What Are the Causes of Restless Leg Syndrome?

Most of those who have this condition are older or middle-aged adults. Those who are under a great deal of stress are more likely to suffer this condition than others are. However, most of the time, doctors are not able to pinpoint a specific cause of RLS. It tends to occur more frequently in those who have chronic kidney disease, diabetes, iron deficiencies, Parkinson’s disease, or peripheral neuropathy. It is also known to be passed down in families. If the symptoms start at a younger age, it could be due to genetics.

What Are the Symptoms of Restless Leg Syndrome?

RLS symptoms are sometimes hard to spot. If you have sensations in the lower portion of your legs, that make you feel uncomfortable unless you move them, then this could be a condition you have. Most often, the condition occurs at night, but it can happen at any time. Other symptoms of it include:

• The feeling of an irresistible urge to move your legs or to get up and walk. When you do, this reduces the discomfort you feel.

• You have rhythmic leg movements while you sleep. This is called periodic limb movement disorder.

• Your symptoms can last an hour or more.

• They occur in the upper leg, feet, and arms sometimes, but not as commonly.

• You have a sensation that feels like aching, pulling, tingling, crawling, or bubbling in your legs.

If you have these symptoms, you may have restless leg syndrome. If you do, talk to your doctor for a formal diagnosis.

What is the Treatment for Restless Leg Treatment?

Though massages and warm baths can help those with RLS, there is no known cure of treatment for the condition. You may be able to find some relief from reducing stress levels and doing gentle stretching exercises to loosen muscles.

For those who have restless leg syndrome, it can be important to talk to your doctor about this condition. Some medications can be helpful to some people who have this condition. This is important for those who have intense disturbances during sleep.

Learn more about Restless Leg Syndrome – What Is It and Do You Have It? at Premier Vein Centers Hudson Valley, New York

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Learn more about Dr. Arlen Fleisher interviewed on Health Talk at Premier Vein Centers Hudson Valley, New York

What Are the Symptoms of Pelvic Congestion Syndrome?

Those who have this condition generally have pain in their abdomen and pelvis areas and that pain is hard to pinpoint a cause of. Your doctor will rule out other conditions first. This will include testing you for cervical cancer. He or she will also rule out a pelvic tumor as the cause. If this occurs, and your symptoms are those of the condition, the doctor is likely to state you have this condition. Symptoms may include:

• Pain that worsens when you sitting or standing

• Chronic pain in the pelvis region

• Pain that is associated with varicose veins located in the thigh or buttock regions

If you have these conditions, your doctor will likely state you have pelvic congestion syndrome. This may seem like a frightening diagnosis.

What Are the Treatment Options for Pelvic Congestion Syndrome?

The hard part is diagnosing this condition. The main difficulty in doing so is that the varicose veins, which are often in the vaginal area, buttocks, and upper thigh, are harder to see. It is often overlooked, then, as the condition. Your doctor may recommend the use of a trans-catheter treatment to get rid of the varicose veins causing the condition. This is a non-invasive type of procedure. It is not a surgery. However, it can be helpful in many cases at treating the condition and allowing you to overcome it.

If you think you may have pelvic congestion syndrome, it is a good idea to talk to your doctor about it. Discuss what could be causing the problem and, if possible, what steps you need to take to overcome it. Many people put it off thinking that it will just go away. However, it will not. If you have pain that is in this area of your body and it has been fairly chronic for six months or longer, it is time to discuss it with your doctor.

Learn more about Understanding Pelvic Congestion Syndrome at Premier Vein Centers Hudson Valley, New York

How pelvic congestion syndrome occurs? 

Due to both ovarian and pelvic varicosities, the blood vessels in the pelvic area tend to loose its elasticity. Moreover, damages to the venous valve system may also develop. Incidentally, the venous system in the pelvic gradually loses its ability to push up the oxygen-depleted blood against gravity to the heart. It results in pooling of blood in the area, which subsequently increase the blood pressure locally.  The blood vessels bulge out, sometimes the blood components ooze out into the surrounding tissues, and severe pelvic pain and heaviness result. 

What are the symptoms of pelvic congestion syndrome? 

One of the major reasons why the diagnosis of PCS is considered difficult is because it presents with a number of symptoms. Some of the common symptoms include pain brought on by an increase in intraabdominal pressure, pain relieved by lying down, dull aching pains, dysfunctional bleeding and dysmenorrhea, low back pain, pain that lasts for hours after sexual intercourse, common episodes of acute pain, menstrual disorders, bladder irritability, gastrointestinal symptoms, and family history of varicose veins. 

How is pelvic congestion syndrome diagnosed? 

Vein specialists mainly resort to imaging techniques for confirmation of PCS after a detailed physical exam and thorough study of medical history. Laparoscopic examination and ultrasound examination are the commonly utilized techniques. In certain circumstances the causes of the pelvic pain remain occult under ultrasound examination and an MRI, MR angiography, or a CT scan may be needed. 

What are the common treatments for pelvic congestion syndrome? 

Depending upon the exact cause of the pelvic congestion syndrome, the treatment approaches are varied. For example, the ovarian varicosities, if found, are embolized under local anesthesia. It is a well-known fact that varicosities in the legs cause pelvic pain. They are also embolized. The success rate and pain reduction may stand anywhere from complete to partial; however, a majority of the patients enjoy complete reduction in pain and pressure after the procedure. Pain management is essential during the first 24 hours after the procedure and the patient may need to stay at the hospital during this period. Later, the patient is discharged and she may need to continue on oral pain medications for some time. 

Learn more about What is pelvic congestion syndrome? at Premier Vein Centers Hudson Valley, New York

What exactly is chronic venous insufficiency? 

Sometimes it’s so happens that the veins in the body fails to pump enough oxygen-depleted blood back to the heart. This condition is known as chronic venous insufficiency. It usually occurs in the lower extremities and it tends to occur more in females than in males. It’s a condition commonly attributed to the sedentary lifestyles of modern world. Our veins must push the oxygen-depleted blood against the gravity for it to reach to the heart. It requires a lot of energy and veins utilize the squeezing movements of the muscles and certain inbuilt structures such as venous valves that prevent the downward movement of blood. When the muscles compress the oxygen depleted blood moves up and when the muscles relax the venous valves close by itself to prevent the blood from freely flowing down. Sitting or standing for long hours without any movement would not promote this process and may ultimately lead to the breakdown of the functionality. Certain diseases such as varicose veins also lead to chronic venous insufficiency. In some unfortunate individuals the vein valves are congenitally absent, which also leads to chronic venous insufficiency. 

What are the symptoms of chronic venous insufficiency? 

At the onset of the condition, there will be swelling and pressure feeling in the lower legs. As the condition progresses, the pressure and the swelling increases and minute capillaries bursts leading to reddish-brown skin coloration in the affected areas. In the advanced stages, it will produce ulceration in affected areas and open sores may be noticeable. Furthermore, these sores may succumb to bacterial infections and associated complications. For example, an uncontrolled infection may spread to the surrounding tissues leading to a condition known as cellulitis. 

Diagnosis and management for chronic venous insufficiency

A usual medical history and physical exam would be conducted with special attention to the legs. It may be followed by evaluation of blood circulation in the legs utilizing duplex ultrasound techniques. It will help the vascular surgeon to clearly visualize the vessels and determine appropriate course of treatment. 

Just like any other disease, chronic venous insufficiency is most curable in the early stages. Physicians utilize a combination of exercises, weight loss programs, lifestyle modifications, compression stockings, antibiotics, etc. in the beginning. If surgery is required, techniques such as ligation and stripping, ambulatory phlebotomy, and venous bypasses come into aid. 

Chronic venous insufficiency and in general most venous diseases could be prevented with healthy lifestyles and regular exercises. 

Learn more about What is chronic venous insufficiency? at Premier Vein Centers Hudson Valley, New York

How in general venous diseases cause swollen legs?

Venous diseases such as varicose veins, deep vein thrombosis, venous insufficiencies, and other systemic diseases are a major cause of swollen legs in adults. In many of these conditions, the normal blood flow is slowed or obstructed for multiple reasons, which result in the buildup of increased local blood pressure. It then forces the blood components to ooze out into the surrounding tissue layers leading to pain and swelling in the affected areas. If the blood vessels on or near the skin layer are affected visible signs such as redness of the skin could be noticeable. 

How are swollen legs due to venous diseases diagnosed?

Vein specialists utilize a number of techniques to determine the exact cause of the swollen legs. Commonly used techniques such as ultrasound, Duplex Doppler, and CT scans are capable of revealing the nature of the blood flow and presence of any obstructions in the path. MR angiography and other venography techniques are also utilized. 

How are swollen legs due to venous diseases managed? 

Vein specialists usually focus on the exact cause of the swollen legs and once the issue is resolved the swollen legs starts to recede by its own. In addition, compression stockings and manual bandages are used around the affected area to balance the blood pressure. In some advanced stages of venous diseases, there may be skin wounds and infections which are treated just like any other wounds and infections. 

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Non occlusive thrombosis – that do not completely obstruct the blood flow through the vein. 

Occlusive thrombosis – that completely obstruct the blood flow through the vein.

Common Causes of Deep Vein Thrombosis

Centuries ago, the occurrence of deep vein thrombosis associated with pregnancy was clearly understood. However, they believed that the symptoms are due to milk deposits in the thigh muscles and called it ‘milk leg.’ It resulted in one of the earliest public health notifications asking mothers to breast feed their children to avoid the complications of ‘milk leg’.

In United States, an estimated 300,000 fresh cases of DVT is reported every year. Certain factors greatly increase the risk of deep vein thrombosis. Young people are less likely than older people to develop thrombosis. Conditions such as cancer, surgery, being confined to bed, etc. can provoke DVT. There are also some speculated factors such as inheritance or congenital onset in people who develop DVT spontaneously. Hormonal drugs such as oral contraceptives also cause deep vein thrombosis. Technically, changes in the vessel wall, changes in the blood flow, and changes in the blood composition are the major causes of deep vein thrombosis.

Symptoms and signs of deep vein thrombosis

At onset, common symptoms of inflammation such as redness, warmth, tenderness, and swelling of the vein and nearby tissues are observed. Some people start to experience DVT as night let pains. Visible dilation of the surface veins is also observed. Most people notice it when their leg swells and become painful. Discoloration of the surrounding skin may follow. Tingling in the leg veins and tiredness are other symptoms. In cases of immediate onset DVT, some people experience fever, dizziness, extreme swelling, purple-reddish coloration, and of course, strong pains.

Bibliography

James, A. H., Ortel, T. L., & Tapson, V. F. (2008). 100 Questions & Answers About Deep Vein Thrombosis and Pulmonary Embolism. London: Jones and Bartlett Publishers.

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How is ultrasound performed in diagnosing venous diseases?

Ultrasound is a painless and noninvasive (sound waves are not radioactive) diagnostic technique widely used to diagnose venous diseases. An ultrasound session may last for 15 to 45 minutes depending upon the body part under examination. An ultrasound operator would place a probe on the surface of the body where internal structure needs to be visualized. A jelly is applied between the probe and skin in order to ensure proper contact. The machine will send ultrasound waves into the body and the echoes of which are then captured by the ultrasound machine to produce pictures or videos of the internal structure in action.

Types of ultrasound performed in diagnosing venous diseases

Various ultrasound techniques are in practice to diagnose different venous diseases. For example, an ultrasound technique called Duplex ultrasound is used to determine the blood flow and structure of the leg veins. An element of Duplex ultrasound called gray scale ultrasound is employed to image plaques and blood clots directly. Another technique called color-Doppler ultrasound is used to visualize the flow or movement of the blood stream. A Doppler ultrasound session may reveal the amount of blood flow through major arteries and veins and help us evaluate blockages to blood flow, floating clots or embolus, or narrowing of blood vessels due to plaque accumulation. Venous ultrasound techniques are nearly as accurate for detecting blood clots in the in the lower legs.

Other specialized ultrasound techniques such as arterial sonography also help us to assess the patency and possible obstruction of the arteries. Thrombosonography, another specialized ultrasound technique, help to diagnose the presence of deep vein thrombosis and venosonography aid in determining the extent and severity of venous insufficiency. 

In short, ultrasound techniques have evolved as an unavoidable component in the diagnosis of venous diseases. 

Bibliography

Hennerici, M., & Neuerburg-Heusler, D. (1998). Vascular Diagnosis with Ultrasound: Clinical Reference with Case Studies. New York: Thieme.

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A vein doctor will understand the type of venous disorder and the treatment required

Technically called phlebology, treatment of vein diseases is a continuously evolving field. As a result, knowledge and experience of a vein doctor is critical in successfully completing treatment modalities. Your understanding about the venous disorder that you are suffering from and the treatment required is central in choosing a vein doctor. For example, a vein physician can perform some treatments such as injections but vein surgeries are often offered only by surgeons. 

Speak to other Patients 

According to American Health Journal (AHJ), patients make the practice. Hence the most important thing about deciding the vein doctor is to talk to the people who had vein treatment in your area for similar disorders. Generally, patients will tell other patients whether they had a good experience at the vein clinic, whether that was a successful treatment, whether they liked that doctor and his team, whether the doctor did a good job, etc. 

In addition, the Internet is a tremendous resource. If you would just type in varicose vein disease with your zip code you are going to come with results of vein doctors in your area and their expertise. 

Is your vein doctor a Board Certified Phlebologist?

If yes, your vein doctor is a medical specialist in diagnoses and treatment of venous diseases. They took the time to take that examination and obviously are dedicated enough towards vein treatments. Incidentally, Board-Certified vein doctors exhibit impeccable standards in their practice as they are certain to have achieved some level of expertise in venous disorders treatment. Certifications such as Registered Vascular Technologist (RVT) certification or Registered Physician in Vascular Interpretation (RPVI) are indicative of physicians with expertise in non-invasive vascular treatments.

Find a vein doctor totally devoted to it 

Some of the vein surgery clinics are run by physicians of other specialities like OB/GYN, dermatologists, cardiologists etc. However, you may be able to find a handful of vein doctors, who wake up thinking about it and go to bed thinking about it. It creates a massive difference because it allows them to be on the cutting edge. Hence it is worthwhile to look for someone who is totally devoted to vein treatment and if they happen to be Board-Certified in vein surgery, it’s the best.  

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Reticular veins are the green veins that are larger than spider veins but smaller than varicose veins. They are usually located on the lateral part of the thigh and legs are are frequently the feeding veins of large clusters of spider veins. These veins do not protrude from the surface of the skin and often need to be illuminated with special lights. If these veins are left untreatedspider therapy will usually be ineffective.

Two Reticular Veins Treatments

Treatment of these veins can usually be divided into two methods: injection with a scleroscent solution or removal through very tiny incisions using a technique called microphlebectomy.

Injection with a scleroscent

The scleroscent is directly injected into the vein as a liquid or foam. Generally, the liquid is a less dilute is the solution and will reduce the risk of possible skin complications which includes staining, hyper pigmentation and necrosis, but will require more treatment sessions. The results will also depend on the diameter of the veins. 

Microphlebectomy

Microphlebectomy is a minimally invasive procedure which is performed using local anesthesia and tiny incisions that are essentially punctures. The veins are then removed using a small hook and pulling the vein out in sections through the small punctures in the skin. There is usually either minimal or no bleeding and the incisions do not require stitches to close only a steri-strip. The leg is then wrapped for 48 hours and then the patient can remove the wrapping and use a compression stocking. There is no downtime and patients can usually resume their normal activities immediately. There are minimal risks especially to the skin. There is usually minimal or no scarring with an immediate excellent clinical and cosmetic result.

Your  Reticular Veins Treatment Choices, Hudson Valley, New York

The choice which procedure to use will usually be based on the size of the veins and experience of the treating phlebologist. My current preference is to perform a microphlebectomy to treat these veins, especially when the reticular veins are larger and more prominent. 

Learn more about your options for Reticular Veins Treatment, contact our Hudson Valley, New York office at 888-359-9462 today.

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