Why would I start having pain and aching in my legs over one year after having EVLT?

I had EVLT in April 2015. My legs did cramp a little before this procedure, but I never experienced aching or pain. My reason for treatment was mainly for spider veins, which were treated with sclerotherapy after finishing EVLT. My legs do look better now, but why do they feel worse than before?

Answers from doctors (3)


More About Doctor David Green, MD

Published on Jul 22, 2021

Your spider veins could have been successfully and permanently removed by sclerotherapy without prior EVLT, as they were after EVLT. Spider veins most often occur in the absence of any underlying venous insufficiency and when there is underlying venous insufficiency, it is rarely the cause of spider veins.

The cause of your "feel worse" legs can be investigated. A thorough duplex ultrasound exam can be administered. If no significant reflux is discovered (and I doubt if there is any) then venous insufficiency is unlikely the cause. Some people experience discomfort with normal veins - some women will have symptoms during different phases of their menstrual cycle due to variations of hormone levels that can affect normal veins. Usually, gradient compression stockings provide significant venous vascular support even in the absence of any venous insufficiency. Most people who wear gradient compression stockings benefit. Even those who have no symptoms who wear these stockings, will appreciate them once they discontinue them.

There are other causes of discomfort in the lower extremities, including musculoskeletal problems.

Answered by David Green, MD (View Profile)

Your spider veins could have been successfully and permanently removed by sclerotherapy without prior EVLT, as they were after EVLT. Spider veins most often occur in the absence of any underlying venous insufficiency and when there is underlying venous insufficiency, it is rarely the cause of spider veins.

The cause of your "feel worse" legs can be investigated. A thorough duplex ultrasound exam can be administered. If no significant reflux is discovered (and I doubt if there is any) then venous insufficiency is unlikely the cause. Some people experience discomfort with normal veins - some women will have symptoms during different phases of their menstrual cycle due to variations of hormone levels that can affect normal veins. Usually, gradient compression stockings provide significant venous vascular support even in the absence of any venous insufficiency. Most people who wear gradient compression stockings benefit. Even those who have no symptoms who wear these stockings, will appreciate them once they discontinue them.

There are other causes of discomfort in the lower extremities, including musculoskeletal problems.

Published on Jul 11, 2012


Advanced Vein Center

Published on Jul 28, 2016

I don't know, and I don't think it has anything to do with the EVLT.

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Answered by Advanced Vein Center

I don't know, and I don't think it has anything to do with the EVLT.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Jul 28, 2016

We often see patients who have these treatments for unrelated spider veins. Not all symptoms are caused by veins, and a little cramping without pain, aching, heaviness, etc. would not lead me to proceed with EVLA. Superficial spider veins on the outsides of the legs, especially are unrelated. Insurance requires medical necessity for symptoms affecting activities of daily living (work, sleep, childcare, etc.), not cosmetic reasons. I am not sure why you now have these symptoms. Perhaps you should seek a second opinion from a board-certified, vascular-trained surgeon.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/623_1499902138.jpg
Answered by Vein Specialties of St. Louis

We often see patients who have these treatments for unrelated spider veins. Not all symptoms are caused by veins, and a little cramping without pain, aching, heaviness, etc. would not lead me to proceed with EVLA. Superficial spider veins on the outsides of the legs, especially are unrelated. Insurance requires medical necessity for symptoms affecting activities of daily living (work, sleep, childcare, etc.), not cosmetic reasons. I am not sure why you now have these symptoms. Perhaps you should seek a second opinion from a board-certified, vascular-trained surgeon.

Published on Jul 11, 2012


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