When a patient complains about a persistent ache or throbbing in a leg, a vein specialist asks questions about a possible link to a sports injury or other event. When there is no obvious reason for the discomfort, the physician might suspect that the individual suffers from chronic venous insufficiency.
What is Chronic Venous Insufficiency?
A vein’s job is transporting blood from internal organs and extremities to the heart. The legs are the most common areas where problems arise. One-way valves in veins help transport blood upward toward the heart. When they are damaged or malfunctioning, they cannot shut properly. Blood leaks back into the vein. The vessel stays full of blood, especially when an individual is standing, according to MedlinePlus. The result is venous insufficiency, which over time can become chronic. A less-common cause is a prior blood clot in the affected limb. The University of Chicago Medicine cites these classic symptoms:
- Swollen legs and/or ankles
- Legs that are painful and itchy
- Calves that feel tight
- Pain that occurs with walking and ceases at rest
- Skin with a brown hue, especially near the ankles
- Presence of varicose veins
- Leg ulcers that might resist treatment
According to the Cleveland Clinic, the following are risk factors:
- Advancing age
- Having varicose veins
- Prior blood clot
- A family history
- Excess weight
- Weakness in muscles
- Being pregnant
- Leg injury
- Suffering from cancer
Treatment Options from a Vein Doctor
Fortunately, there are many options for treating chronic venous insufficiency. The best one depends on the condition causing the insufficiency, the patient’s overall health, and the individual’s preference. The University of Chicago Medicine cites these main categories:
- Options to boost blood flow in leg vessels. Two important examples are elevating the legs to lower pressure in blood vessels and wearing compression stockings. Additional lifestyle changes include losing weight, avoiding crossing the legs while seated, getting more exercise, and not standing or sitting for extended periods.
- Drugs. Some medications improve blood flow. A vein doctor might prescribe them plus compression therapy when leg ulcers are present. Aspirin also helps heal these ulcers.
- Sclerotherapy. Typically used to eliminate spider and small varicose veins, this non-invasive procedure involves injecting a chemical that causes a vein to seal shut. Neighboring healthy veins pick up the circulatory workload of the destroyed vessel, which the body absorbs.
- Surgery. A vein doctor usually recommends it for fewer than 10 percent of patients with this condition. Others are eligible for non-invasive treatments such as lifestyle changes, sclerotherapy, or ablation. For patients who need surgery, the options include ligation, surgical repair, vein transplant, and subfascial endoscopic perforator surgery.
Most patients do require treatment. However, self-care measures during the early stages of chronic venous insufficiency can sometimes reduce discomfort and prevent the condition from worsening.