16872 Chronic Venous Insufficiency Cvi

Overview

Chronic venous insufficiency (CVI) is a condition where the veins in your legs have trouble sending blood back to your heart. This causes blood to pool in the lower legs, which can lead to swelling, skin changes, and sometimes leg ulcers.

Yes, CVI is very common. It becomes more likely as you get older and affects about 1 in 5 adults in Western countries.

CVI mainly affects older adults, people who stand or sit for long periods, women during or after pregnancy, and people with a family history of vein problems.

Symptoms

Common symptoms

• Heavy or aching legs, especially after standing
• Swollen ankles and calves
• Itchy or flaky skin on the legs
• Visible varicose veins
• Skin changes like brown or red discoloration
• Leg ulcers (open sores) that are slow to heal

Causes

Main causes

• Damaged or weak one-way valves inside the leg veins
• Previous blood clot in the leg (deep vein thrombosis or DVT)
• Pressure in the veins from prolonged standing or sitting
• Hormonal changes during pregnancy or menopause

Risk factors

• Getting older
• Being overweight or obese
• Family history of vein problems
• Standing or sitting for long hours at work
• Pregnancy
• Smoking
• Having had a blood clot in the past

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency or urgent symptoms listed above, seek medical help right away.

Book a routine appointment if:

• If you have persistent aching, swelling, or skin changes in your legs that do not improve with self-care.

Diagnosis

Your doctor will ask about your symptoms and medical history, examine your legs, and check your pulses. They may also order an ultrasound of your leg veins to see how well the valves are working.

Tests that may be done

• Physical exam of the legs (looking for swelling, skin changes, and varicose veins)
• Duplex ultrasound: a painless scan that shows blood flow in your veins
• Sometimes a blood pressure test in the feet called ankle-brachial index

What to expect at your appointment

The diagnosis is usually straightforward. Most people do not need complex tests. The ultrasound is painless and takes about 20–30 minutes. After the appointment, your doctor will talk to you about treatment options and lifestyle changes.

Treatment

Treatment for CVI focuses on improving blood flow and reducing symptoms. Most people start with lifestyle changes and compression stockings. If these are not enough, there are medical procedures that can close or remove damaged veins.

Self-care at home

• Elevate your legs above heart level for 10–15 minutes several times a day
• Move around or flex your ankles every hour if you sit or stand for long periods
• Wear compression stockings as recommended by your doctor (they gently squeeze the legs to help blood flow)
• Keep your skin moisturized to avoid dryness and itching

Medical treatments

For veins that do not improve with self-care, doctors can offer medical procedures. These include ablation (using heat or glue to close the vein), sclerotherapy (a solution injected into the vein), and surgery to strip or tie off damaged veins. Your doctor will discuss the best option for your situation. Medications for blood clots or skin changes are sometimes prescribed, but only a doctor can decide if you need them.

When is surgery considered?

Surgery is usually considered when other treatments have not worked or if the veins cause severe pain, bleeding, or leg ulcers. The most common procedures are minimally invasive and do not require an overnight stay.

Living with this condition

Living with CVI means making small habits part of your day — like taking short walks, putting your feet up, and checking your skin for changes. This can make a big difference.

Lifestyle tips

• Take regular breaks from sitting or standing
• Wear comfortable shoes and avoid tight clothing around the waist
• If you smoke, ask your pharmacist or doctor about support to quit
• Keep your legs clean and moisturized

Diet and exercise

Regular exercise like walking, swimming, or cycling helps pump blood through your legs. A healthy diet with plenty of fibre and fluids can help you keep a healthy weight and prevent constipation, which reduces pressure on your leg veins.

Mental health and emotional wellbeing

Dealing with chronic leg pain or visible changes can be frustrating and can affect your mood. It’s normal to feel upset sometimes. Talk to your doctor or a counsellor if you feel anxious or low.

Prevention

You cannot always prevent CVI, but you can reduce your risk by staying active, keeping a healthy weight, avoiding long periods of standing or sitting, and following your doctor’s advice about compression stockings if you have early signs.

Complications

If left untreated

• Progressive swelling and discomfort
• Skin changes such as darkening, hardening, or eczema
• Leg ulcers that can become infected
• Bleeding from varicose veins
• An increased risk of deep vein thrombosis

Long-term outlook

With the right treatment, most people with CVI feel better and can keep doing their daily activities. Leg ulcers can heal with proper care, and procedures to fix vein problems have a high success rate. Staying engaged in your own care is the most important step.

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