Peripheral neuropathy pain can be very challenging to treat using conservative management modalities.  Our study observes the effect of endovenous ablation on painful neuropathy symptoms in patients with EMG-confirmed chronic distal symmetric polyneuropathy and comorbid venous insufficiency.

The study included 50 patients with EMG-confirmed idiopathic polyneuropathy and peripheral neuropathy pain who received endovenous ablation for comorbid chronic venous insufficiency in the lower extremities.  A retrospective chart review was conducted to assess baseline and follow-up parameters. All patients received endovenous radiofrequency ablation (EVRF) of the greater saphenous vein (GSV). Pain scores and complications were reported up to 6 months post-ablation.

At the end of the 6-month post-ablation period, 44/50 (88%) subjects reported greater than 50% reduction in pain, numbness and tingling, and improved quality of life. The average VRS pain score decreased by 63.5% (baseline mean VRS 7.12, 6 month mean VRS 2.6).  The only complications were self-limiting saphenous neuritis and superficial thrombophlebitis (n=1).

Endovenous ablation may reduce painful neuropathy symptoms while treating comorbid chronic venous insufficiency of the lower extremities. Given that pain is the most burdensome symptom of distal symmetric polyneuropathy, physicians evaluating peripheral neuropathy should have a lower threshold for identifying venous insufficiency for potential treatment.