Chronic venous insufficiency is a medical condition caused by weak valves in the leg veins. In this condition, these valves don’t properly function so blood won’t normally flow and return from the legs to the heart. In other words, blood tends to collect or “pool” in these leg veins and cause unpleasant symptoms in return.
Chronic venous insufficiency is often related to other venous system disorders, such as varicose veins. There are also factors that can increase your risk of venous insufficiency. These risk factors include heredity, obesity, aging, a history of leg trauma or injury, smoking, and a sedentary lifestyle (1, 2). As the condition progresses, symptoms such as leg pain, swelling, skin pigmentation, dermatitis, and ulceration also tend to get worse.
Although chronic venous insufficiency can progress and become risky, it is not always as life-threatening as peripheral artery disease. Venous insufficiency can be disabling and painful, but there are things that we can do to help ease these symptoms.
How is venous insufficiency treated?
If you are diagnosed with venous insufficiency, most treatment plans created by your healthcare provider are often based on the following factors:
- Health condition
- Medical history
- Specific signs and symptoms
- Your response to certain medications or treatment methods
The main goal of CVI treatment is to reduce the swelling in your legs and prevent the formation of leg ulcers. Depending on your overall health condition, your healthcare provider may recommend a combination or treatment or therapies, which include:
1. Lifestyle Modification
To help improve the flow of blood in your legs, most healthcare providers suggest certain changes in your lifestyle. If you heed your doctor’s advice, lifestyle changes can help prevent and reduce the symptoms of venous insufficiency, such as edema or swelling, leg pain, and cramping. If you have had surgery or invasive procedures due to venous insufficiency, lifestyle changes can significantly improve your recovery and prevent debilitating symptoms from recurring.
2. Elevating Your Legs
The risk of blood pooling in your leg veins increases if you sit or stand for a long period of time, whether you’re at work, driving long distances, or getting on long-haul flights. Simply elevating your legs can help improve the flow of blood in your legs and reduce swelling, including other symptoms of venous insufficiency. Avoid crossing your legs and try to move your ankles or legs from time to time to keep your circulation going. You can place your legs on a footstool to elevate your feet and legs.
3. Keeping a Healthy Weight
People who are obese have an increased risk of developing chronic venous insufficiency, which is why losing weight and maintaining a healthy weight can really help improve and prevent the recurrence of CVI symptoms. To help you maintain a normal body mass index, your healthcare provider may recommend a weight management program to help you adjust, cope, and develop healthy eating habits, including exercises to keep you active. Some of these exercises may include walking, jogging, or bicycling, which you can do several times per week.
4. Wearing Compression Stockings
Compression garments may not always be pleasant to wear, especially when the heat index goes up to 115 degrees outside. However, they really do help in supporting your veins and improving the blood flow from your legs up to your heart. Compression garments are made with an elastic fabric with different levels of graduation or pressure. They also come in different styles and lengths.
When it comes to venous insufficiency, compression socks or stockings can be prescribed by your healthcare provider. The amount of pressure prescribed will also depend on the severity of your condition. Those who have developed ulceration in their legs may require compression bandages. Different studies have also confirmed the effectiveness of compression garments in improving the signs and symptoms of venous insufficiency (3, 4).
5. Avoiding High Heels and Tight-Fitting Clothes
Wearing ill-fitting clothes and high heels can hinder blood to properly flow in your legs, putting you more at risk of developing venous insufficiency. Choose lose-fitting clothes and wear low-heeled shoes instead to help your feet and legs feel more comfortable and at ease.
6. Limiting Your Salt Intake
Swelling in your legs tends to get worse if you regularly consume a diet that’s high in sodium or salt. Our bodies retain water and cause excessive fluid buildup in our legs if we consume a high sodium diet. This fluid buildup puts extra pressure on our leg veins, which weakens the walls of our veins. Constant pressure and weakening of vein walls eventually lead to venous insufficiency.
7. Taking Medications
Together with compression garments, certain medications, such as aspirin, may also be prescribed by your healthcare provider, particularly if you have developed leg ulcers. This treatment combination can help improve the flow of blood in your legs and ease most symptoms of venous insufficiency.
Diuretics or medications that can help expel excess water in the body are also prescribed in certain cases, especially when other medical conditions, such as renal disease and heart disease are linked to swelling. When an infection is present, antibiotics may also be prescribed.
Complications of chronic venous disease such as stasis dermatitis or skin irritation due to CVI can be relieved by using skin moisturizers. Although moisturizers do not treat CVI, they can definitely help keep your skin from cracking or drying. If you also have leg inflammation with itching, topical corticosteroids may also be prescribed.
8. Medical Procedures
Certain medical procedures can be suggested by your healthcare provider if the above remedies don’t work for you. These procedures can either be surgical or nonsurgical. However, surgery is only performed in patients with severe CVI. The type of surgery usually done is ligation or vein stripping, in which damaged veins are tied or removed through tiny incisions. Other minimally invasive procedures for venous insufficiency include sclerotherapy and laser ablation.
Sclerotherapy involves the injection of a chemical into damaged veins and uses local anesthesia. The injected chemical causes scarring in your damaged leg veins and inhibits them from carrying blood. When this happens, blood can smoothly flow through other veins and return back to the heart. Laser ablation involves tube or catheter insertion into the damaged leg vein and closes it. When these damaged veins are closed, there will be a reduction in blood pooling in your leg resulting in improved blood flow.
- MA, P. (2003). Chronic venous insufficiency: the genetic influence. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12934752
- Criqui, M., Denenberg, J., Bergan, J., Langer, R., & Fronek, A. (2007). Risk factors for chronic venous disease: The San Diego Population Study. Journal Of Vascular Surgery, 46(2), 331-337. doi:10.1016/j.jvs.2007.03.052
- Owayed Al Shammeri, A. (2014). Chronic Venous Insufficiency: prevalence and effect of compression stockings. International Journal Of Health Sciences, 8(3), 231. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257358/
- Ibegbuna V, e. (2003). Effect of elastic compression stockings on venous hemodynamics during walking. - PubMed - NCBI . Ncbi.nlm.nih.gov. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12563216
- Venous Insufficiency Treatment & Management: Approach Considerations, Graduated Compression and Other Physical Modalities, Venoablation. (2018). Emedicine.medscape.com. Retrieved from https://emedicine.medscape.com/article/1085412-treatment
- Chronic Venous Insufficiency – Vascular Cures. (n.d.). Vascularcures.org. Retrieved from https://vascularcures.org/chronic-venous-insufficiency/
- Chronic Venous Insufficiency | Society for Vascular Surgery. (n.d.). Vascular.org. Retrieved from https://vascular.org/patient-resources/vascular-conditions/chronic-venous-insufficiency