Successful Treatment Improves Symptoms in Multifactorial Leg Pain

Patient: Female, 63 years old
Date of Follow-Up: Two weeks after left GSV ablation; scheduled for right GSV ablation

Background:
Karen R., a 63-year-old woman, initially experienced heaviness, fatigue and pain behind her left knee when standing for long periods, along with swelling of her left leg. She underwent a successful VNUS ablation of the left great saphenous vein (GSV). Since the procedure, her symptoms have greatly improved or resolved. She also reports better strength, increased leg movement and less swelling in her left leg compared to her right.

Diagnosis and Testing:
Ultrasound imaging confirmed the successful ablation of her left GSV and showed reflux in her right leg’s GSV, which needs treatment. Her symptoms, like heaviness and aching, are typical of venous insufficiency—sometimes called “ortho-venous disease”—which may be overlooked because her legs lacked visible varicose veins or skin changes.

Treatment Plan:
She is scheduled to undergo endovenous ablation of the right GSV to address the remaining reflux and symptoms. Her initial success on the left side demonstrates how treating venous issues can greatly improve leg discomfort, especially in patients with previous orthopedic injuries or arthritis that may also contribute to leg pain.

Discussion:
This case highlights how venous insufficiency can coexist with orthopedic conditions, complicating leg pain. Simple, noninvasive treatments like ablation can significantly relieve symptoms, even when typical signs like varicose veins are absent. Addressing venous reflux often improves overall leg comfort and function, especially in complex cases with multifactorial causes of leg pain.