Venous insufficiency is the inability of the veins to pump blood from the feet back up to the heart. This is usually due to the wall or the valve of the vein being damaged, causing the blood to pool in the foot. Chronic venous insufficiency or CVI is a long-term version of this condition that can lead to severe symptoms, such as ulcers.
Symptoms of Venous Insufficiency
The most common symptom of the condition and usually the earliest is a swelling of the foot. This is because the blood is not being pumped back to the heart but is being retained in the foot. There are other symptoms that will signify that you have venous insufficiency; these include cramping, a heavy feeling in the legs and feet, itching, redness and varicose veins.
The condition can also be painful. The pain is often worse when standing as the veins have a harder time making the blood reach the heart. The pain can ease when the legs are elevated, helping the blood flow to the heart.
In more serious cases of CVI, you may also experience a thickening of the skin on the legs and feet. You can also develop ulcers, these can be painful and if left can become infected.
Causes of Venous Insufficiency
Venous insufficiency is more common in people who have had previous leg conditions, especially a blood clot (deep vein thrombosis) or varicose veins. This is because the vein has been weakened and it now does not carry blood properly and the blood can leak through the damaged walls.
Similarly, if you have recently injured your leg or had surgery there is a possibility that you may develop the condition. This is again due to the vein being weakened or damaged.
There are a number of other health factors that, while they may not be the direct cause of the condition, certainly add to the chances of developing it. Weight is one of these; venous insufficiency is more common in people who are obese. Similarly, people who do little exercise or sit or stand for long periods of time are more likely to develop it as they are not helping the blood to move.
There is a hereditary link to the condition as well; it has been found that people who have venous insufficiency in their families are more likely to develop it themselves than people who have no history of it.
Venous Insufficiency Treatments
There are a number of different treatments for the condition which we have outlined below. For more detailed information please visit our Venous Insufficiency Treatments page.
As previously mentioned, people who are overweight have a higher chance of developing venous insufficiency. Therefore, to combat the condition it is important to lose weight by eating healthily and exercising regularly. This can have a number of other health benefits too.
Medicines, such as diuretics and anticoagulation medication can be used to help treat venous insufficiency. However, they do not always work and surgery may be more successful in the long term.
This is more of an advanced procedure than medication but not quite as drastic as surgery. During sclerotherapy, a chemical is injected into the damaged vein which scars it so it can’t carry blood anymore. Blood will then be pumped through other veins.
If none of these options works or if you have chronic venous insufficiency then surgery may be required. There are a number of different types; some try and reopen the vein, such as angioplasty where the vein is opened with the use of a tiny medical balloon.
Surgeons may also try to repair the valve if it is this which is causing the condition, so it can function again properly.
Other venous insufficiency surgeries aim to block or remove the vein completely so it no longer pumps blood. Ablation is the act of closing off the vein using heat while ligation involves tying the vein off.
Vein stripping is a procedure where a vein is removed completely through an incision in the leg. This is only done when the vein is heavily damaged.
Venous Insufficiency Treatments
There are various treatments for the condition, both non-surgical and surgical with varying levels of effectiveness.
Non-Surgical Treatments for Venous Insufficiency
This is the most common treatment for venous insufficiency. Compression stockings or socks apply pressure to the lower leg which improves blood flow and reduces swelling. They can be purchased from most pharmacies but it is important if you are dealing with venous insufficiency to get a prescription sock from a doctor so you know you are getting one that is right for your condition.
Keep Blood Flowing
Doctors suggest several methods to help increase blood flow and get the blood pumping back to the heart. Keeping the foot elevated is one of them; you don’t have to do this all the time but if you can raise the leg above the heart for part of the day it should help the blood to flow.
Regular exercise also helps; as well as keeping you healthy it will help the blood pump and ensure you are not in a stationary position for too long, which can make the condition worse.
Obesity can increase your chances of developing venous insufficiency as well as worsen the condition if you already have it. It is important to manage your weight and keep your body mass index (BMI) at a healthy level so as not to put more pressure on your veins than is necessary. A nutritious diet and regular exercise can help. A doctor or dietician can provide advice on what the best weight for your height is and how to go about losing the weight.
Doctors can prescribe medicine to help combat venous insufficiency. This is usually some form of blood thinner which will help the blood to flow through the veins. Sometimes doctors will prescribe diuretics that draw excess body fluid through the kidneys. This should help to reduce the swelling in the foot area.
If home remedies and compression stockings don’t work then your doctor may suggest sclerotherapy. This process involves injecting a chemical into the vein which will scar it, blocking the vein and sealing it so it can’t pump blood. This is usually done under local anaesthetic. You will be required to wear compression stockings for a few weeks after the procedure.
Surgical Treatments for Venous Insufficiency
Ablation uses heat to seal off a vein. This is done with either laser or radiofrequency energy via a catheter inserted into the vein. The blood will no longer flow through it afterwards, moving through healthy veins instead.
Vein litgation involves tying off the vein so blood is no longer pumped through it. It is similar to ablation in that the idea is that blood flows through other, healthy veins instead. It is done under local anaesthetic and involves making an incision in the leg and inserting an instrument to litgate it.
If it is a valve causing the blood not to flow then this can sometimes be fixed. Doctors will either do it through an incision in the leg, like litigation or with a long catheter. The idea is to get the valve to pump the blood properly again so the vein can still be used.
If the vein is very damaged then the decision may be made to remove it together, this is known as vein stripping. Like litigation, an incision is made in the leg through which the vein is removed. This is only done in very bad cases but it can be effective as the whole of the unhealthy part is taken away; the blood then has no option but to flow through the remaining healthy veins.