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Why Do My Legs Bother Me?

Author: 29 March 2017 No Comment

(Why Do My Legs Bother Me? Varicose Veins)

Venous disease affects one quarter of the human population. So if your legs ache when you have been standing you may have venous disease, otherwise known as venous insufficiency or incompetence. Also if your legs itch, burn, swell, or you have restless legs, you may have venous disease. Of course, visible varicose veins are a skin level manifestation of venous problems. Venous disease occurs when the veins that are supposed to take blood flow out of the leg fail. This allows blood to flow backward toward the ground rather than toward the heart, hence the words insufficiency or incompetence. A sequence of events follows: blood pools in the legs and pressure in the veins increases. Then more blood pools and so on. This cascade of events in the leg tissue culminates in the somewhat varied symptoms of venous insufficiency. This condition is considered a medical condition, which can cause your legs to feel, function, and appear less than what you may prefer. The great news is that venous disease can now be treated using minimally invasive techniques in an office setting with immediate return to normal activity after treatment.


Who gets venous insufficiency?

Well, one quarter of 311 million people in the United States is more than 77 million people, so the first answer to the question

above is lots and lots of people get venous disease. The next time you’re in a movie theater, look to your left and to your right. Someone within reach has venous insufficiency. Beyond this though, leg veins fail because of hormonal influence, trauma, and heredity. The main hormonal suspect is progesterone, which women have a lot of during pregnancy and well…during being a woman. Progesterone has an adverse effect on vein valves. Among other effects, it causes vein valves to fail, leading to the creation of vein pressure overload. This is probably why 75 percent of vein insufficiency patients are women. Beyond simply being female, though, vein disease runs in families and occurs after trauma such as a broken leg. Perhaps the most compelling scenario is the individual who has to stand or sit for long hours every day, either at their job or taking care of their children, or both. By repetitive pressure trauma on the veins these individuals are at risk to suffer from venous insufficiency. The long hours of standing and sitting cause a constant barrage of pressure on the leg vein system and herein lies the problem. The leg veins are not made for high-pressure. They have only one layer and in the context of how blood vessels are commonly regarded are extremely thin. Simply put, leg veins exposed to pressure over time will fail. Having incompetent veins is like trying to cap a fire hydrant with cellophane. It is just not going to work.


How does the venous insufficiency cause my legs to bother me? (Varicose Veins)

When the leg veins fail, then, the pressure within the veins is transferred to the leg tissue and into the vein branches under the skin. This pressure on the tissue and the veins leads to blood engorgement in the veins and inflammation in the tissue. This sequence of events then is what leads to visible unsightly veins, varicosities, aching, swelling, burning, or even restless legs. Amazingly in people with both restless legs and venous insufficiency the restless leg symptoms are often improved after minimally invasive treatment for venous insufficiency. So to sum it up, venous insufficiency is a sequence of events that starts with vein valve failure. Because of high pressure in a vein system not meant for high-pressure, a cascade of events follows and leads to the broad array of different possible symptoms of vein disease described above.


What can be done about venous insufficiency?

 The short answer is that there are now multiple minimally invasive options for venous insufficiency (Varicose Veins) . The first step is an evaluation in a vein disease specialty office. Examination by an experienced team dedicated to treatment of venous disease will determine the presence of venous insufficiency. Thereafter a treatment plan and course of action can be plotted with your vein specialist surgeon. Insufficient superficial veins can be closed by a minimally invasive, catheter-based, office procedure with return to normal activity immediately. By and large vein stripping requiring hospitalization is no longer necessary. The procedure is covered by insurance because venous insufficiency is a medical condition. So there are newer options to treat vein disease which are reliable safe and get you back to your life.


What are the results of venous disease treatment?

woman resting her feet on a coconut in the caribbean

Multiple clinical trials have demonstrated the efficacy of office-based minimally invasive therapy for vein disease. Within the year, the British Journal of Surgery published a prospective randomized trial by Dr. Rasmussen of Denmark comparing four different treatment modalities for venous insufficiency (Varicose veins). If you do not happen to know, a prospective randomized trial is the ultimate type of medical study, which often produces the most reliable information upon which medical decision-making and medical care is based. The decisions for treatment options in such studies are made by random computer choice and thus biases are removed from the study. The upshot of this important study was that of all the modalities investigated, office-based radiofrequency venous closure of insufficient leg veins was the least painful, most effective, and most likely to allow immediate return to normal activity, including work. Amazingly, when questioned about their quality of life overall in a 36 point questionnaire, patients stated that their quality of life one year after the procedure was improved. This is absolutely stunning because the patients in the study started out with legs that bothered them. One year later their whole life is better.


What can I do to be evaluated?

 So if your legs have developed prominent veins, or ache, swell, burn, itch, or are restless you should consider an evaluation. Obviously you would like this evaluation to be at a high-quality, experienced, venous disease specific organization. At Maryland Vein Professionals (MVP), we have performed more than 12,000 radio frequency, office-based minimally invasive venous closure procedures. The success rate has been in excess of 99.9%. We are a training center for ultrasonography and so we have the experience and quality required for complete evaluation of venous insufficiency. Call or go online to make an appointment Monday through Saturday.