I've had two separate venous ultrasounds done at two different clinics. Neither showed much reflux, yet symptoms still persist. Can very mild reflux cause lots of pain in legs or is this typically only seen in people with a more significant amount of reflux? Are there other problems that could be causing symptoms similar to vascular/vein issues?
Mild reflux usually does not cause many symptoms. On the other hand, patients with only spider veins can complain of pain. I have seen many patients with varicose veins and leg pain, but they are not connected. Sciatica, arthritis in the hip or knee, and restless legs syndrome are just a few of the other causes of leg pain. A physical exam and a trial of compression hose can very helpful in sorting these out.
Published on Jul 11, 2012
Good question. Mild reflux can cause significant symptoms, while more severe reflux may not. If wearing properly fit compression stockings temporarily relieves your symptoms, this suggests venous reflux is the
problem. If not, consider a consultation with your primary care physician to explore other options.
Published on Jul 11, 2012
Mild reflux can cause significant symptoms like you are having. Doctors will still treat veins with mild reflux if there is pain and heaviness. There could be other problems, but they could be hard to determine especially without any previous official diagnosis. Find an interventional radiologist to have treatment. They will do another ultrasound and document reflux in all veins.
Published on Jul 11, 2012
It is not unusual for some patients to have difficulty proving there is reflux, in spite of classic symptoms. Some of these patients could be treated conservatively for a few weeks by wearing compression stockings. If they find some relief of their symptoms, then a more definitive treatment can be done. Also, it is important that the reflux exam is done by a vein specialist who understands the details of the ultrasound exam and how to elicit the reflux. Many clinics employ technologists who might not have enough experience and they pass the information to the physician, who never even saw the ultrasound images. You should ask if the exams are done by technologists or by the actual physician the next time you get an evaluation.
Published on Jul 11, 2012
Lower extremity symptoms fall into three basic categories:
1. Vascular- arterial and/or venous
2. Musculoskeletal- muscles, bones, joints, ligaments, and tendons
3. Neurologic- peripheral nerves, spinal, and central
A detailed history and physical will usually identify which category(ies) your symptoms are attributable to, and then you can be referred to the correct specialist.
Published on Jul 11, 2012
It is doubtful that minimum reflux would cause significant symptoms. There are many other reasons to explain leg discomfort. You should be evaluated by a vascular surgeon.
Published on Jul 11, 2012
It is very difficult to predict the amount of symptoms one may have based on the degree of reflux on their ultrasound. Additionally, the degree or amount of reflux that is present may vary throughout the day and change from day to day. If your symptoms resolved when you wear your compression stockings, then that is generally a good sign that your symptoms are from your veins, regardless of the degree of reflux. Hope that helps.
Published on Jul 11, 2012
Depends on how your legs look, the quality of the exams, and a few other variables. Peripheral neuropathy, spinal stenosis and muscle weakness disorders may also cause leg issues.
Published on Jul 11, 2012
The symptoms patients experience often don't correlate. For example, lots of reflux in large veins may not have many symptoms or hardly any symptoms, while someone else with a small amount of reflux may have a significant number of symptoms. It is the nature of the symptoms, their quality [ what they feel like ] and what makes them better or worse that best correlates with whether they are caused by vein problems.
Published on Jul 11, 2012