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I had my GSV ablation done 13 days ago and still have intense pain in a segment on the inner thigh just above the knee. Is this level of pain normal and, if so, for how long? I have to take Advil for relief, but my stomach is sensitive to NSAIDS.
Generally speaking, two weeks after a laser procedure, you should have limited discomfort. The reality is that there are certain patterns where discomfort might be expected. I would suggest following up with your physician to be certain that you do not have a superficial blood clot, a deep vein clot, or other uncommon problem that could be causing pain. Even with older laser devices, your discomfort should be better by now. Your best course of action is to call and follow up with your vein specialist.
It would probably be a good idea to have another follow up with your provider, but it's probably just a little superficial clot, which is painful like you've said, but it is not a health risk. Your provider could possibly drain the area to help with some pain relief if the segment is lumpy under the skin.
Most patients who are two weeks out from an Endovenous laser ablation treatment can have some mild tightness and soreness/bruising in the proximity of the treated vein. If you are having intense pain in a specific location on your leg, I suspect that you are suffering from a feeder branch that is trying to pump blood into the vein that was treated. This can cause you to develop a pressure spot and, possibly, some trapped blood in that location. The result is a localized phlebitis causing tenderness in that location. Your options are simple. Either have your doctor treat the feeder with sclerotherapy and eliminate your pain within a day, or manage the discomfort until it goes away over the next 4-6 weeks.
Sometimes it depends on the type of laser used. Lower wavelengths have more post procedure pain than higher wavelengths. It should improve soon. Keep up your walking.
Most people have mild to moderate discomfort in the treated vein for a few days after laser ablation. Occasionally I have patients that report more intense discomfort such as you have, which is suspect is due to a more intense inflammatory reaction to the laser or some thermal injury to an adjacent nerve. The discomfort should still gradually resolve over times as the inflammation improves. Anti-inflammatories and warm heat to the area often help.
Intense pain should not be experienced even immediately after endovenous laser ablation. I would recommend you see your surgeon and have an ultrasound examination. If this is okay, apply low heat to the area often for about 10-15 minutes and/or ice. This can relieve the discomfort. Our patients use Arnica cream gently massaged into the ablated area, which is soothing and promotes healing. If you are sensitive to NSAIDS, you should take them with a lot of food in your stomach and alternate with extra strength Tylenol. Your doctor can also prescribe something stronger to get you through this phase.
Pain post endolaser ablation is most commonly due to post-laser inflammation. This is why the protocol has been to prescribe anti-inflammatory medicines routinely. As you have stomach issues, other methods of analgesia need to be considered or even cold laser treatments. I am surprised that you are not seeing your treating physician to address these issues, and have a recheck and ultrasound to exclude the possibility
of wound infection or thrombosis, which have different treatments. I encourage you to seek attention without delay.
Some patients might occasionally experience pain several days after EVLT, more commonly if the vein is too superficial, too large or they did not take anti-inflammatories. Wearing compression stockings, ambulation and use of acetaminophen (if NSAIDs cannot be used) will help.
This is not usual, please see your MD.
Patients typically report pain from 0-2 on a 10 point scale so your situation seems unusual, especially at two weeks post treatment. You should probably have your doctor ultrasound your leg again.
The great saphenous vein in this area may be very superficial (without much fat around it and close to the skin) so it is not unusual this early after the procedure to have fairly intense inflammation (and pain) directly over the vein. It should be in a line directly over the vein. Warm soaks, high dose anti-inflammatories (ibuprofen 8600-800 mg 3-4 x per day with food), and patience are the mainstays of treatment. The cord underlying the inflammation may remain for months as the acute pain and inflammation slowly and gradually resolve. Be patient.
What you describe is common after venous ablation. This is due to the heat of the laser and the contraction of the vein from the treatment. The discomfort is usually worse the second week after the procedure and lasts about one to two weeks. Wet heat to the area helps. NSAIDS are recommended, but if you cannot tolerate them, then try extra strength Tylenol.