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Leg Pain & Fatigue

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Concerned about Leg Pain?

We evaluate and treat leg pain that is related to poor circulation, varicose veins and blood clots. These are all vascular conditions. However, there are numerous causes of non-vascular leg pain including injuries in the joints, bones, muscles or ligaments. Arthritis can also cause leg pain. Low back pain can radiate to the legs and also cause pain. It is always important to have a thorough evaluation by your doctor to determine the correct cause.

 

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Causes of Leg Pain

  • Blood Clots
  • Deep Vein Thrombosis (DVT)
  • Injuries in the joints, bones,
    muscles, or ligaments
  • Venous Reflux Disease
  • Low back pain radiating to the legs
  • Arthritis
  • Peripheral Arterial Disease (PAD)
shows calf pain in red on photo of leg

Blood Clots

Leg pain caused by blood clots can vary in how it presents. Not all blood clots will cause pain. Blood clots in the deep veins, called deep vein thrombosis, (DVT) can cause a sudden onset of swelling in the leg, pain, and sometimes redness and warmth. It usually affects one leg instead of both. It may be difficult to walk. A blood clot in a superficial vein, called superficial vein thrombosis, often occurs in a varicose vein. The vein can feel hard, painful, lumpy, or you may feel a rope-like knot just beneath the skin. The skin may appear red and hot.
illustration showing effects of blood clots

Venous Reflux Disease

Leg pain caused by venous reflux disease often presents as leg pain, heaviness, fatigue, that tends to get worse throughout the day and with standing. It may be worse in hot weather. Women may experience worsening symptoms during menstruation from hormonal influence. Night-time symptoms of leg cramping and restlessness is common. There may or may not be visible signs of venous disease, as venous reflux usually starts in veins that are not visible to the naked eye before becoming visibly apparent. Signs of vein disease include varicose veins (bulging, twisted, enlarged veins and the surface of the skin), spider veins, ankle swelling, and long term venous reflux, called chronic venous insufficiency can cause the skin to darken around the ankles and ulcerate.
example of vein disease in legs

Peripheral Artery Disease (PAD)

Poor arterial circulation in the legs is referred to as peripheral arterial disease (PAD). PAD has a different presentation than venous disease. Leg pain is often with walking and can cause cramping most frequently in the calf muscles but also can occur in the thighs or buttocks. The cramping stops usually with rest. Signs may include poor perfusion to the toes causing paleness and thickened toe-nails. Pulses at the feet may be absent.
peripheral arterial disease (PAD) illustration showing effects of plaque build up in a leg artery

TREATMENT

All of these conditions are treatable. Improvement of blood flow usually resolves or reduces leg pain. These conditions are diagnosed by a medical history, physical examination and non-invasive ultrasound imaging. An ABI test can screen for PAD.

If you are concerned about one of these conditions, call us today to set up a diagnostic imaging and a consultation with one of our healthcare providers to discuss results and options for relief.

 

 

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What patients are saying

All the staff are awesome the doctor was great and nurse practitioner the nurses they were all great I really enjoyed my visit there they made me feel very comfortable they attended and explained everything to me anything I needed or needed to be done they were there I'd recommend this place to everyone great place and the people are wonderful thank you can't wait to see you in 6 weeks.
D.R.
The entire team is professional, attentive and kind. They all make you feel as comfortable as possible when going thru an unfamiliar procedure. Their knowledge is comforting. Dr. Steinberg is outstanding! She an expert in her craft and is thorough when designing a specific plan for each patientpays close to details of a patients plan. She is detailed oriented and will make adjustments to make sure she executes the most successfull solution. I love her positivity, energy and confidence. Entire team = PRICELESS
R.M.
This place is awesome. They really go into detail with you about your problem. I have problems with the veins in my legs & they seem to really take interest in helping to find a way to sovle my problem. This is my first time here but they are very professional & really seem to care about me personally. They tend to all your needs here. Very kind people & they treat you with the utmost regard.
J.S.
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VARITHENA® CHEMICAL ABLATION

illustration of varithena foam injection
Varithena® may be recommended based on your vein location, size, anatomy and vein tortuosity.
Varithena® is:
• Effective to treat veins of different sizes above and below the knee
• Requires no incisions, sedation or general anesthesia
• Does not require a wire to be inserted along the length of your vein
• Does not use heat, eliminating the risk of thermal injury
WHAT IS VARITHENA®?
Varithena® is a "microfoam" formulation of polidocanol (sclerosing agent) and CO2. The result is a microfoam that has an appearance and consistency similar to white, foamy shave cream.
Ultrasound guidance is used to inject Varithena® microfoam into the vein. The microfoam fills the lumen for circumferential contact where it's designed to displace blood and destroy the endothelial lining efficiently.
cross section of Illustration of a vein with foam sclerotherapy injection
Video below shows the proceedure.
How many treatments will I need?
The number and frequency of treatments depends on a patient's anatomy, how quickly the veins respond, and the patient's treatment goals. There is a limit on the amount of medication we can give you each day to avoid causing side effects. Some larger or resistant veins may require two treatments to respond completely but most veins respond to Varithena® after one treatment.
What should I expect on my treatment days?
You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol, then use ultrasound to localize the veins. The foam medication will then be injected into your veins with a fine needle. The foam fills and treats the desired section of the vein. The diseased vein collapses and the foam is deactivated. Your legs will be elevated on a comfortable wedge pillow for approximately 15 minutes. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car.

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Dependiendo de su plan de seguro, es posible que tenga o no gastos de bolsillo. Trabajamos con sus aseguradoras para maximizar su cobertura y brindarle un resumen completo del costo de su tratamiento. Creemos en la transparencia de costos y le proporcionaremos un estimado de cualquier gasto de bolsillo previsto. El costo es importante. ¡Podemos colaborar con su seguro para obtener esta información hoy mismo!
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Dr. Amanda Steinberger is a Harvard-trained, board-certified vascular interventional radiologist. She specializes in a broad range of superficial vein disease including varicose veins, spider veins, venous leg ulcers, lymphedema and cosmetic laser vein treatments. Dr. Steinberger sees patients in our La Jolla Office.

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With Molina insurance plans, most patients should not have out of pocket expenses. We work with Molina to maximize your insurance coverage and provide a complete overview of your treatment cost. We believe in cost transparency and will provide a cost estimate of any anticipated out of pocket expenses. Cost is important. We can work with your insurance to find out this information today!