I've had two sessions of sclerotherapy. The spider veins look good (gone), but there is still some pain in the area next to the knee on both of my legs. Can veins beneath the surface hurt? Will more sclerotherapy help this?
Yes. Veins beneath the surface can hurt, and sclerotherapy can help
Published on Jul 11, 2012
Yes they can hurt, and if an ultrasound determines that you have underlying varicose veins, then ultrasound-guided sclerotherapy can possibly do the trick. For that, you will need to see a physician who is accredited by the American College of Phlebology.
Published on Jul 11, 2012
Proper treatment of a person's vein issues involves addressing and treating "all or most" of a person's abnormal vein structure. This means that you want to treat as many of the veins in the legs that are dysfunctional, not just the spider veins. Contrary to popular belief, all of those veins that you see beneath the skin surface, which we call reticular veins, are generally all abnormal veins and need to be treated. Furthermore, your leg should have undergone an ultrasound evaluation prior to any treatment in order to ascertain whether there are any defective veins arising from deep inside the legs. That said, in order to properly answer your questions, I really need to know what else is broken in your leg. That will determine what treatment modalities are needed.
Published on Jul 11, 2012
Veins beneath the surface can cause pain. Usually, painful veins will be large and noticeably dilated. Smaller veins do not usually cause much discomfort.
Published on Jul 11, 2012
Sub-surface veins connecting to surface veins can cause discomfort, but sub-surface veins cause varicose veins, not spider veins. Reticular veins frequently cause pain and are often the origin for spider veins, making it
necessary to eliminate both types of veins. Reticular veins are 2-4 mm greenish flat veins; abnormal ones are often identified by their tortuous zig-zag course.
Published on Jul 11, 2012
It is possible that there are varicosities that are not noticeable which, because of venous back pressure, are causing you discomfort. If you have not had a venous competency ultrasound study done already, I would encourage you to have one now and consult with a vascular surgeon to interpret the findings. If there are varicosities and you have venous incompetence, then there are modalities to address this and help alleviate your pain.
Published on Jul 11, 2012
If the "feeder" veins under the spider veins had fluid injected into them (we do this as part of the treatment with a vein lite), they may be inflamed. You should be evaluated by an experienced vascular surgeon who is experienced in treating these types of veins. The pain may not be related to the vein.
Published on Jul 11, 2012
Those veins beneath the skin are inflamed. Ibuprofen will clear up the pain and inflammation.
Published on Jul 11, 2012
If the pain is in the area of the previous injections, it is most likely superficial phlebitis (inflammation of the vein from sclerotherapy), which is common after sclerotherapy. You can take ibuprofen or Aleve, which will help the discomfort by treating the inflammation. It is not dangerous and will resolve over the next couple of months. More sclerotherapy would not improve the discomfort.
Published on Jul 11, 2012
We recommend duplex ultrasound to evaluate the veins that are not visible on the surface.
Published on Jul 11, 2012
Yes, they can hurt and Sclerotherapy might be one option.
Published on Jul 11, 2012
Yes, there may be painful veins you can't see beneath the skin. Best treatment for these veins depends on your anatomy based on a physical exam by your doctor and an ultrasound.
Published on Jul 11, 2012
Veins beneath the surface are usually called blue or reticular veins. They should not hurt you. Sclerotherapy can treat these veins, but I an not sure that this will resolve your pain. Perhaps the pain is none vein related. Speak to your treating physician about this.
Published on Jul 11, 2012