Many patients now recognize that varicose veins may not be visible from the outside. Most of our patients report experiencing tiredness, cramping (charley horse), restlessness, or swelling in the legs. Those whose condition has not reached one of the advanced stages often wonder if they are at increased risk of anything that could be limb or life-threatening.

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At least one-third of our patients clearly have signs of advanced venous insufficiency – when varicose veins have progressed to a point where the chronic pooling of blood (stasis) in the legs causes skin changes. They may notice skin discoloration, thickening or hardening of the skin, recurrent skin infections, bleeding that can be profuse, and poorly healing sores in the legs. In addition, varicose veins may be an early warning sign of potentially deadly blood clots.

We routinely see patients with blood clots. Some are referred by their primary care providers and others present themselves with concerns about blood clots. Yet there are many patients who are surprised to find that they have a blood clot when we examine them using duplex ultrasound.

Introduction

Restless Leg Syndrome (RLS) is characterized by an irresistible urge to move the legs to alleviate discomfort, ranging from aching and throbbing to itching and crawling sensations.² Articulating these sensations can be challenging for some patients.

Who gets it?

Initially documented in 1945, RLS, also known as Willis-Ekbom disease³, was reported to affect around 5% of the population. Recent studies, however, indicate a prevalence ranging from 3% to 15%. It tends to occur more frequently in women, with a nearly 2:1 female-to-male ratio. As age advances, there is a positive correlation with RLS prevalence. Genetics plays a role, as up to 25% of first-degree relatives of individuals with RLS report similar symptoms.⁴

Connecting Varicose Veins and RLS

Even in the 1940s, when Restless Leg Syndrome (RLS) was first identified, Dr. Ekbom suggested that venous disease could be a potential cause. However, it took around fifty years to firmly establish this connection. A groundbreaking 1995 study published in the Journal of Dermatologic Surgery treated 113 individuals with restless legs and ultrasound-confirmed vein disease using sclerotherapy.⁵ Surprisingly, 98% of participants reported immediate relief. Subsequent studies have consistently supported this link, uncovering RLS symptoms in individuals with primary and recurrent varicose veins¹. Addressing superficial venous insufficiency has proven effective in alleviating RLS symptoms for most patients. Nonetheless, it's essential to acknowledge that certain conditions, including iron deficiency anemia, pregnancy, kidney failure, various neurological conditions, and specific medications, can also contribute to RLS symptoms.

Explaining the connection

Impaired venous blood return in the legs, particularly in chronic venous insufficiency (CVI), may drive the subconscious urge to move the legs (RLS), forcing you to use your muscles that help pump blood back to the heart. Inflammation associated with CVI could lead to overactive nerves, intensifying the situation. Nighttime leg cramps and pain, often linked to varicose veins, can further disrupt sleep, aggravating leg restlessness.

Determining if Varicose Veins might be responsible for Restless Legs

A straightforward and noninvasive duplex ultrasound in your Vein Specialist’s office can identify any underlying venous issues. The Vein Specialist will review a treatment strategy if venous insufficiency is found. Typically, the affected veins are closed using one of the FDA-approved treatment modalities to reroute blood flow through healthier veins.⁶

Conclusion

Restless Leg Syndrome (RLS) is a common issue often linked to varicose veins. You might also be encountering other symptoms of varicose veins and associated venous insufficiency, including sensations of heaviness, fatigue, aching, cramping, and swelling in the legs. If left untreated, the condition can worsen, leading to potential complications such as blood clots, bleeding, frequent skin infections, and slow-healing sores. Medications for RLS, such as Ropinirole and Pramipexole, may mask the symptoms without addressing the underlying problem. Reach out to Alsara Vein Clinic at 816-396-0245 for a complimentary Consultation.

Take the initial step towards relief and an improved quality of life.

1. Restless legs syndrome symptoms in primary care: a prevalence study. Nichols DA, Allen RP, Grauke JH, et al. Arch Intern Med. 2003;163:2323–2329
2. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology:Sleep Med. 2003;4:101–119. 
3. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria Sleep Med. 2014;15:860–873. [
4. Treatment of Leg Veins for Restless Leg Syndrome: A Retrospective Review, Swaminathan et al, Cureus 2019
5. The effect of sclerotherapy on restless legs syndrome Dermatol Surg 1995 April 21 
6. The effect of endovenous laser ablation on restless legs syndrome Hayes et al Phlebology June 2008

Restless Legs (RLS) and Leg Cramps

Read More about Restless Leg Syndrome

• Consultation

• Contact Us

Varicose Vein Treatments are coved by insurance including Medicare and Medicaid

• Signs & Symptoms
• Leg Cramps & Restless Legs

Please describe your experience with us:

Front Desk staff:

Friendly and helpful.

Ultrasound Technologist:

Friendly, informative,, and helpful.

Provider/Doctor/Nurse Practitioner:

Friendly.

Billing/Patient Account Services:

Friendly.

What made you choose us?

Needed help with my legs.

What symptoms were you experiencing?

RLS [restless leg syndrome], heaviness, achiness, burning sensation.

How were you affected by your legs previously? What couldn't you do? How has that changed now?

Couldn't walk hardly and couldn't chase and play with my almost 4 year old 🙁.

What improvements have you seen in your legs?

Not as restless or achy. Can walk and run around [now].

Additional Comments: What did you appreciate? What makes us different than other medical clinics? What could we have done better to exceed your expectations? What changes would you like to see?

How nice everyone is. [At other clinics,] not everyone is nice.

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I had heaviness, [leg] pain, a lot of movement in my legs, which they call ‘Restless Leg Syndrome,’ and it would bother me at night mostly.  And since I’ve been coming here, he’s done a great job on me, a great job!

Now I can ride in a car or plane without the aching that was before.  I sleep much better.  I don’t have restless legs or aching, so it is great that I can sleep without moving my legs all the time.  I’m so glad and I can walk without hurting.

The treatments were very easy.  I didn’t have any pain, and I was very comfortable with the way the doctor did [the treatment].  I didn’t feel anything.

I came here because you’re right here in St. Joe.  I didn’t have to travel 30 minutes to Kansas City.  I’ve been to two different [clinics]and this [Alsara Vein Clinic] is the best.  I think it’s much better.  [You’re] friendlier than the other places I’ve been.  The doctor is very, very nice, very kind, and he explains things thoroughly.  I really like him.

I have inherited this vein disease from my mother and my father.  My mother had her [veins] stripped at least two times that I know of.  She always had trouble with her legs.

I started noticing them in my sixties because I walked about five miles every day.  I think that helped the circulation in my legs. But then I got kind of sick and I couldn’t get up and do what I normally did, and my legs really started hurting.  It was very uncomfortable.

The doctor was very thorough.  He would explain things so you could understand them He would take time to answer your questions.  It was excellent.  Recovery was excellent.  You have a little bruising sometimes but that all went away, it was very satisfying.

I was on a plane ride last year and my legs didn’t ache or anything like they had before.  I can walk the dog a little farther now. He wants to go, so I got right behind him, and my legs are not hurting while I’m walking him.

My whole experience with the clinic has been wonderful.  I would tell everybody to come here.  The staff is wonderful.  The doctor is wonderful.  I just really like it here.

He’s a very kind doctor, he’s very concerned about how it feels, ”are you uncomfortable", he’s very concerned about how you are taking the treatment.  So, [I’m] very satisfied with him.  Dr. Gupta was very easy on me.

I love the staff.  They’re so friendly and helpful.  I have a lot of fun with them when I come.  I’m very satisfied.

I would absolutely recommend this clinic to people with vein problems.

Signs and Symptoms

The initial signs and symptoms may include:

• Aching
• Burning or numbness
• Cramping or 'Charley horse'
• Heaviness
• Itching
• Leg pain
• Restlessness in legs
• Tiredness

• Swelling in feet ankles and calves

• Left untreated, may result in skin discoloration, bleeding veins, sores that heal poorly, and blood clots.

• Consultation

• Contact Us

Varicose Vein Treatments are coved by insurance including Medicare and Medicaid

• Signs & Symptoms
• Leg Cramps & Restless Legs

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I’m a cardiovascular tech and I’ve had some leg and feet issues ever since I was about 18 years old. And so, throughout the years, I have tried to find what the issue was; what was causing the problem. That is when I learned about your clinic.

Many treatments that I have tried, we went into lab work to x-ray, we’re never able to find the problem in anything. I had waited several months, kind of let things go to see if my doctor would end up doing any more testing. That was another great reason whenever I came here for my consultation, that we were going to go further here. Once you guys did my ultrasound, that is when Dr. Gupta said that I had some issues and he wanted to try the treatment. I have a lot of relief in my legs now.

Once I was billed with my insurance, I was very surprised that there was little cost to me.

I was a little bit nervous whenever I made the appointment and we were going to continue with the treatment. But the more that Dr. Gupta explained to me with very great detail, I felt more and more comfortable, and I was ready to make the appointment and go further with it. My first impression that I had after Dr. Gupta had said that we were going to try the laser procedure, that I felt a little bit of relief and I had great hope that I would be able to be active again.

Actually, for the treatment – laser procedure – there was no pain, [a] quick recovery, and I also had quick relief of all of the symptoms that I was experiencing. I would say, once the recovery process – about after 3 days – I could tell a difference. I would say, give it about one week, and I felt a major relief. The main thing after the treatment that I can tell that has helped the most is I don’t feel as if I’m an elephant standing on two little feet. All the pressure is gone and the weight has come off of my legs. It feels extremely good!

During the laser treatment, I guess “mosquito bites” is a good example for [the initial numbing pin pricks]. They were small. There weren’t many. Once you had the complete numbing process, there was nothing that you could feel. During my recovery, after we had the treatment here at the office, everyone – the staff – helped me get my leggings on so I could leave, and I went on about my Friday evening to a painting class. There was no downtime.

[Before], it was just a lot of the restless leg. I felt like my legs were numb. I felt like I needed to get up, walk around, get some movement. There’s a lot of difference, anywhere from being in the car rides to just doing your normal activities, or me being at work just standing for long periods of time. [Now], a lot of it is gone.

Between Dr. Gupta and his polite bedside manner, and the staff – they’re great too, I’ve recommended and I’ve told people about your office. It’s a great place. Helped me a lot. I can say, Dr. Gupta will sit and talk to you and explain everything thoroughly to help you feel more relaxed about the treatment that you’d be having.

I have a feeling, if I would not have had the procedure done, that I would still be at home trying to avoid a lot of activities, not getting out there and doing as much as what I could be doing or what I had been doing, so, it’s just been a big relief to me.

Unhealthy veins are like weeds in a garden

Left untreated, they continue to worsen and turn into a serious problem.

Maybe you’ve seen the blue or purple squiggly veins on your legs that look like lines on a roadmap and wondered how to get rid of them. Maybe you are experiencing pain, cramps, restlessness, or have sores on your legs, and you were told by your Primary Care Provider that you have varicose veins. Perhaps you wondered “What the heck are varicose veins anyway” and “How do I get rid of them?”

What is a Varicose Vein (and CVI)?

In simplest terms, varicose veins are faulty blood vessels that have become overstretched and swollen with blood.

When your heart beats, it pumps blood through arteries to every part of your body carrying oxygen and essential nutrients. Since you have a limited amount of blood (about 5 liters in an adult), the deoxygenated blood returns to the heart via countless veins in your body. The veins in your legs are farthest from the heart and must work against gravity to push blood back to the heart. Compounded by other risk factors, some veins wear out over time and become “varicose”. The pooling of blood in varicose veins may cause symptoms such as heaviness, tiredness, itching, burning, cramping, restlessness and pain. Left untreated, the increased pressure of blood in the leg veins can leak out, causing problems such as edema, skin discoloration, sores in legs that heal poorly, and frequent skin infections. This condition is called Chronic Venous Insufficiency (CVI).

Who gets them?

Although varicose veins affect both men and women, they are slightly more common in women who tend to have them at an earlier age. This may also have to do with the fact that men are less inclined to seek timely medical care. Hence, it is not a surprise that men have more advanced stages of varicose veins and CVI by the time they see a vein specialist compared to women. People in general are more likely to get them as they get older.

Frequently there is a genetic predisposition to vein problems. That means that if your mom or your sister has them, you are more likely to also have them. Things that put pressure on your legs and feet — like being overweight or standing for a long time, every day, without exercise — can also cause varicose veins. Pregnancies also make veins worse due to increased pressure of the uterus and the extra blood volume.

Do I need these veins?  How do I get rid of them?

Once a vein is varicose, it is a diseased blood vessel much like a “weed” in your yard. Just like weeds compete for space and nutrients in your yard (and are formidable competitors!), varicose veins have weakened walls that facilitate easy entry of blood but instead of pushing the blood back in circulation, the blood tends to pool in them causing a wide variety of problems including life-threatening blood clots.

In the past, varicose veins were “stripped” much like pulling weeds from the yard. This was a painful, imprecise, and invasive surgery with significant downtime, scarring, and risk of complications. Even worse, many patients required additional treatment due to other veins rapidly becoming varicose.

In the last 15 to 20 years, our increased understanding of venous disease, modern tools available for accurate diagnosis, and minimally invasive treatments have revolutionized how we treat vein problems in legs. After your vein specialist has performed a detailed ultrasound scan of your legs, he/she will create a “road map”. Then, using tools such as Endovenous Laser Ablation (EVLA), your Vein Specialist can seal the underlying varicose veins at their source, much like closing the large root of weeds from the inside. Any smaller, persistent veins can then be treated using injection sclerotherapy that is analogous to using a weed killer in your yard. Some unsightly varicose veins are removed by microphlebectomy, the careful removal of unwanted veins through tiny openings using very fine instruments without the need for sutures or risk of scarring.

Current treatments are very safe, effective, and provide long-lasting relief without any downtime or painful recovery. Since varicose veins and CVI are serious problems, almost all health insurance companies, including Medicare and Medicaid, offer coverage for necessary scans and treatments.

Contact Alsara Vein Clinic at 816-396-0245 to set up a Consultation today.

– and bikini contests!

Where did summer go? It seems like only yesterday the snow had finally melted, after a prolonged winter, and here I am talking about fall. In fairness, this summer was an extraordinarily busy time for us at Alsara Vein Clinic. We saw more new patients in July than any other month in the past. Every one of my staff members worked extra, long hours to ensure each patient received top-notch care, even in the face of increased patient volume and the numerous urgent requests to see a patient the same day.

I am humbled by both the confidence that numerous referring providers have in our care and the trust of patients who refer family and friends. For example, Jim*, a 76-year-old gentleman, came to Alsara Vein Clinic after exhausting all options at hospitals and other clinics in the area. With a tracheostomy collar in place, he was unable to talk and breathe at the same time, yet he had much to discuss. After providing his medical history, he cleared his “airway trash”, drew a deep breath, and concluded by saying, “I am hanging by the last straw. My neighbor across the street advised me to come to you. You took care of him when he had no hope that anything could be done.” Since then, the topic of his conversation has been anything but medical. Taking swift breaks to inhale, he seemed more interested in talking about his friends, family and his many aspirations although, as he politely stated, “I realize that I won’t be able to participate in a bikini contest anytime soon!”

Later that week I saw Tom**, a 58-year-old, who had avoided seeking care as he was sure that leg amputation was going to be the only option available, given the advanced stage of chronic venous insufficiency in his leg. It seems that every clinic day has its fair share of patients with swelling, severe leg cramps, and restlessness. We also see many male patients with clots, bleeding, and poorly healing sores in their legs, all of which are features of advanced, chronic venous insufficiency.

A detailed duplex ultrasound scan (Mapping) provides us with a “road map” of all the key veins in the legs. The goal of every treatment modality is to get rid of the underlying varicose veins and restore proper blood flow by routing blood to the healthy veins. The new, modern, minimally invasive treatments allow us the opportunity to eliminate the diseased veins safely and effectively with very little downtime; these are also much safer than surgeries used in the past. Over the last 10 years, further advancements have occurred in our understanding of venous diseases and the options available to treat them. For instance, the latest 1470 nm laser used at Alsara Vein Clinic offers a 40-fold improvement in energy absorption, compared to older generation lasers, resulting in even less bruising and discomfort. All treatments including Endovenous Laser Ablation and Ultrasound Guided Sclerotherapy are performed in the comfort of the office setting and patients can resume normal activities immediately.

I feel very fortunate for the technology and scientific knowledge backed by the experience of successfully treating thousands of patients over the past decade. Although participating in a bikini contest is not completely ruled out for Jim*, I suspect that he will put his legs to much greater use in the years ahead!

Concerns about your legs? Call Alsara Vein Clinic at 816-396-0245 to set up a Consultation today.

Sam Gupta, MD, MPH

* Jim is an actual patient of Alsara Clinic and has graciously given permission to use his quotes, story and images.
** Tom – his name changed to protect confidentiality.

An estimated 60% of women and men suffer from vein disease.

Some of the signs and symptoms include leg pain, achy legs, burning in legs, numbness in legs, leg cramps, heaviness in legs, itching legs, restless legs, tired legs, swelling in ankles or leg calves. Left untreated, it may result in skin discoloration, bleeding veins, sores that heal poorly, and blood clots.

To understand vein disease, you must first understand the function of veins. Arteries are blood vessels responsible for delivering blood to all areas of the body, including the legs. Veins are responsible for collecting the same blood and bringing it back to the heart. Leg veins, located farthest from the heart, have to work extra hard to push blood upward against gravity toward the heart.

Studies have shown that a vast majority of people have genetically weak veins. Now, if you add more risk factors such as standing or sitting for prolonged periods of time, pregnancy, excess weight, and trauma, veins can start to fail. As veins begin to fail, blood starts to pool in the legs resulting in veins that are "varicose"—abnormally swollen or knotted.

It might be surprising to learn that restless leg syndrome, leg cramps, swollen ankles (edema), leg ulcers, varicose veins, and spider veins could all be symptoms of vein disease. We've helped thousands achieve relief with in-office treatments. Alsara Vein Clinic is located north of Kansas City in St. Joseph, MO a.k.a. St. Joe. Schedule your Free Consultation today with Alsara Vein Clinic. Walk-ins are welcome, no referral necessary!

Varicose Vein Treatments are covered by insurance, including Medicare and Medicaid.