Medically Reviewed by David Shevitz, MD, ABEM, DABVLM, on December 27, 2024
Varicose veins are more than a cosmetic concern. Like other conditions involving chronic venous insufficiency, varicose veins can significantly impact one’s quality of life through physical symptoms such as pain, cramping, itching, leg heaviness, swelling, and discoloration of the skin. While many find it appealing to eliminate these irritating veins and their painful symptoms, others may have reluctance due to misconceptions that the treatments available are also painful—perhaps even more so—or that they have long recovery phases.
While people have different reactions and tolerances to pain and discomfort, one thing is true: varicose vein treatments have evolved remarkably in recent years, making modernized therapy options quick and minimally invasive. Many treatment options require just a small bandage. In addition to reducing patients’ healing time, these advancements decrease discomfort and allow those undergoing treatment to return to an active lifestyle immediately afterward.
Keep reading as we explore the expectations of common varicose vein treatments and how they measure up in terms of comfort. We’ll then weigh these modern treatments against vein stripping and ligation, the former treatment standard, to provide a comprehensive comparison and give peace of mind to those interested in improving their overall quality of life by boosting their vascular health.
Are you unsure if you’re experiencing leg pain related to varicose veins? Let the experts at Center for Vein Restoration (CVR) help you find answers. Begin your journey by completing our self-assessment, designed to provide valuable insights into your suitability for vein treatment.
Sclerotherapy involves injecting a solution into the vein to close it. Some patients report mild discomfort or a temporary burning sensation during the injection, but it is generally well-tolerated.
RFA is one of two procedures that use heat to close off the vein. A local anesthetic is applied to numb the area, minimizing discomfort among patients who undergo the procedure.
Another heat-based procedure, EVLT, may cause slight pressure or a pulling sensation, but it is typically not painful due to the use of local anesthesia.
Varithena is a proprietary type of foam sclerotherapy that is FDA approved to treat varicose veins in the GSV system. The medication is administered through a few small needle pokes.
Foam sclerotherapy is another minimally invasive treatment for both varicose and spider veins. Like traditional sclerotherapy, it involves injecting a solution into the affected veins, causing them to collapse and be reabsorbed by the body. Foam sclerotherapy uses a foam-like solution, which may cause some to experience minor and temporary irritation in the vein. Performed outpatient, foam sclerotherapy improves cosmetic appearance and alleviates symptoms with minimal discomfort, allowing patients to resume normal activities shortly afterward.
Phlebectomy is a minimally invasive procedure that removes varicose veins through small incisions in the skin. It effectively treats smaller vessels and relieves pain, swelling, and other physical symptoms while improving cosmetic appearance. Recovery is typically quick, allowing most patients to resume normal activities soon after. Most patients experience little to no pain due to the local anesthesia.
Follow all aftercare recommendations to improve comfort and increase healing times. While temporary soreness or bruising is relatively common, over-the-counter pain relievers such as Ibuprofen help patients significantly reduce short-term discomfort.
The bottom line? Most patients find that the long-term relief from the uncomfortable and persistent symptoms of varicose veins far outweighs the potential short-term soreness they experience after any of these professional treatments. Don’t hesitate to share any lingering concerns with your expert CVR physician, who can customize aftercare recommendations based on your health history, level of CVI severity, and other factors.
Now that we’ve discussed the basics of sclerotherapy, laser therapy, radiofrequency ablation, Varithena, and phlebotomy, let’s clarify what makes these options unique from the former preferred treatment method for varicose veins: ligation and vein stripping.
Used for decades, ligation involves tying off a vein to stop blood flow entirely, often as a preparatory step. In contrast, vein stripping removes a longer segment of the vein to alleviate symptoms and improve appearance. While both procedures address venous insufficiency, their approach differs: ligation closes the vein, and stripping removes it completely.
According to the Cleveland Clinic, traditional varicose vein stripping and ligation aren’t just painful. While effective, they have several risks, such as blood clots, infections, nerve irritation, and incision site scarring. Is there any question as to why the performance of these procedures has decreased dramatically since their inception? Our minimally invasive treatments are just as effective as traditional stripping surgery with less treatment related pain, less painful recovery, no need for missed time from work, and fewer complications.
Varicose vein ligation, specifically, has been abandoned as an “isolated procedure” by many physicians for failing to provide long-term relief despite triggering higher pain levels, using multiple incisions, and eventually requiring the entire removal of the affected vein, according to the National Center for Biotechnology Information, which describes the procedure as “bound to fail” when addressing visible varicosities:
“Popularized in the 1970s and 1980s, the concept of ligating visible varicosities utilizing multiple incisions has fallen out of favor as both ineffective and cosmetically unacceptable. Multiple small incisions are made along the course of visible varicosities and the veins are segmentally ligated and cut. With the current understanding that venous insufficiency must be addressed at its point of highest reflux, it is easy to understand why simple ligation of visible varicosities is bound to fail. Only after correcting the origin of highest reflux in the axial vein can secondary visible varicosities be ligated and removed. Failure to do so results in predictably early local recurrences at the sites adjacent to the previous incisions…The majority of the clinicians who perform venous surgery have therefore mostly abandoned varicose vein ligation as an isolated procedure.” -National Center for Biotechnology Information
While all medical procedures come with at least some level of risk, the trusted physicians at CVR are experts at keeping patients informed and comfortable before, during, and after each procedure. As patients of the largest physician-led vein center in America, those undergoing treatment at CVR can count on compassion, transparency, communication, and superior care from the moment they walk into any of our 110+ clinics.
Are you ready to take the first step toward healthier legs and improved quality of life? Let us help! Call our hotline today at 240-965-3915 to schedule an appointment and explore your treatment options. You can also schedule online.
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