A Closer Look at Chronic Venous Insufficiency: Understanding Symptoms and Treatments

Written By Center for Vein Restoration
Understanding venous insufficiency

Chronic venous insufficiency (CVI) affects approximately 40% of Americans, but only 90% of these individuals are treated. Venous insufficiency (also called vein disease) ranges in severity from a cosmetic issue to a life-threatening problem. Spider veins are often only cosmetic, but other issues, such as CVI, can be life-altering.

Knowing when to get help is essential because venous insufficiency can affect anyone. Here's what you need to know about the causes, diagnosis, and treatment of venous insufficiency.

What is Chronic Venous Insufficiency?

Chronic venous insufficiency is a type of vein disease. Weak or malfunctioning valves within blood vessels cause poor perfusion. Valves are one-way doors pushing blood against gravity.

Arteries are large vessels that deliver oxygenated blood to the body. Veins are blood vessels that take deoxygenated blood back to the heart and lungs for more oxygen. Capillaries and other small vessels connect arteries and veins.

CVI affects the entire circulatory system because large and small blood vessels use valves to circulate blood in the right direction.

Symptoms of Venous Insufficiency

Do you wonder if you have venous insufficiency? Does your provider dismiss your concerns or attribute them to "part of getting older"?

CVI is a medical problem, and it should not be ignored. Instead, it needs to be treated.

Here are the main symptoms of chronic vein disease:

What Causes CVI and Varicose Veins?

Inefficient or damaged valves can cause blood to stagnate, called pooling. Blood can also flow backward, which is known as reflux.

Both pooling and reflux increase the pressure in the vascular system, which causes the vessels to become stretched, enlarged, and inefficient.

"Mommy Veins"

During pregnancy and menopause, monumental physical and hormonal changes occur. Though most pregnancy changes are temporary, "mommy veins" may not be.

Two factors contribute to varicose veins during pregnancy. The growing baby puts increased strain on the vessels. Secondly, pregnancy hormones cause vein walls to relax.

These combined factors increase stress on the valves, causing them to malfunction. When blood vessels enlarge, blood pools causing pain, itching, and feelings of heaviness.

"Work Veins"

Do you have a job that requires long periods of standing or sitting? You may be at risk of developing varicose veins. Blood reflux and pooling are more common in people who are on their feet for hours.

Veins already fight gravity in their daily duties. Standing or sitting for a long time increases their workload. Slight changes can help with poor circulation in your feet and legs. Changing positions periodically increases blood flow, and you can do heel-toe raises or seated leg lifts to increase circulation.

"Heavy Veins"

Excess weight puts pressure on the body, including the veins. Overweight or obese individuals are more likely to experience CVI because the extra weight damages the valves and stretches the vessels.

Most of your nutrients should come from fruits and vegetables. These foods help maintain a healthy weight, decrease inflammation, and reduce stress on the body. Evaluate your lifestyle choices to determine if changes are necessary for overall health improvement.

"Family Veins"

Do you eat right, exercise, and avoid smoking? You may wonder why you still have varicose veins. Sometimes, it's all in the genes. You are at risk if you have a family history of spider veins, varicose veins, venous insufficiency, or deep vein thrombosis (DVT).

Is Restless Legs Syndrome Linked to Venous Insufficiency?

Phlebologists (medical professional who treats vein disorders, mainly in the legs) recognize restless legs syndrome (RLS) as a symptom of venous insufficiency. Although it isn't always the culprit of RLS, your provider should rule it out before proceeding with a treatment plan.

Restless legs are a nuisance and are characterized by the following:

  • Pain, throbbing, skin-crawling sensation in the legs
  • The urgency to move legs
  • Aching or itchy legs during relaxation, inactivity, or rest
  • Increased symptoms at night

Restless legs syndrome affects your quality of life. It's irritating and interferes with sleep and relaxation.

The treatment of RLS depends on the cause. Sufferers should have a vascular ultrasound done by a vein specialist. This study evaluates the structure and function of blood vessels and determines the speed and direction of blood flow.

If you have both CVI and RLS, laser ablation or sclerotherapy may help. These treatments show significant improvement and relief in RLS symptoms. It is clear that treating the cause, not just the symptoms, is always the best course of action.

Early Diagnosis of CVI is Vital

"Is CVI that big of a deal?" Yes! If left untreated, CVI can progress to life-threatening complications. When circulation is impaired, blood clots are more likely.

Deep vein thrombosis (DVT) occurs when clots develop in the larger, deep vessels. Clots can travel to the lungs. They can become lodged in the lungs causing pulmonary embolism (PE). PE is a medical emergency.

In short, CVI can become a big deal.

An evaluation with a vein specialist is easy and painless. A vein specialist will review your history and do an exam. A vein ultrasound determines the structure and function of the vascular system. Evaluating the speed and direction of blood flow helps determine if you suffer from CVI.

Treatment of Chronic Venous Insufficiency

For decades, the options to treat venous insufficiency have been invasive. Fortunately, today’s CVI treatment is less stressful, more effective, and patients can return to their normal activity immediately with few restrictions.

Several options are available, ranging from conservative lifestyle changes to surgical interventions. It all starts with a simple visit to a qualified vein specialist for an evaluation.

At-home treatment

Wear compression stockings: Compression stockings support weak vessels by providing gradient pressure. With more compression in the feet and less in the calves, blood is encouraged to flow back to the heart.

Elevate legs: Positioning legs at or above chest levels helps veins fight gravity. Elevating the legs increases blood flow and reduces swelling in the lower extremities. It's simple and effective but often under-utilized.

Exercise: The goal of exercise is not misery. It's simply to get the blood moving, which prevents pooling and reflux. It improves circulation and helps maintain a healthy weight.

Choose an anti-inflammatory diet: Fruits and vegetables are wonderful weapons against CVI. These foods are naturally packed with antioxidants and fiber. Eat one fruit and vegetable at each meal to improve circulation and overall health.

Medications and supplements

Venotonics: This group of medications reduces the symptoms of venous insufficiency. Many vein specialists use Venotonics throughout treatment for improved results.

These drugs prolong vein contraction, causing the vein diameter to shrink. Though this medicine doesn't cure CVI, it improves circulation and swelling.

Diosmin: This flavonoid is naturally found in citrus plants, especially oranges. Diosmin is available internationally as a concentrated extract. However, it's obtainable by prescription only in the United States.

Vasculera, the prescription's name, is FDA approved for hemorrhoids and varicose veins. It decreases the permeability of capillaries, reduces swelling, and increases the pH of the blood.

While some claim herbal supplements are helpful, others see no benefits, even after consistent use. Certain herbal supplements can negatively interact with your current medications. So, talk to your doctor before taking any over-the-counter drugs or supplements.

Minimally invasive procedures

Gone are the days of extended hospitalizations for vein restoration. Modern medicine provides innovative treatment methods that improve results and minimize risks. Here are some of the most common ones:

Though each method differs, they aim to seal the damaged vessels. The body then redirects blood to healthy veins.

All vein therapy procedures aim to minimize pain, prevent complications, and improve appearance. But what happens during these treatments? And when are they typically used?


Sclerotherapy is a non-surgical, in-office procedure that boasts same-day recovery. A vein specialist injects a liquid chemical into the damaged veins. The solution seals the vessel and causes a small scar. Over time, the scar fades away. This vein treatment method is effective for treating small vessels and spider veins.


Varithena is similar to sclerotherapy. The main difference is the injected solution. Varithena uses a microfoam medication to collapse the damaged blood vessel. It's also a non-surgical, in-office procedure with a short recovery time. Specialists use Varithena for a broader range of vein sizes and locations.

Radiofrequency ablation

Radiofrequency ablation (RFA) is a minimally invasive technique for treating varicose veins. An ultrasound-guided catheter delivers sound energy, or radio frequencies, to the damaged vein.

Collagen in the vein wall heats, shrinks, and seals off the vessel. The recovery for RFA is also short. You can resume your regular activities on the same day as treatment.

Laser ablation

Laser ablation also uses an ultrasound-guided catheter to deliver energy to the vessel. But laser ablation uses light energy instead of sound energy to seal the vein. Vein specialists use RFA and laser ablation for medium to large veins. Ultrasound assistance makes treating deep veins possible and safe.

Ambulatory phlebectomy

Vein specialists use ambulatory phlebectomy when other methods are not appropriate. A doctor cuts a small incision in the skin and manually removes the diseased vessel.

Though phlebectomy is the most intensive of these techniques, it's still qualified as minimally invasive. It's a quick procedure with a small amount of recovery time.

CVI: Commonly Misdiagnosed

Could your provider be missing your venous disease? Yes! Does your provider dismiss your varicose veins as an expected result of getting older? You need a specialist who takes your spider or varicose veins seriously. Here are some questions to ask when choosing a vein specialist.

“What is your certification?” Many vein doctors are certified in dermatology, plastic surgery, or internal medicine. Treatment is often limited to cosmetic therapy. Some providers don't even evaluate for possible underlying CVI. When seeking help with your spider or varicose veins, choose a clinic with board-certified vein specialists.

“Do you provide both cosmetic and venous disease treatment?” Holistic vein clinics treat both cosmetic issues and CVI. They understand that varicose veins cause both physical and psychological problems.

“Is a vein ultrasound done before any treatment?” Qualified vein specialists always begin treatment with an ultrasound of the veins. This evaluation shows the structure and function of your veins.

Providers can even know the exact location of venous incompetence. An ultrasound also indicates if the impact is superficial or deep. With this evaluation, providers are equipped to treat the problem, not just the appearance.

“How do you treat CVI?” Vascular care has come a long way over the years. Treatment no longer includes lengthy hospitalizations and recovery times. Previously, treatment was limited to extensive vein stripping under general anesthesia.

Ensure your vascular surgeon is current on vein treatment methods. Laser ablation has an incredible success rate with minimal risks. However, many vein specialists are not trained in this highly effective procedure.

“What is your success rate for treating vein disease?” If the veins specialist's success rate is 75-80%, know you can do better. Top-rated vein specialists boast a 96-99% success rate and promise rapid recovery with minimal complications.

“What type of anesthesia do you use?” Unlike old-fashioned invasive procedures that require general anesthesia and a hospital stay, CVR uses only modern, advanced technology to treat problem veins. Patients are kept comfortable using only numbing medicine around the area to be treated.

Need Help with Your Venous Insufficiency?

Treatment for chronic venous insufficiency, spider, and varicose veins is no longer extensive, expensive, or traumatic. Center for Vein Restoration is America's largest physician-led vein center. We are led by vein doctors and inspired by patients.

We pride ourselves in delivering various treatments that eliminate unsightly and painful veins. We have more than 110 vein clinics nationwide with over seventy vein doctors. We are most proud of our customer satisfaction rate of 98%.

Are you tired of painful varicose veins? Do you want to look good in that black dress? Don't wait! Schedule your consultation today.

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