Orthostatic Pain

Orthostatic Pain is described as pain that is worst upon standing and relieved by lying down. Orthostatic pain is located in the legs in general, not pain that is just limited to varicosities. Venous pain is described in multiple publications in passing as well as in textbooks. The main thing to remember is that the pain should be worst standing or with the body higher and less when lying down. When we talk about "Orthostatic Pain" what we are really saying is that there are signs and symptoms of pain that is deeper than just superficial painful varicosities. If pain is present in superficial varicosities it is also generally worse standing and relieved by lying down. There are many types of "orthostatic pain" and when we use this term we generally mean that it is what the patient came in for. Orthostatic pain is thought to be a sign of venous problems that are deeper and require more examination and testing than just regular superficial veins that are unsightly. The Venous Hypertension Syndrome is characterized by severe orthostatic venous pain. These patients are often young or middle-aged women. Other features of Chronic Venous Insufficiency are minimal or absent. In Complex Multisystem Venous Disease clinical features of advanced Chronic Venous Insufficiency such as the presence or absence of pain, swelling, stasis dermatitis or ulceration are present in varying combinations. Significant orthostatic venous pain makes us think of these types of syndromes. Venous Leg Swelling syndrome can have significant orthostatic pain as well although the hallmark here is swelling (as the name suggests).

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