I'm 3 months post-vein ligation and 2 months post-sclerotherapy. I still have the same intense pain I had prior to surgery. What is wrong?

On 2-11-16, I had vein ligation of the GSV. Then, on 3-21-16, I had sclerotherapy on my left leg. Pain in my left leg is the same & more frequent than before surgery. Elevating my leg and resting it on any elevated prop eases the pain. When my foot is put back down flat & the walking or standing continues, pain comes back. I wear shoes that are custom-made for my feet with arch support, so it isn't the shoes. The other night I was awakened by the pain in left leg. What's wrong?

Answers from doctors (3)


The Sheen Vein Institute

Published on May 11, 2016

What is wrong is that your treatment was incomplete. First off, if I am interpreting your treatment correctly, your GSV was ligated (cut/tied off) and not ablated like with a laser. If that is correct, that is your first issue. Ablation with a laser or RF is the gold standard in treating GSV reflux--not ligation. Secondly, a single sclerotherapy treatment is rarely going to adequately address the average patient's vein issues. The combination of the two treatments that you have undergone indicates to me that your treatment was incomplete. Resolution of your discomfort occurs when the circulatory defect--that is, vein disease--is adequately resolved through treatment. You never got enough treatment to fix your venous circulation. This is why your pain persists. Find a doc who treats the venous circulation; meaning, a doc who treats the whole leg and not just a couple of veins here and there.

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Answered by The Sheen Vein Institute

What is wrong is that your treatment was incomplete. First off, if I am interpreting your treatment correctly, your GSV was ligated (cut/tied off) and not ablated like with a laser. If that is correct, that is your first issue. Ablation with a laser or RF is the gold standard in treating GSV reflux--not ligation. Secondly, a single sclerotherapy treatment is rarely going to adequately address the average patient's vein issues. The combination of the two treatments that you have undergone indicates to me that your treatment was incomplete. Resolution of your discomfort occurs when the circulatory defect--that is, vein disease--is adequately resolved through treatment. You never got enough treatment to fix your venous circulation. This is why your pain persists. Find a doc who treats the venous circulation; meaning, a doc who treats the whole leg and not just a couple of veins here and there.

Published on Jul 11, 2012


Hratch Karamanoukian, MD, FACS, RVT, RPVI, RPhS

Published on May 11, 2016

Let's hope that in 2016 you did not need vein ligation. It is rarely indicated as there are better procedures to treat venous insufficiency. The only place where I do vein ligation is outside of the U.S., where I do medical missions.

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Answered by Hratch Karamanoukian, MD, FACS, RVT, RPVI, RPhS

Let's hope that in 2016 you did not need vein ligation. It is rarely indicated as there are better procedures to treat venous insufficiency. The only place where I do vein ligation is outside of the U.S., where I do medical missions.

Published on Jul 11, 2012


Susan B Fox, D.O. RPVI, FSVM

Published on May 11, 2016

Maybe something else is causing the pain. Consider the other causes. Could it be your foot, your back, a pinched nerve, etc.?

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Answered by Susan B Fox, D.O. RPVI, FSVM

Maybe something else is causing the pain. Consider the other causes. Could it be your foot, your back, a pinched nerve, etc.?

Published on Jul 11, 2012


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