Chronic Venous Insufficiency
Chronic Venous Insufficiency is a common cause of leg pain and swelling. CVI is also associated with varicose veins.
What is Chronic Venous Insufficiency (CVI)?
Veins are small blood vessels in our body that carry blood from around our body to our heart. Vein problems are some of the most widespread chronic health conditions in the U.S. By age 50, nearly 40% of women and 20% of men have serious leg vein problems. A common concern is varicose veins. This condition happens when veins in the legs and feet become enlarged and twisted. Sometimes varicose veins are hereditary (run in the family). Sometimes they develop after trauma or injury to the leg.
Chronic Venous Insufficiency I is associated with varicose veins and is a common cause of leg pain and swelling. CVI happens when the valves of the veins do not function properly. This causes an issue with the blood circulation in the legs.
Symptoms
People who only have varicose vein problems don’t usually have symptoms. When varicose veins are linked with CVI, the common signs and symptoms are:
Ankle and foot swelling that moves up the lower leg
Skin changes in the lower leg, including:
Discoloration, or changes in color
Eczema, or skin rash
Scarring, or hard, thickening of skin
Sores or breaks in the skin’s surface (ulceration)
Aching or “heavy” feeling in
Leg tiredness
Pain or throbbing
Burning or itching sensation
Discomfort or muscle cramping
The worst cases of varicose veins may cause bleeding from varicose veins and blood clots in the veins near the surface of the skin (thrombophlebitis). This is a medically urgent problem and needs to be addressed by a healthcare professional right away.
Diagnosis
CVI is primarily diagnosed during a physical exam with a healthcare provider. The provider may use the following tests to assist with the diagnosis:
Venous duplex ultrasound exam which provides an ultrasound image of the leg vein. This can help detect blockages, blood clots, or poor vein function.
CT scan or MRI which may be used to look for other causes of leg swelling.
Causes
CVI is caused by vein valves that don’t work like they should. Vein valves are designed to allow blood to flow against gravity from the legs back to the heart. In other words, they are supposed to prevent a backflow of blood. Vein valves may fail to close due to:
Vein wall weakness that causes the vein to enlarge so that the valves cannot close
A history of blood clots or deep vein thrombosis in the vein that damage the valve
An absence of vein valves since birth
When valves do not work properly it can cause a build-up of blood pressure in the leg, leading to venous hypertension or high blood pressure in the vein. This may result in the veins becoming larger.
When the valves don’t close properly, the blood doesn’t flow back to the heart as it should. This is called venous reflux. This issue can lead to painful varicose veins and may worsen over time. Without treatment, CVI symptoms may become more advanced or complicated. It’s important to note that the source of the problems is not always the legs. Vein problems can happen in the pelvis or hip area, too. In fact, blockage of veins in the hip area can result in more severe symptoms and could require a different type of treatment.
Treatment
The treatment of CVI involves both medical intervention and changes to lifestyle habits such as:
Primarily eating foods low in fat and sugar & high in nutrients from fruits, vegetables, & whole grains.
Avoiding sitting or standing for long periods of time
When sitting, elevating the feet above the thighs and above the heart
Lying down with feet elevated above the heart 3-4x a day (if possible). This can help reduce swelling.
Finding time everyday to exercise or participate in a physical activity, such as walking, biking, or swimming.
Asking your healthcare provider if graduated compression, or pressure stockings are right for you. These stockings are tighter around your ankle and get looser as they move up your leg.
Risk Factors
Family history
Increasing age
One or more blood clots in superficial or deep veins
Multiple pregnancies
Prolonged standing
Heavy lifting
Sedentary lifestyle or limited physical activity
High blood pressure and excess weight have also been linked with the presence of varicose veins in women
Resources
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