About this condition
Chronic venous insufficiency (CVI) develops when blood flow from the legs is impaired by faulty venous valves, reflux or an obstruction to venous return. Higher pressure in the veins can gradually affect the skin and tissues around the lower legs.
Common symptoms and changes
Patients may notice ankle swelling, a heavy or aching feeling towards the end of the day, itching or visible enlarged veins. Over time, the skin may darken, become firm or develop venous eczema and, in advanced cases, ulcers. Swelling can also have non-venous causes such as heart, kidney or medication-related conditions.
How venous function is assessed
The doctor reviews symptoms, previous deep-vein thrombosis, general health and the effect of standing. Duplex ultrasound can identify reflux and examine vein patency. Other causes of swelling are considered, and arterial circulation may need evaluation before therapeutic compression.
Individual treatment options
Movement, appropriate exercise, skin care, carefully selected compression and treatment of confirmed venous reflux may all have a role. The right plan depends on disease severity, ultrasound findings and other medical conditions; visible veins alone do not determine treatment.
Signs and symptoms
- Recurrent swelling around the ankles or lower legs, often worse in the evening.
- Heaviness, aching, pressure, sometimes itching or cramps.
- Darkened, dry or hardened skin and possible venous eczema.
- Slow-healing leg ulcers in more advanced disease.
These findings can also occur for other reasons; individual assessment is needed.
Diagnosis and tests
A phlebologist reviews the history and examines both legs, including swelling, veins and skin changes. Duplex ultrasound assesses patency and reflux. Further tests may be needed to investigate other causes of swelling or check arterial circulation before compression treatment.
Care and treatment approaches
Care is tailored to the cause and severity. Options may include walking and daily movement, skin care, compression selected after circulation assessment and vein procedures for appropriately confirmed reflux. Strong compression should not be applied without suitable medical advice.
When to seek urgent care
Urgent assessment is needed for sudden swelling in one leg, increasing pain, redness or warmth, because deep-vein thrombosis must be considered. Sudden breathlessness, chest pain or fainting requires emergency services.
Frequently asked questions
Is chronic venous insufficiency the same as varicose veins?
No. Varicose veins describe enlarged veins, whereas venous insufficiency refers to impaired return of blood with clinical effects. The two may coexist.
Why is leg swelling often worse by evening?
Prolonged standing can increase venous pressure and swelling, but other causes must also be considered.
Can I select medical compression stockings myself?
The appropriate type and strength of therapeutic compression should be chosen after clinical evaluation, including arterial circulation when indicated.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
