Varicose veins are just one visible outgrowth of venous insufficiency, but there are other indications your veins aren’t working properly.

The terms varicose veins and chronic venous insufficiency (CVI) are often used interchangeably. But in fact, CVI refers to a broader range of vascular disorders than just swollen veins. You can have CVI but not see varicose veins on your legs or feet. Chronic venous insufficiency is also called venous reflux.

CVI indicates a disruption in the normal flow of blood between veins in the extremities and the heart. Our circulatory system relies on arteries that push nutrient-rich oxygenated blood from the heart to our organs and tissues. It’s the veins’ job to pump that blood back to the heart, where it gets a boost of oxygen. 

When that movement is interrupted due to defective valves in the veins, which permits blood to backflow and collect in the veins, the result is CVI, or venous reflux, a condition characterized by a host of symptoms including tightness in the legs, skin changes (flaking, itching), cramps, pain, and swelling —  and sometimes varicose veins.

What is Chronic Venous Insufficiency?

Varicose veins are just one by-product of CVI. When CVI develops in superficial veins closer to the skin’s surface, the most visible expression is a varicose vein. If the condition affects a deeper vein, you likely won’t see any apparent sign, but you may experience throbbing and swelling in your lower leg.

Other indications of CVI include spider veins, which are not painful and are considered more of a cosmetic problem. In its most advanced form, CVI could cause slow-healing skin ulcers that might become infected without treatment.

CVI and varicose veins share several risk factors, namely, sitting or standing for long periods, a generally sedentary lifestyle, and obesity. All those factors put extra pressure on the veins and increase your chances of poor blood flow and potentially CVI.

A breakdown in blood flow also occurs as a long-term complication of a blood clot in the deep veins, also known as deep vein thrombosis (DVT). About a half to a third of people who suffer a DVT incident go on to develop CVI, usually marked by swelling, pain, and discolored skin on the affected leg. CVI may be the result of an injury to the vein or of phlebitis, an inflammation of the superficial vein.

Diagnosis and Treatment of CVI

If you suspect you have CVI, your vein specialist will review your health history and perform a series of diagnostic tests. A common test for CVI is an ultrasound to get a clearer picture of your blood flow. A venogram also images your blood flow by injecting a dye into your veins. The contrasting dye makes the veins appear opaque, providing your doctor with a snapshot of how well your veins are working.

Treatment for CVI depends on the severity, but typically begins with compression therapy. Compression stockings gently squeeze your veins, forcing the blood to move upward and not pool within the vein. These tight elastic garments can be purchased in a drugstore or medical supply outlet. Commercially available compression socks are of a lower pressure. If you require a higher grade, you’ll need a doctor’s prescription.

Besides compression stockings, you can try some at-home therapies to relieve the pain and swelling. Elevating your legs whenever possible and flexing your ankles as you sit at your desk encourage proper blood flow. Toning your calf muscles with daily walks increases circulation, as well.

If CVI is the result of DVT, your doctor may recommend blood thinners. Other medications that could be used to treat CVI range from diuretics or a prescription hemorheologic agent known as pentoxifylline to improve blood flow. Your doctor will decide which medication is right for you.

If you and your vein specialist decide surgery is the best route, you have several procedures from which to choose. Current varicose vein surgical procedures are minimally invasive and use either a safe solution or heat to collapse the damaged vein. Once the varicose vein is sealed, blood flows to nearby veins and the appearance and discomfort of varicose veins gradually diminishes.

Time to Take Care of Your Veins

VEINatlanta specializes in varicose veins and other other venous disorders. If painful, swollen veins interfere with your quality of life, it’s time to see a vein specialist and explore your treatment options. Schedule your appointment today.