Restless Leg Syndrome: Varicose Veins and Chronic Venous Insufficiency

By Dr. John P. Landi, MD, FACS, RPVI, RPhS, Diplomate of The American Board of Venous and Lymphatic Medicine

Restless Leg SyndromeRestless Leg Syndrome (RLS) is a disorder that affects 10% of the American population and about 10 million people per year.  It is characterized by an irresistible urge to move the legs usually at night or at rest. Associated symptoms occurring in the legs are aching, cramping, itching, pain and a feeling of crawling.  There is no known cure for RLS although exercise, massasge, warm baths, quinine water, getting up to move around and some meds such as requip and neupro may help. Since symptoms tend to worsen with age, obesity and lack of exercise RLS can be progressive and devastating leading to frequent complaints of insomnia, weakness and fatigue.

One of the causes of restless leg syndrome which is commonly overlooked by the average physician is the relationship between RLS and varicose veins and venous insufficiency. In fact, as more and more information is discovered in the vein therapy world, we vein physicians are realizing that RLS is often times directly related to both varicose veins and venous insufficiency. There are 3 levels (superficial, middle and deep) of veins in the leg whose role is to return blood from the feet back to the heart. With both varicose veins (ropey, grape-like veins in the legs) and venous insufficiency ( chronic swelling and discoloration of the legs) the underlying problem is malfunctioning (leaking) of the valves of the superficial saphenous system of veins. This superficial system has multiple one way valves or flaps which aid in pushing the venous blood up the legs back to the heart.  If these valves malfunction (leak) then the blood will have trouble going through the valves, then backup and this will lead to the pressure increasing in the lower portion of the legs. This venous pressure buildup worsens as the day progresses, and, by the end of the day it is at its maximum.  When we get off our feet at night, while either on the couch or in bed, our bodies are more relaxed, and since the venous pressure is now high in the legs, the symptoms of restless legs can occur.

Not all restless leg symptoms are due to venous valvular insufficiency, but if malfunctioning valves are the cause, then this can easily be treated by a simple in office procedure under local anesthesia.  The procedure is called closure of the saphenous vein and it can be done by a laser or radiofrequency cathether. If the leaking valves are the cause of the restless legs, closure carries a high success rate but it is not 100%.  However, when successful, the results are noticeable within several days. In order to determine if the venous valves are working correctly an extensive non invasive ultrasound is done of the venous system in the legs.  If you have RLS, then you shoulc be evalutated by a vein specialist.

About Dr. Landi
Dr. Landi is medical director of Vanish Vein and Laser Center, a state of the art, dedicated vein treatment center. He is one of less than 2,000 physicians worldwide to achieve the designation of Diplomate of the American Board of Venous and Lymphatic Medicine. He is a fellow of the American College of Surgeons, a fellowship trained vascular surgeon, Board Certified in General Surgery and has achieved both the RPVI and RPhS certifications in vascular ultrasound.

To learn more or to schedule an appointment, please call Vanish Vein and Laser Center at 239-403-0800 or visit us online at

North Park Center
9955 Tamiami Trail North,
Naples, FL 34108
(99th Avenue North across from
the entrance of Pelican Marsh)

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