Patients with spider veins often ask "How much do the needles hurt?". Because each person has a different pain threshold, it is difficult to give a precise answer to this subjective question. However, I think these are some of the important points that might help in order to assist with expectations:
- The needles used in sclerotherapy are very fine. They are a slightly larger gauge than acupuncture needles but much smaller than vaccination needles.
- The pain arises for three different reasons: Initial puncture of the skin by the needle is the initial source of pain, so small gauge needles cause less pain in this situation. Secondly, pain might arise from tissue expansion. If the needle tip is not accurately placed with inside the lumen of the vein, the injected sclerosant, rather than running up through the vein, spills outside the vein and causes the tissue to expand. This will cause pain in the same way as a "boil" causes pain because of the tissue expansion. Small amounts of spillage will always occur but skilled sclerotherapists pay meticulous attention to this aspect of treatment. Thirdly, the different types of sclerosants each have their own properties and vary in the amount of discomfort they cause if they enter the interstial tissue.
- Some areas of the leg tend to be more sensitive than other areas. Just behind the knee and around the feet tend to be quite sensitive areas, so I always use the finest needles possible when injecting in these areas and selecting sclerosants least likely to cause pain.
At our clinic we are very mindful of the anxiety patients often have about injections. You are welcome to bring a friend along if you would like someone to hold your hand and don't forget to bring your iPod to relax (or be distracted) by your favorite music during treatment sessions.