Chronic Venous Insufficiency
Vein problems are among the most widespread chronic health conditions in the U.S. By age 50, nearly 40% of women and 20% of men have serious leg vein problems. At least 20 to 25 million Americans have varicose veins. Varicose veins, or enlarged veins found in legs and feet, are hereditary. They can often develop after pregnancy, trauma or injury.

Chronic venous insufficiency (CVI) is a common cause of leg pain and swelling. CVI occurs when the valves of the veins do not close properly, and blood return from the leg veins is impaired. It is also associated with varicose veins.CVI may affect up to 20% of adults. Common symptoms may include (but are not limited to):

  • Ankle and foot swelling that progresses up the lower leg
  • Skin changes in the lower leg that include:
    • Discoloration
    • Eczema
    • Scarring, or hard, thickened skin and ulceration (a break on the skin’s surface)
    • Aching
    • Restlessness
    • Tiredness/leg fatigue
    • Pain or throbbing
    • Burning
    • Itching
    • Muscle cramping

CVI is caused by either poorly functioning vein valves or blockage in the veins. Vein valves are designed to allow blood to flow against gravity from the legs back to the heart. When the valves fail to close properly, gravity wins and the flow reverses. This is called venous reflux. Vein valves may fail to close due to:

  • Vein wall weakness that causes the vein to enlarge so that the valves cannot close
  • A history of deep vein thrombosis (DVT), blood clots in the deep veins of the legs that damage the valve
  • Being born without vein valves

Regardless of cause, when valves do not work properly, it can cause a buildup of venous pressure in the leg, leading to venous hypertension, or high blood pressure in the vein. This may result in enlargement of the varicose veins and over time an increased likelihood of other symptoms, such as swelling, skin changes, and chronic ulcers at the ankles or lower leg.