Neuropathy

Chronic venous insufficiency (CVI) is a prevalent health issue when the valves in the veins of the lower limbs malfunction. This results in the blood flowing back and accumulating in the legs, leading to symptoms such as swelling, pain, skin changes, and ulcers. Peripheral neuropathy is a condition that causes numbness, tingling, and weakness in the limbs by affecting the nerves in the legs and feet, for example. Despite appearing unrelated, research has indicated a potential correlation between these two conditions beyond simply the parts of the body they affect.

Is There a Relationship Between CVI and Peripheral Neuropathy?

Although not thoroughly studied yet, there have been several studies published describing a potential relationship between CVI and peripheral neuropathy. One study indicated that worsening CVI coincided with sensory neuropathy in the legs (1). A separate study demonstrated that there are significant differences in the function of multiple nerve fiber types in patients that have documented venous insufficiency. It is even thought that this neuropathy, induced by CVI, may contribute to the development of venous ulcers, the most severe and latest progression of CVI. This is similar to how neuropathic ulcers develop in diabetic patients (2). Multiple studies have also found that patients who have CVI score worse on neuropathy assessments. Unfortunately, the neuropathy symptoms appear to worsen along with severity of venous insufficiency (3,4).

Can Treating Chronic Venous Insufficiency Improve Peripheral Neuropathy Symptoms?

Traditional treatments for peripheral neuropathy include identifying and treating any underlying causes such as diabetes, alcohol use, medications, or nutritional deficiencies. Additionally, medications can be used to improve symptoms in some patients.

 There are a variety of well studied, effective treatment options that are demonstrated to reduce the symptoms of chronic venous insufficiency. These procedures reduce pressure build-up in the legs that worsen throughout the patient's upright hours due to gravity. By treating the problematic veins, common symptoms of CVI including heaviness, aching and swelling can be reduced. It has been observed in patients with both CVI and peripheral neuropathy that when the CVI is treated, neuropathic symptoms can also improve in up to 65% of cases, including both spinal and diabetic causes of neuropathy (5).

Should you pursue vein treatment?

Overall, treatment of chronic venous insufficiency with minimally invasive endovenous techniques can reliably help to resolve symptoms specific to CVI itself. In some cases, patients with both venous insufficiency and neuropathy, the neuropathy symptoms can improve with treatment of the venous disease. Undergoing evaluation to determine if treatment of venous disease will be beneficial for you is best to be discussed with a vein specialist or your primary care provider.

Sources

  1. Frank T. Padberg, Allen H. Maniker, Gwendolyn Carmel, Peter J. Pappas, Micheal B. Silva, Robert W. Hobson,Sensory impairment: A feature of chronic venous insufficiency, Journal of Vascular Surgery, Volume 30, Issue 5, 1999, P ages 836-843.
  2. Reinhardt F, Wetzel T, Vetten S, Radespiel-Tröger M, Hilz MJ, Heuss D, Neundörfer B. Peripheral neuropathy in chronic venous insufficiency. Muscle Nerve. 2000 Jun;23(6):883-7.
  3. Yim E, Vivas A, Maderal A, Kirsner RS. Neuropathy and ankle mobility abnormalities in patients with chronic venous disease. JAMA Dermatol. 2014;150(4):385-389. doi:10.1001/jamadermatol.2013.6723
  4. Newland MR, Patel AR, Prieto L, Boulton AJM, Pacheco M, Kirsner RS. Neuropathy and Gait Disturbances in Patients With Venous Disease: A Pilot Study. Arch Dermatol. 2009;145(4):485–486. doi:10.1001/archdermatol.2009.14
  5. Dobson L, Collier P. Improvement of Neuropathy After Venous Ablation. Journal of Vasc Surg, Vol 8, Issue 2, 2020, p. 327.

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