Question: I am 69 years old and have bad veins under my left foot that hurt when I walk. I had an operation done on my left leg, and my doctor told me that he doesn't want to operate to take out the veins. What should I do?
Dr. Hibberd's Answer:
Vein surgery performed for relief of foot pain is somewhat suspect to me. If you have vein incompetence, it will usually affect the foot, ankle, and leg with swelling that's relieved by elevation. Persistent foot pain after corrective vein surgery often indicates your pain is caused by something else.
Many times we forget to use our primary care physician when medical and surgical options need to be evaluated, and we do not realize that by directing ourselves to subspecialty care, we may force a surgical procedure since we are seeking an opinion from an individual whose specialty is surgery. Always start with your primary care physician, and rely upon their judgment to decide upon surgical referral. Self-referral to specialty care is wasteful, and does generate excessive health care expenditures that we all are paying for now.
If your personal doctor feels it is appropriate, you may ask for an orthopedic consultation unless your treating doctors are sure you have no stress fracture (shown by a negative MRI). You may have a simple plantar fasciitis which rarely needs surgery and will respond to anti-inflammatory medications, orthotics, and perhaps local cortisone. Perhaps you have neuropathy (nerve) pain, so do you need to see a neurologist? Be sure the arterial supply is intact. I'm sure your vascular surgeon checked for this, or did you go to a "vein center?" If you did not see a vascular surgeon, I recommend that you do so.
Pain is a protective sensation. As a general rule, always search out the cause and you will live a healthier and more comfortable and productive life with less need for medication. There is no room for guesswork here.