and treatment clinic for both spider and varicose veins. Patients come to Vein Specialist Centers because they are seeking expert vein care and are provided personalized attention by a healthcare team deeply committed to the patient-physician relationship. Dependability, Quality, and Respect are a few of the core values that have helped us grow from a small practice in Princeton NJ. We invite you to see the difference of a patient-centered approach.

Comprehensive vein care including diagnostic ultrasounds and vein treatment is provided on-site at our state-of-the-art facility in Great Neck NY. The Vein Specialist Center in Great Neck NY is located on the Gold Coast of Long Island at 560 Northern Boulevard in Suite 205, close to the Northwell Hospital system.

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