What is venous insufficiency?

What is venous insufficiency?

Venous insufficiency or dysfunction of the veins occurs when your leg veins don’t allow blood to flow back up to your heart. Normally, the valves in your veins make sure that blood flows toward your heart. But when these valves don’t work well, blood can also flow backwards. This can cause blood to collect (pool) in your legs.

Understanding vein health

To understand when veins don’t work well, we must first understand how they are supposed to work. A widely branching system of blood vessels transports our blood around our bodies. The blood vessels are divided into arteries and veins depending on the direction in which the blood is flowing. The heart pumps blood through the arteries to every part of the body and supplies the cells with oxygen.

  • The venous system is a network of veins, organized into two main parts, or circuits. It is the way our veins connect with other blood vessels and organs throughout the body. Once the arterial system has transported oxygenated blood and nutrients to the outermost parts of the body, the venous system transports the blood back to the heart.
  • The vascular system, also called the circulatory system, is made up of vessels that carry blood and lymph throughout the body.
  • Veins are blood vessels that carry blood from the body back to the heart. Venous valves take blood back to the heart against the force of gravity. Venous valves are especially important in the arms and legs as they prevent the backflow of blood in response to this pull of gravity.
venous insufficiency red blood cells vein function

Function of the veins

How our veins work is especially important to our body working as it should. The veins in the legs have to pump the blood upwards against gravity. This is done by the leg muscles that squeeze the veins together every time they contract (ie., calf muscle pump).

What are the common conditions and disorders that affect veins?

Veins in our legs carry blood back to our hearts. They have one-way valves that keep blood from flowing backward. If you have a venous disease, the valves won’t work as they should, and some blood may go back down the legs. If veins cannot operate effectively, the blood pools in the legs. This results in various Venous Disorders developing, such as spider veins, varicose veins, venous inflammation, and, in very advanced stages, venous leg ulcers, as a result.

Examples of venous diseases:

How does venous insufficiency develop?

If the venous valves no longer close tightly, the blood in the veins can flow back down and it becomes congested and pools in the lower parts of the legs. The vein walls surrender against the higher pressure and the veins widen. The result of this is that the venous valves now close even less than they did before. Moreover, the distended veins eventually become visible as thin spider veins and the larger veins as convoluted, bluish varicose veins, many of which also protrude conspicuously under the skin. The blood that has pooled in the veins also leads to fluid leaking out into the surrounding tissues.

venous insufficiency varicose and spider veins

Symptoms of chronic venous insufficiency may include:

  • Swelling in your legs or ankles
  • Tight feeling in your calves or itchy, painful legs
  • Pain when walking that stops when you rest.
  • Brown-colored skin, often near the ankles
  • Varicose veins
  • Leg ulcers that are sometimes hard to treat
  • Having an uncomfortable feeling in your legs and an urge to move your legs (restless legs syndrome)

Do I have venous disease?

What happens if venous insufficiency is not treated?

Without treatment, the pressure and swelling can burst the tiny blood vessels in your legs called capillaries. This could turn your skin reddish-brown, especially at the ankles. This can lead to swelling and ulcers. These ulcers are tough to heal. Venous insufficiency is the trigger for a whole series of symptoms and disorders with increasingly grave consequences: 

At the first sign of venous insufficiency, such as painful, tired, heavy or swollen legs, and spider veins and varicose veins, a specialist (phlebologist, angiologist, vascular surgeon or dermatologist) should examine your legs. With an ultrasound examination (Doppler ultrasonography), a doctor can judge the state of your venous system and can recognize disorders and blood clots that may have formed. 

If the venous system proves to be weak and is not treated promptly, it may progress to varicose veins and thromboses that also affect the deep venous system as a condition call deep vein thrombosis. If blood clots become dislodged from the thrombosis, this could lead to a life-threatening pulmonary embolism. Venous leg ulcers (ulcus cruris) is another effect of chronic venous insufficiency.

How to treat venous health conditions?

There are varying degrees of venous disease from early stages of spider veins or varicose veins, to more advanced conditions such as deep vein thrombosis or venous stasis ulcers.  Always seek treatment from your physician or a vein specialist for a recommended treatment plan. 

There are two courses of treatment, conservative treatments with compression therapy garments and nutritional supplements, and corrective treatments that are interventional procedures conducted by vein specialists. In many cases, both conservative and correctional methods will be used.

Compression therapy involves the use of special garments that put external pressure on the leg to push valves closer together, increasing their efficiency. Compression socks and stockings provide support and apply graduated compression. To learn more about the role compression stockings play in venous insufficiency treatment, visit How do compression stockings work?

Corrective treatments may involve minimally invasive procedures and surgery. These options may be useful if venous disease interferes with your everyday activities or if you’re at risk of developing DVT or a pulmonary embolism. Treatments may reduce your risk of life-threatening complications of venous diseases, such as a pulmonary embolism. These treatments can also bring relief from symptoms like the feeling of heaviness or achiness in your legs, itching or ulcers and even swelling.

Explore Treatment Options in more detail.

walking to help prevent venous insufficiency

Tips for everyday living to prevent venous insufficiency

  • Avoid sitting or standing for long periods
  • Go for regular walks
  • Take the stairs, not the elevator
  • Activate the legs’ muscle pump with sports such as swimming, cycling and power walking
  • Strengthen your veins with vein exercises
  • Alternating hot and cold showers strengthen the vascular system
  • Make sure you drink enough water
  • Keep your weight down
  • Limit your use of high heels
  • Wear medical compression stockings as soon as you notice the first signs of early venous insufficiency

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