Back, Leg or Foot Pain?

Your veins may be the problem.

John Ganos was a busy entrepreneur in his native New Hampshire. He owned multiple retail businesses, from restaurants to a convenience store to a tobacco shop. He retired 12 years ago, but not before the standing and stress of his work left him with multiple health issues. Still, he was taken aback when a new symptom emerged.

Dr. Joseph Magnant of Vein Specialists in Fort Myers and Bonita Springs treated Elise (alias) and John Ganos for venous disease.

Dr. Magnant’s treatment relieved the burning pain in John’s calf

“I have a number of problems with both my legs,” John shares. “In my right leg, I have a bad arch in my foot, a very arthritic knee with a torn ACL, a chronic pulled hamstring and peripheral neuropathy. My left leg isn’t as severe, but I do have a somewhat bad knee and neuropathy.

“I was experiencing pain in my knee from the arthritis and ACL, but most of the uncomfortable symptoms in my right leg were from the neuropathy, including numbness, heaviness and weakness. Then, this new burning sensation started in my calves. I thought it was neuropathic in nature because that’s what precedes nerve damage.”

All along, John was receiving treatment for his leg pain from an orthopedic surgeon. Doctor and patient often discussed John’s leg issues as well as strategies to treat them. At one appointment, John offered a possible new diagnosis.

“There’s a fellow who worked for me who told me about Dr. Magnant and his vein specialty, and I brought it up to the orthopedic surgeon,” John remembers. “I asked him if he thought my symptoms could be from a vein problem.

“As I understood it, idiopathic peripheral neuropathy, which isn’t caused by
chemotherapy or diabetes and is what I have, is sometimes caused by a lack of circulation. I said, Perhaps I should investigate if I have a circulatory problem in my legs. I mentioned Dr. Magnant’s name, and the orthopedic surgeon said, “Dr. Magnant is who we recommend.

Joseph G. Magnant, MD, is a board-certified vascular surgeon at Vein Specialists in Fort Myers and Bonita Springs. Vein Specialists is a practice dedicated to the comprehensive, modern evaluation and most advanced minimally invasive treatment of vein disorders.

When John met Dr. Magnant, he found the doctor pleasant and very precise.
Dr. Magnant carefully explained what he does to diagnose vein problems and treat whatever he discovers. He also gave John an idea of what could be expected from treatment.

“First, Dr. Magnant suggested I have an ultrasound scan of my legs, and he discovered the valves in my leg veins were leaking,” John says. “He confirmed my right leg was worse than my left, and that I was having some leaking exactly where I was experiencing the new pain and burning symptoms.

“Dr. Magnant was very knowledgeable and accurate. He understood the particular risks treatment could have for me because I’ve had some very serious heart surgeries and take multiple heart medications. He said he could work around the risks with the right treatment for the condition I had.”

Once he identified the problem veins, Dr. Magnant recommended a minimally invasive procedure called endovenous ablation to seal John’s leaky blood vessels.

“During endovenous ablation, we guide a very thin catheter through a tiny needle placed in the vein via a small puncture in the leg,” Dr. Magnant explains. “Using either radiofrequency or laser energy, we gently collapse the diseased veins, which are eventually absorbed by the body.”

After Dr. Magnant described endovenous ablation, John agreed to move forward with the procedure. He knew exactly what to expect during the procedure because
Dr. Magnant explained each step in the process beforehand. Even so, he was surprised by the ease of the treatment.

“Dr. Magnant came up with a treatment plan that worked around my particular health conditions and was the best course of action for me,” John relates. “The procedure on my right leg was done using a catheter with a laser. On my left leg, he just used injections with a chemical because that leg wasn’t as bad.

“I was very surprised that the laser procedure was actually a pleasant experience. I had no serious discomfort at all compared to procedures I’ve had in the past, like arthroscopic surgery. Dr. Magnant’s treatment wasn’t difficult, and the effect was immediate. The new burning sensation in my calves disappeared immediately. I was very pleased.”

Proactive Professional

Originally from Kentucky, Elise* lived most of her life in Alabama. Her son attended the University of Alabama, and the two are huge Alabama football fans. Elise loved to spend time with her son watching the games, but whenever she sat that long, she experienced unpleasant symptoms in her leg.Dr. Joseph Magnant of Vein Specialists in Fort Myers and Bonita Springs treated Elise (alias) and John Ganos for venous disease.

“I had really bad varicose veins in my right leg, which caused extreme swelling in my leg and foot when I sat for long periods of time,” Elise discloses. “If I rode in a car for more than two hours, my leg would swell up, and my calf would get rock hard. I could bounce a quarter off of my calf, it’d be so hard. Sometimes, my leg also felt very tired.

“When I’d bump my leg against a piece of furniture and hit one of the varicose veins, the pain was excruciating. It made me sick to my stomach. I’d want to sit down and cry, it hurt so bad.”

Having worked in health care for 37 years, Elise knew that varicose veins were not healthy for leg circulation. The condition ran in her family, and her mother suffered with severe varicose veins, so Elise realized hers would just get worse over time.

“I decided to be proactive and have my leg checked,” she states. “I started researching physicians in the area. I didn’t want just anyone cutting into my leg, especially if we had to remove the vein, which I expected was going to happen.

“I’m a retired health care professional, so it’s not hard for me to find a physician, and Dr. Magnant’s office used to be across from mine. I did my background work on him and liked his profile. I met him at an introductory session he held and was very impressed with him and his staff, so I made an appointment.”

As he did with John, Dr. Magnant began his treatment of Elise with an ultrasound examination of her leg. He identified the problem areas, which included the greater saphenous vein, the major vein in the lower leg, and its branches. For Elise, the doctor recommended a phlebectomy in addition to endovenous laser ablation.

“Phlebectomy is another minimally invasive procedure,” Dr. Magnant assures. “During phlebectomy, we make a series of small nick incisions in the skin around the vein, which we numb first. We insert a special instrument with a tiny hook on it though the incisions and remove the problem vein in small sections.”

“The varicose veins were on the front and side of my leg, and they were getting bigger,” Elise recounts. “And I was getting more of them. I had to make a decision to have the procedures done so they didn’t get worse.”

Elise decided to go ahead with the procedures. She didn’t find the phlebectomy particularly painful or stressful, and she says Dr. Magnant and his surgical staff were instrumental in that. They helped her understand exactly what was happening, which helped her relax.

“Dr. Magnant was kind, friendly and very interactive,” Elise describes. “He kept me occupied during the procedure, and the OR staff made me feel very comfortable.
Dr. Magnant explained what he was going to do, then started numbing my leg. Then he removed the parts of the vein. The procedure wasn’t bad at all.”

Different Paths

John and Elise got to Dr. Magnant and Vein Specialists via different paths. John suffered with symptoms for years and went to many doctors before considering his symptoms might be related to venous disease. Elise witnessed the effects of varicose veins on family members and chose to act before her veins had more serious complications.

Dr. Joseph Magnant of Vein Specialists in Fort Myers and Bonita Springs treated Elise (alias) and John Ganos for venous disease.

Before & After Treatment

“When I met John, he told me he’d been experiencing discomfort in his legs for a long time and had been to pain management physicians, orthopedic surgeons and neurologists,” Dr. Magnant reports. “He also had obvious signs of venous disease including fatigue, heaviness and skin changes.

“John was also experiencing neuropathy symptoms such as burning and numbness, and venous disease is on the list of causes for neuropathy that gets worse as the day goes on. Unfortunately, with many physicians, it’s not at the top of their minds that their patients with these symptoms might have vein issues.”

Elise could see the bulging varicose veins on her right leg and the swelling that occurred with them. She didn’t have the cramping pain, heaviness or skin changes that often also occur with venous disease. However, these symptoms could develop over time, along with ulcers on the skin, if she didn’t have her veins treated.

“It was appropriate with today’s modern technology to evaluate and treat Elise before she began experiencing leg pain and skin changes,” Dr. Magnant observes. “The ultrasound technology is very accurate in terms of identifying and stratifying the
disease, and the procedures for sealing veins are leading-edge and well supported.

“Elise got in front of this disease because she saw in her own family the ravages of untreated venous disease in the pre-endovenous closure era. She didn’t want to wait until she was one of those patients with severe disease. John, on the other hand, went undiagnosed, suffered years of discomfort and came in with late-stage disease.”     

Sources of Pain

Patients who seek treatment at Vein Specialists often have multifactorial issues causing pain. The issues can be orthopedic or neurologic, and in many cases, patients seek the care of pain management specialists to control their discomfort. Pain in areas such as the back, buttocks, pelvis, legs and feet can, however, be related to venous disease.

“Pain is one of the most common symptoms of venous disease,” Dr. Magnant stresses. “In the legs, it occurs when blood from leaking veins pools in the legs over time. In the pelvis, pain can occur from blockages in the veins keeping blood from flowing freely. This pain can also radiate to other areas of the body. These types of pain are often misdiagnosed, so patients turn to orthopedics or pain management for treatment.

“What happens in many cases is that physicians aren’t aware of the other signs and symptoms of venous disease such as heaviness, fatigue and skin changes. Therefore, they don’t recognize venous disease as a possibility when their patients present with pain. They simply treat the pain.”

Pain from venous disease can, however, be different than that of orthopedic disease and other conditions that might lead to pain management, points out Dr. Magnant. Orthopedic disease, whether it’s in the ankle, knee or hip, is usually worse after prolonged immobility, such as lying down, sleeping or sitting in a chair.

“With orthopedic disease, when you stand up, there’s a stiffness that generally works its way out a little bit as you walk,” Dr. Magnant offers. “However, by walking, you put stress on the affected joint, so eventually, it’s going to hurt more.

“Venous disease is generally better after sleeping or elevating the legs for a period of time, and gradually gets worse as the day wears on. It’s improved by walking, and gets worse with sitting or standing.”

Whether patients have orthopedic, neurologic or another type of pain, Dr. Magnant recommends all those with painful conditions in their legs seek a vein evaluation. He suggests they have this done before turning to long-term care with orthopedic surgeons and pain management specialists.

“There are many different sources of pain – leg pain, lower back pain, pelvic pain – and there are many different treatments,” Dr. Magnant notes. “Many pain management physicians and orthopedic surgeons try to remedy their patients’ discomfort in ways that are much more invasive than the treatments we use to seal veins.

“Before trying a procedure that burns their nerves or a surgical intervention, patients do well to get a vein evaluation first. This way, they can see if there’s something correctable with a much simpler and more definitive procedure that has a higher likelihood of a permanent result.”

Genuine Outcomes

Following his endovenous laser ablation, John noted a significant improvement in his leg discomfort. He’s grateful to Dr. Magnant for this success and for preparing him so well for the procedure. John’s also grateful Dr. Magnant took his other health conditions into consideration when creating his treatment plan.

Dr. Joseph Magnant of Vein Specialists in Fort Myers and Bonita Springs treated Elise (alias) and John Ganos for venous disease.

Dr. Magnant’s treatment relieved the burning pain in John’s calf

“Dr. Magnant’s vein treatment gave me genuine relief from the burning sensation in my legs, and now it’s gone,” John enthuses. “When I had the procedure, Dr. Magnant described it to me, and I experienced no problems whatsoever with it. It was exactly what he said it would be.

“I think the key to my successful treatment was realizing that I had multiple issues, not just one, and they’re all operating in conjunction with each other. It was important to determine which symptom was coming from which condition. It worked out very well for me.”

The outcome of Elise’s treatment at Vein Specialists was genuine as well – genuine joy. She’s excited by how good her right leg looks and feels since her procedures were done and has become far more active since the swelling and fatigue have disappeared.

“The varicose veins are gone,” Elise marvels. “My right leg looks exactly like my left leg. They’re a good matched set now. I don’t have to worry about the swelling anymore. I haven’t taken a long car ride yet, but sitting down, I don’t have the swelling in my foot and around my ankle like I used to. And I don’t have the rock-hard calves anymore.
It’s a big difference.

“I started walking last February, and I could only walk about a mile a day back then. Now, I walk three miles every other day, and my leg doesn’t bother me.”

Like John, Elise is grateful to Dr. Magnant for her positive outcome, but she goes further and praises his staff as well.

“Dr. Magnant is very, very good, and he’s built an excellent team at Vein Specialists, from the front office to the OR team,” she comments. “They’re professional, talented and friendly. The physician assistant was my contact, and I just loved her. She made me feel very comfortable. It’s just a very comfortable environment in that office.”

For Elise and John, treatment at Vein Specialists was the answer to their leg problems. They both walked away from their procedures with improved circulation and healthier legs. It’s something they’re both willing to talk about.

“My results are excellent,” Elise relates. “The procedures were an absolute success for me. I’ve already recommended them to five other women.”

John has been spreading the word about Dr. Magnant and Vein Specialists as well.

“Getting rid of that burning sensation in my legs was something Dr. Magnant was very helpful with,” John says. “I recommend him to anyone.”

*The patient’s name was changed at her request.
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    • Vein Specialists

      Vein Specialists is 100 percent dedicated to identifying and treating vein disorders. Led by Dr. Joseph G. Magnant, they understand that the venous system varies between patients and consists of both deep and superficial venous systems and a net... Read More

    • Joseph G. Magnant, MD, FACS, RPVI

      Joseph G. Magnant, MD, FACS, RPVI, is a Fellow of the American College of Surgeons and is board certified by the American Board of Surgery in vascular surgery. He earned his medical degree from Medical College of Virginia. He completed a g... Read More