Venous Insufficiency

Chronic venous insufficiency is a condition leading to swelling in the feet and legs.  This occurs because of pressure build up due to weakening and incomplete closure of the valves in the veins. Reverse of the flow of blood in the veins, known as reflux, is a result of long standing problems with the valves.  In addition, blood clots can cause damage to the veins contributing to chronic venous insufficiency. This condition can cause severe leg swelling, varicose veins, skin discoloration and much more, so it's important to seek treatment early to prevent real damage to your legs. Read on for more information about this condition and tips for relief and prevention.

Most commonly, chronic venous insufficiency is a disease encountered with weakening of the veins.  As we age, the valves in the veins are not as strong and lead to fluid build up in the ankles and feet.  This can also be caused by damage to the veins as a result of a blood clot (venous thrombosis). These blood clots can be caused by any of the following factors:

• Injuring a vein's inner lining.
• Hypercoagulability within the vein. Hypercoagulability is defined in the dictionary as the "tendency for excessive blood clotting. It is a potentially dangerous condition in which blood coagulates excessively, even within the blood vessels."
• Little or no movement following surgery or pregnancy.
• Long periods of sitting in a cramped and immobile position (economy class syndrome).
  • Please note: Even normal and healthy people can get this condition, especially travelers on prolonged air flights.

People with chronic venous insufficiency may develop the following symptoms:

• Edema
• Dilated or engorged superficial veins
• Fullness, aching or tiredness in the legs

Symptoms of chronic venous insufficiency worsen when standing and walking, and improve with rest and elevation.

If you develop acute thrombophlebitis and DVT, you will need to check into a hospital for treatment. You will need blood thinners to prevent a pulmonary embolism, a condition where the clot breaks off and travels to the lungs.

Elevate the legs periodically during the day. You can prop up your feet and legs using things around the house or office, or simplify things with a ready-made leg elevator.

Sleep with your legs on cushions or pillows, or elevate the foot of the bed a few inches with blocks.

Check out pneumatic compression devices, such as air compression boots, which help return blood to the mid-body and reduce pooling in the legs.

Put on support hosiery first thing in the morning PRIOR to getting out of bed. Graduated support stockings are much better at preventing swelling than reducing swelling.

Think about taking diuretics (water pills), but don't overdo it.

Start a walking program to increase musculature in your legs to help blood flow return to the heart. Consider the electronic pedaler or any low-impact exercise equipment if hitting the outdoor pavement is not your style.

Later on, if you do not wear support stockings, you could develop the following symptoms and should see a doctor for treatment:

• Skin pigmentation (dark discoloration), especially on the inside parts of the ankle and lower leg.
• Scaling, itching rash.
• Breakdown of the skin with fluid weeping out.
• Development of varicose veins.

Again, the key to prevention of the late sequelae of DVT and thrombophlebitis, called chronic venous insufficiency, is wearing supportive hose.

This information on foot, leg and lower body health conditions is provided by The Podiatry Institute, dedicated to advancing the standard of care in podiatric medicine and its effects on musculoskeletal health. The Podiatry Institute does not endorse a specific treatment, product, or therapy. This information is not intended to be a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider on all matters relating to this or any other condition that may affect your health.