1 week post RFA/Stabphlebectomy, Follow-up ultrasound was normal. I still have pain around the RFA area, is this normal?

Question

So i went to my follow up ultrasound after my RFA it was normal, no risk of DVT. I was reading here, that the leg is usually more painful on the second week since veins are collapsing inside the leg, is this true? Because, i had minor pain the first week... now I am in my second week, and around the RFA area, i feel part of the thigh is numb with pulling pain. I have been taking advil, applying warm compress, and using Arnicare Gel.. I am also keeping on compression socks. Is pain normal?

Raffy Karamanoukian, MD, FACS · Answer

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian
Realself100 Surgeon

Kevin Haney, MD · Answer

After both of these procedures are completed, it's very normal to experience a little pain or soreness around the treated area for a few weeks following. You're doing the right things to manage by continuing to wear the compression stocking and pain relievers. You should have a follow up appointment with your vein specialist, make sure to mention you've experienced some pain but it is nothing to get alarmed about.

Gary Nackman, MD, FACS · Answer

What you are describing is very common following RF ablation of the saphenous vein. After the vein is injured by the heat, an inflammatory process begins within your leg. Feeling of "numbness" and "pulling" are common. No need to worry.  Anti-inflammatory medications, heating pad or even ice, may improve the symptoms. No need for concern.

Michael M. Omidi, MD, FACS · Answer

Thank you for the question! It's not uncommon to experience some discomfort such as numbness and the pulling sensation for the first two weeks after RFA. It may persist up to one month but eventually resolve on its own. In order to aid the healing process, you may want to consider compression stockings. In addition, take care to avoid strenuous physical activities for the next week or two. 
An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and obtain expert medical advice. Best of luck!

John Landi, MD · Answer

What you are describing are normal things that occur post a closure procedure and you are doing all the correct things to help healing.  Usually more discomfort occurs during the 2nd week post treatment as the tumescent anesthesia wears off and the vein contracts.

Hratch Karamanoukian, MD, FACS · Answer

We don't combine the two procedures at the same time for the reasons that you list. The "pulling" sensation is from the ablation. Stab phlebectomy should cause minimal discomfort a week after the procedure. as long as there is not deep vein clot (post closure) or superficial vein clots or retained coagulum in the tunnels left behind from where tributaries were removed, Place topical heat regularly and take ibuprofen regularly and follow up with  the vein specialist. An aescin based cream containing arnica will significantly help relieve discomfort (see link below). We use it extensively in our large vein only practice.

Michael Nguyen, MD · Answer

Most patients after radiofrequency ablation (RFA) report improvement in their symptoms within one to two weeks following the procedure. However, some discomfort in areas of the procedure is anticipated. It is excellent that your post procedure scan is normal. Try to avoid strenuous exercise and heavy lifting for two weeks after the procedure. Follow up with your physician at a month same way you did for your post procedure ultrasound exam. Taking analgesics for the discomfort is fine as long as you follow your doctor’s advice. It can take more than 1 month to see full results for your treatment. 
Best,

1 week post RFA/Stabphlebectomy, Follow-up ultrasound was normal. I still have pain around the RFA area, is this normal?

Answers (7)

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