Sending a patient to Vein Center for Leg Pain

Q: I'm a physical therapist. We are trained that exercise can heal the body; how do we know when to send a patient to you if they still have leg pain and we’ve been working with them?

We always appreciate the hard work of physical therapists who help patients overcome pain issues. Often times, we see patients referred from orthopedic surgeons, neurosurgeons, physiatrists, and physical therapists. These patients frequently have musculoskeletal issues addressed with various treatment modalities including an intensive physical therapy regimen. The musculoskeletal symptoms can include pain localized to hip, knee, and ankle joints, shooting sciatic pain radiating from the lower back, and tightness of muscles groups. If patients continue to experience pain such as tired, achy, itchy, or heavy legs associated with swelling or pain, we feel that they should have an ultrasound evaluation to assess for venous insufficiency. Further, if patients have any visual stigmata of venous insufficiency such as spider veins, varicose veins, phlebitis, or hyperpigmentation, a venous evaluation at a vein center is warranted.