Varicose veins are swollen, twisted blood vessels that commonly appear just beneath the skin’s surface, most often in the legs. They occur when the one-way valves inside the veins weaken, causing blood to pool and the veins to enlarge. The most frequent concern for individuals considering treatment is the level of pain or discomfort they might experience during modern, minimally invasive procedures. Understanding the sensations associated with these treatments can help alleviate anxiety.
Common Minimally Invasive Treatments
Modern treatment for varicose veins focuses on minimally invasive techniques that seal or collapse the affected vessel, rerouting blood flow to healthier veins.
Sclerotherapy
One common approach is Sclerotherapy, which involves injecting a liquid or foam solution, known as a sclerosant, directly into the vein. This solution irritates the vein lining, causing it to scar and eventually close off.
Thermal Ablation
Two other widely used methods are thermal ablation techniques: Endovenous Laser Ablation (EVLA) and Radiofrequency Ablation (RFA). Both procedures treat the vein from the inside using a thin catheter inserted through a small skin puncture. EVLA uses laser energy to heat and collapse the vein wall, while RFA uses radiofrequency energy. These techniques are highly effective in treating larger, underlying veins that contribute to the visible varicose veins.
Pain Experienced During the Procedure
The immediate pain felt during a varicose vein procedure is minimal and well-managed because local anesthesia is routinely used.
Sclerotherapy Sensation
For Sclerotherapy, the sensation often compares to a minor pinprick as the fine needle enters the skin. Patients may experience a mild stinging, burning, or cramping feeling as the sclerosant solution is injected and begins to work on the vein wall. This sensation is typically brief and tolerable, with the entire injection process lasting only a few minutes per site.
Thermal Ablation Sensation
For thermal ablation procedures like EVLA and RFA, the area surrounding the vein is numbed with an injection of local anesthetic before the catheter is inserted. This tumescent anesthesia creates a buffer of fluid around the vein, which serves to compress the vessel and protect surrounding tissues from heat damage. Patients will feel a brief, sharp discomfort from the initial anesthetic injections. Once the area is numb, they may only perceive a dull pressure or pulling sensation as the catheter is advanced, but no actual pain from the thermal energy itself.
Post-Treatment Discomfort and Recovery
Following the procedure, patients can expect some discomfort as the body reacts to the treated vein. The most common symptoms include a dull ache, tightness, or mild tenderness along the path of the closed vein. Bruising is also a frequent occurrence and can take several days to a couple of weeks to fully resolve.
Post-procedural soreness is typically managed effectively with over-the-counter pain relievers, such as ibuprofen or acetaminophen, for the first few days. Patients are instructed to wear compression stockings, which help reduce swelling and alleviate tightness. Walking is encouraged immediately after the procedure to promote healthy circulation and reduce the risk of blood clots. The discomfort usually peaks within the first 48 to 72 hours and then steadily decreases, with most individuals returning to their normal daily activities almost immediately.