 Veinus disease is very common cause of leg pain it's really underestimated even doctors tend to miss how frequent venous disease as a cause for pain in the legs. So veins bring the blood back to the heart those veins are what you see on the skin you don't see arteries you see veins sometimes you see them as varicose veins which is very abnormal which tells you that they are under pressure from a condition called venous insufficiency. So let me explain that the veins bring the blood back to the heart against gravity to do that they need valves inside them to support blood flow upward toward the heart against gravity sometimes the valves go bad why do they go bad well family history is the most common reason for it genetically some of us are not lucky enough to have strong valves and they degenerate or become weak and they leak second reason will be pregnancy a woman who have multiple pregnancies especially more than three could have more chances for venous insufficiency and leaky veins so in any way the blood that is going up to the heart start to leak through those valves and spill over to superficial veins those veins become under pressure and they become like balloons they start to expand and you can see them on skin tortures like snakes so that create pressure on the skin and the nerves around them and cause a lot of discomfort especially with standing or sitting or long travel usually it does not happen much when we lay down flat because then the gravity helps the blood flow upward toward the heart and is of the pressure also using compression stockings help this problem by easing the pressure of the veins and I recommend those stockings to be used daily from the time we wake up to a time we go to bed it's hard thing to do I got a lot of complaint about it patients cannot be compliant with it every day because they are high pressure stockings but they are very beneficial if could be used the other thing is if we cannot use those stockings forever and the pain continues in spite of using stockings we can do procedures to really close those bad veins including radio frequency ablation including laser including injection with sclerotherapy or even taking the vein out in the office with a procedure called microflibrectomy which is micro surgery to remove the veins under local anesthesia all those procedures are minimally invasive done in the office under local there's no downtime the patient walks in and walks out obviously every patient will need ultrasound before we do the procedure and also afterward to make sure that we do the good job other issues could happen with veins that is not necessarily varicose veins we call venous compression syndrome this is a unusual situation where also the vein get compressed rather than closed but it's compressed by an artery and a bone around it and that caused lack of blood flow upward to the heart and back out of blood and congestion with swelling and pain we treat those by going inside the vein we'll put the camera to diagnose the problem camera has ultrasound and once we diagnose it we put a stent to open the vein and keep it open that condition could resolve easily just by simple procedure like this third issue with veins could be clot in the veins now this usually is more acute we call acute d vein thrombosis or DVT the leg got swollen and painful usually it's one leg not both so if that happens to you you should see your doctor immediately or go to the ER because this clot could go to the lung and give you a big problem so those cases where you see sudden swelling with pain in the leg this is highly suggestive of acute thrombosis or a plant and that requires immediate blood thinners rest and some other evaluation that could be necessary like putting a stent in the vein that is blunt