Venous insufficiency

Painful, swollen, heavy legs are a sign of venous insufficiency. At Atrium Health Floyd and Harbin Clinic, our vascular medicine specialists provide expert care to help ease symptoms. You’ll find advanced diagnostics and the latest minimally invasive treatments.

What is venous insufficiency?

Venous insufficiency, also called chronic venous insufficiency, occurs when blood doesn’t flow well from your legs to your heart. It happens when the valves in your leg veins that prevent backflow become weak or damaged. Blood collects in your legs, increasing pressure inside your veins.

Causes of venous insufficiency

Venous insufficiency is a chronic condition caused by malfunctioning valves in the leg veins.

Venous insufficiency symptoms

Symptoms of venous insufficiency include:

• Aching or heaviness in the legs
• Itching or tingling in the legs
• Leg cramps
• Leg sores (venous ulcers) that are slow to heal
• Pain in the legs that worsens when standing
• Restless leg syndrome
• Skin discoloration, especially around the ankles
• Swelling in the ankles or legs
• Thickening and hardening of the skin on the legs and ankles
• Varicose veins

Venous insufficiency diagnosis

Your doctor will ask about your symptoms and medical history. They’ll examine you and look at your legs when you’re standing and sitting.

The main test for diagnosing venous insufficiency is a duplex ultrasound. This imaging test measures blood flow in your legs and can help rule out other problems, such as a blood clot.

Depending on the severity of your symptoms, you may see a vascular medicine specialist for diagnosis and treatment.

Venous insufficiency risk factors

Many factors can increase your risk of venous insufficiency, including:

• Age over 55
• Family history of venous disease
• Female sex assigned at birth
• History of deep vein thrombosis (DVT)
• Obesity
• Past leg injury
• Physical inactivity
• Pregnancy
• Prolonged periods of sitting or standing
• Smoking

Venous insufficiency prevention

Venous insufficiency isn’t always preventable, but adopting a healthy lifestyle can help. To reduce the risk, doctors recommend the same self-care strategies they use to treat the disease.

Venous insufficiency treatment

Venous insufficiency usually worsens with time. Treatment is most effective when started early. Your doctor may first suggest self-care strategies to help you manage symptoms, such as:

• Avoid long periods of standing or sitting.
• Exercise regularly.
• Maintain a healthy weight.
• Wear compression stockings to improve blood flow and decrease swelling.

If your symptoms are severe, treatment usually involves a minimally invasive procedure or surgery (less often) to treat varicose veins or open a blocked vein. Your options may include:

• Sclerotherapy: A solution is injected into the vein to cause scarring. The vein hardens and then fades away.
• Endovenous ablation therapy: Laser or radiofrequency energy heats the vein and destroys it. The vein disappears over time.
• Angioplasty and stenting: A tiny medical balloon is inflated inside the vein to open it. A metal mesh tube (stent) is then inserted to keep the vein open.
• Vein stripping and ligation: The vein is cut, tied off and surgically removed.