Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2024; 12(1): 232-235
Published online Jan 6, 2024. doi: 10.12998/wjcc.v12.i1.232
Chronic venous insufficiency, could it be one of the missing pieces in the puzzle of treating pain?
Min Cheol Chang
Min Cheol Chang, Department of Physical Medicine and Rehabilitation, Yeungnam University Hospital, Daegu 705-717, South Korea
Author contributions: Chang MC designed the research study, performed the research, analyzed the data, and wrote the manuscript; Chang MC has read and approve the final manuscript.
Supported by The National Research Foundation of Korea Grant Funded by The Korea Government (MSIT), No. 00219725.
Conflict-of-interest statement: The author has no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Cheol Chang, MD, Professor, Department of Physical Medicine and Rehabilitation, Yeungnam University Hospital, Daemyungdong, Namku, Daegu 705-717, South Korea. wheel633@gmail.com
Received: November 16, 2023
Peer-review started: November 16, 2023
First decision: December 18, 2023
Revised: December 18, 2023
Accepted: December 20, 2023
Article in press: December 20, 2023
Published online: January 6, 2024
Processing time: 46 Days and 14.7 Hours
Abstract

Pain is a common complaint among patients seeking medical care. If left untreated, pain can become chronic, significantly affecting patients’ quality of life. An accurate diagnosis of the underlying cause of pain is crucial for effective treatment. Chronic venous insufficiency (CVI) is frequently overlooked by pain physicians. Moreover, many pain physicians lack sufficient knowledge about CVI. CVI is a common condition resulting from malfunctioning or damaged valves in lower limb veins. Symptoms of CVI, ranging from mild to severe, include pain, heaviness, fatigue, itching, swelling, skin color changes, and ulcers in the lower limbs. Recently, it has become more widely known that these symptoms can be attributed to CVI. Even slight or mild CVI can cause related symptoms. Pain physicians primarily consider neuromusculoskeletal disorders when assessing patients with leg pain, and often neglect the possibility of CVI. In clinical practice, when pain physicians encounter patients with unresolved leg pain, they must assess whether the patients exhibit symptoms of CVI and conduct tests to differentiate CVI from other potential causes.

Keywords: Pain; Chronic venous insufficiency; Diagnosis; Treatment; Vein

Core Tip: Severe pain can interfere with activities related to daily living and work. To treat pain effectively, accurately diagnosing its underlying cause is crucial. However, the specialization of medical disciplines may lead pain physicians to only consider the nervous or musculoskeletal systems as the primary causes of pain. Often, they do not strongly consider the possibility of pain of vascular origin. Chronic venous insufficiency (CVI) is one of the most common venous disorders causing leg pain. Therefore, the possibility of CVI should be considered in patients with leg pain, potentially leading to resolution of chronic debilitating pain in these patients.