Burning Sensation in the Legs — Is It a Vein Problem?
Dr. Shimon Aronhime, Interventional Radiologist and Endovascular Surgeon, trained at Mount Sinai and Columbia University, New York. Israel Vein Center, Tel Aviv.
Dr. Shimon Aronhime — Interventional Radiologist and Endovascular Surgeon
Trained at Mount Sinai and Columbia University / NYP Hospital, New York
Shamir Medical Center | Israel Vein Center, Lilienblum 17, Tel Aviv
Last reviewed: May 2026
A burning sensation in the lower legs — particularly around the shin and calf — is a recognized but frequently overlooked symptom of chronic venous insufficiency (CVI). Many patients live with this symptom for years, unaware that it can be evaluated and treated.
How Veins Cause a Burning Sensation
When venous valves fail, blood pools under increased pressure in the lower leg veins. This elevated hydrostatic pressure triggers inflammatory processes in the vein walls and surrounding tissue, activating sensory nerve fibers. The result is a characteristic burning, warm, or tingling sensation — distinct from muscular or neurological causes — that worsens with prolonged standing and improves with leg elevation.
Venous Burning vs Other Causes
- Venous burning: worsens throughout the day, improves with elevation, associated with varicose veins or swelling, worse in heat
- Peripheral neuropathy: burning that is symmetric, often affects feet, associated with diabetes or B12 deficiency
- Arterial insufficiency: burning worse with exercise, relieved at rest, associated with skin changes at the foot
A duplex ultrasound differentiates venous from non-venous causes.
When to See a Vein Specialist
If burning leg sensations are accompanied by: visible varicose veins, ankle swelling, heaviness at day’s end, or skin changes around the ankle — a venous evaluation is warranted. Dr. Aronhime performs duplex ultrasound at the initial consultation, providing same-day results and a treatment plan.
Treatment
When venous reflux is confirmed, treating the underlying vein with EVLA, RFA, or VenaSeal relieves the venous hypertension responsible for the burning sensation. Most patients experience significant symptom improvement within 4-6 weeks of treatment.
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FAQ: Burning Legs
Burning legs — is it a vein problem or neuropathy?
Both can cause burning, but the pattern differs. Peripheral neuropathy (commonly diabetic) usually causes symmetric burning or numbness in both feet in a “stocking” distribution, often worst at rest at night, with altered skin sensation. Venous burning typically affects the shin and calf, worsens after prolonged standing and toward the end of the day, improves with leg elevation, and is often accompanied by heaviness, swelling or visible veins. A venous duplex ultrasound settles the question — and if it is normal, a neurological evaluation is the logical next step.