HERSHEY, Pa. — Chronic venous insufficiency (CVI) is a common but underdiagnosed condition where the veins in the legs have trouble moving blood back to the heart efficiently. This can lead to uncomfortable symptoms like leg swelling, aching and varicose veins. CVI affects 10% to 35% of U.S. adults, the National Institutes of Health reports — twice as many women as men, especially in middle age. The good news? By understanding how CVI works and taking early action, you can manage it effectively and protect your leg health.
What is chronic venous insufficiency?
Venous insufficiency happens when the valves inside your leg veins become weak or damaged. These valves normally prevent blood from flowing backward, but when they don’t work properly, blood can pool in the legs, increasing pressure in the veins. Left untreated, CVI can cause skin discoloration and thickening, ulcers or even blood clots.
“Venous insufficiency can significantly impact your quality of life. That’s why it’s important for people to recognize the symptoms early so they can seek timely medical evaluation and care,” said Faisal Aziz, chief of vascular surgery at Penn State Health and Penn State College of Medicine.
What are the symptoms and causes?
CVI often develops gradually. Common symptoms include:
- Swelling in the legs or ankles
- A feeling of heaviness or aching in the legs
- Enlarged or twisted varicose veins
- Skin changes, such as darkening or hardening
- Itching or irritation
- Ulcers near the ankles (in advanced cases)
Several factors can cause CVI, including:
- A history of deep vein thrombosis
- Obesity
- Pregnancy
- Aging, which reduces vein elasticity
- Family history of vein problems
- Sedentary lifestyle or job that requires long hours of standing or sitting
How is CVI diagnosed and treated?
Diagnosing chronic venous insufficiency typically starts with a medical history and physical exam. Your provider may order a noninvasive ultrasound to evaluate how well your veins and valves are working and check for signs of blood pooling or backward flow.
Treatment depends on the severity of the condition and may include:
- Lifestyle changes: Regular exercise, maintaining a healthy weight, and avoiding long periods of standing or sitting can help reduce symptoms.
- Compression therapy: Wearing compression stockings can help to improve circulation and reduce swelling.
- Vein procedures: In selected cases with severe CVI symptoms, minimally invasive treatments like endovenous laser therapy or sclerotherapy can seal off damaged veins and reroute blood flow to healthier ones.
“Simple at-home strategies such as elevating your legs and applying warm or cool compresses can also provide relief,” Aziz said.
Top tips to lower your risk
You can reduce your risk for CVI or slow its progression by:
- Staying physically active and moving regularly throughout the day
- Avoiding sitting or standing for long periods without a break
- Maintaining a healthy weight
- Eating a balanced diet high in fiber and low in sodium
- Wearing compression stockings if recommended by your provider
- Avoiding smoking, which can damage blood vessels in general
Can chronic venous insufficiency be reversed?
While CVI can’t be reversed, its symptoms can be managed — and often significantly improved.
“With the right combination of medical treatment and lifestyle changes, you can prevent complications and stay active and comfortable,” Aziz said.
Learn about heart and vascular clinical trials at Penn State College of Medicine.
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The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.