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  • Achy, Tired Legs? Is it Too Much Holiday Shopping – or Varicose Veins?

Published on December 06, 2012

Achy, Tired Legs? Is it Too Much Holiday Shopping – or Varicose Veins?


SIOUX FALLS (Dec. 6, 2012) – If tired, achy legs are slowing you down this holiday season, perhaps your Christmas wish is an end to the symptoms of varicose veins.

Even though she wore support hose, Mary Devlin of Sioux Falls still ended every day with aching, swollen legs. “I just felt exhausted at the end of the day.” After about five years, she decided to give up on the support hose, and researched a solution known as endovenous ablation.

It meant two, two-hour sessions – one for each leg – in a clinic setting, with no anesthesia or sedation. “The only discomfort was the little needle pokes. I work part time so I was off for the afternoon, but I could have gone back to work. There is absolutely no down time after this procedure.” Now, she has energy in the evenings. “My legs don't feel so heavy, tired and fatigued at the end of the day – and I don’t have to wear support hose anymore – yea!”

Varicose veins are the “big roping veins” in the leg, as opposed to tiny spider veins which look more like purple lines on the skin, said Dr. Matthew Casey, interventional radiologist with Avera Veradia Vein Center. While spider veins are unsightly, they don’t cause symptoms like varicose veins do.

A common medical issue, varicose veins affect 25 percent of women and 15 percent of men. “They are most commonly related to failure of valves, which happens for no known cause. Blood doesn’t flow in the right direction – toward the heart – causing increased pressure in the veins,” Dr. Casey said. The great saphenous vein in the leg is most often affected.

The condition runs in families, and is more common in people who are heavy, people who work in standing occupations, as well as in women who have had children – especially more than one.

“For more than 100 years, surgical stripping was the therapy for varicose veins,” Dr. Casey said. “The great saphenous vein was surgically removed.” Yet after enduring this painful procedure, patients still faced a high recurrence rate of 20 to 40 percent.

Wearing compression stockings is therapy that is helpful for some people. However, it provides symptom management rather than a cure. “Most people don’t like to wear them,” he added.

Endovenous ablation is a relatively new treatment, which has been around for about 10 years. Using either a laser or radiofrequency device, the vein is destroyed through heat during a minimally invasive, outpatient procedure.

For cosmetic reasons, spider veins can be “cleaned up” on an outpatient basis using sclerotherapy, which involves injecting a small amount of chemical into the veins. “About 50 to 70 percent of them go away when we treat a field of spider veins,” Dr. Casey said. The procedure is painless other than the tiny needle sticks. “Most patients say it feels like getting stung by a mosquito.”

If varicose veins exist, they have to be treated first, or the treatment for spider veins won’t be very long lasting. “It’s like mopping the floor when you have a broken pipe in the basement,” Dr. Casey said. However, not everyone who has spider veins has varicose veins. In fact, 70 percent of middle-aged women have spider veins somewhere on their legs. If there is no venous insufficiency, the spider veins can be treated alone with sclerotherapy. Dr. Casey says most insurance companies consider this a cosmetic procedure. It’s important to realize that spider veins, even in a treated area, can come back in other veins. “If you’re a woman who gets spider veins, you’re going to get spider veins,” Dr. Casey said.

Unlike spider veins, the underlying reason to treat varicose veins is the troublesome symptoms, and also possible complications, such as blood clots.

Symptoms were exactly why Amy Moncur of Sioux Falls sought treatment for varicose veins. “My legs ached at night, making it hard to sleep.” The veins weren’t noticeable, but she could definitely feel the problem at the end of the day. Her mom and both her grandmothers had varicose veins, so Amy got it checked out, and had her legs done back to back over two days.

“The procedure really was a piece of cake. There was a little tenderness with the needle sticks to numb my legs, but otherwise, it didn’t hurt at all. After the procedure, there was a little achiness and a sensation of pulling, but within a week or two, my legs felt completely normal.” Now, Amy sleeps pain-free at night, although she’s on her feet much of the day. “I definitely feel so much better.”

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