Chronic Venous Insufficiency

Chronic Venous Insufficiency

There are many diseases first seen in physical medicine due to the painful symptoms they produce. Patients are often complaining to me of heaviness in their legs, inability to sleep due to restless legs, consistent cramping in their calves, as well as swelling in their ankles and lower extremities. More often than not when I look at their legs I see signs and symptoms of venous disease. This can cause many of the same clinical manifestations of lower back issues, but has a very different physiological process.

Your arteries carry blood from your heart to the rest of your body and your veins carry that same blood back to the heart. If you have Chronic Venous Insufficiency (CVI), valves in your veins (usually in the leg or sometimes the arms) don’t work, causing blood to pool in your legs and puts increased pressure on the walls of the veins.  This may be due to valve dysfunction (usually hereditary) or due to valve destruction after a deep vein thrombosis (DVT) or blood clot. It is more common in women than men, and much of this is due to pregnancy.

Symptoms of venous insufficiency include swelling of the legs or ankles, pain in your legs that gets worse when you stand and better when you elevate your legs, leg cramps, feelings of heaviness in your legs, itchy legs, thickening of the skin or other skin changes on your legs or ankles, varicose veins, leg ulcers, and feelings of tightness in your calves.

Venous insufficiency is diagnosed by physical exam and ultrasound. Treatment can include several different strategies including: improving blood flow by elevating your legs when possible, wearing compression stockings to apply pressure to your lower legs to force the blood up, and by exercising regularly; medications such as diuretics and anticoagulants; and through minimally invasive surgical procedures that remove the damaged vein, repair damaged veins or valves, removing varicose veins, sclerotherapy, and vein ablations.

Prevention of venous insufficiency involves lessening your chances of developing the condition by: not standing in one position for long stretches of time, not smoking, getting regular exercise, and maintaining a healthy body weight.

If you think you may be suffering from venous insufficiency it is advisable to have a full physical evaluation. It is a chronic, progressive disease, and a very serious health condition. If you have questions or would like an evaluation ask me or visit


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