What is Venous Insufficiency?
Venous insufficiency is a condition where the veins in your legs cannot pump blood back to your heart effectively, causing blood to pool in your lower legs. 1
How Your Leg Veins Normally Work
- Your leg veins contain one-way valves that help push blood upward toward your heart, working against gravity 1
- When you walk, your calf muscles squeeze the veins and help pump blood upward 1
- Normally, when you're standing still, pressure in your leg veins is high (80-90 mm Hg), but when you walk, this pressure drops to about 22 mm Hg because the muscle pump and valves work together 1
What Goes Wrong in Venous Insufficiency
When the valves in your leg veins become damaged or weakened, they fail to close properly, allowing blood to flow backward (reflux) instead of only upward. 1 This creates several problems:
- Blood pools in your lower legs instead of returning efficiently to your heart 1
- Pressure in your leg veins stays abnormally high even when you're walking (called "ambulatory venous hypertension") 1
- The persistently high pressure damages the vein walls and surrounding tissues over time 2
What Causes the Valve Damage
The valves can become incompetent due to:
- Loss of elasticity in the vein wall, causing the valve leaflets to separate and not fit together properly 1
- Previous blood clots (deep vein thrombosis) that damaged the valves during the healing process 1, 3
- Genetic predisposition combined with increased pressure inside the veins 1
- Chronic increased pressure from obesity, pregnancy, prolonged standing, or chronic constipation 1
Symptoms You Might Experience
Your symptoms typically worsen at the end of the day or after prolonged standing, and improve when you rest with your legs elevated. 1
Common symptoms include:
- Aching, heaviness, or tiredness in your legs 1, 4
- Swelling (edema) in your ankles and lower legs 1, 4
- Pain, burning, itching, or tingling sensations 1
- Leg cramps, throbbing, or restlessness 1
- Visible bulging, twisted veins (varicose veins) 1
Progressive Skin Changes
If left untreated, venous insufficiency can cause visible changes to the skin of your lower legs: 1, 2
- Brown discoloration (hyperpigmentation) from blood pigment leaking into tissues 1
- Stasis dermatitis - red, itchy, inflamed skin 1, 4
- Lipodermatosclerosis - hardening and thickening of the skin and underlying tissue, creating an "inverted champagne bottle" appearance of the lower leg 1, 5
- Venous ulcers - open sores, typically near the ankle, that heal slowly 1, 2
Risk Factors
You're more likely to develop venous insufficiency if you have: 1, 3
- Family history of venous disease 1
- Female gender 1, 3
- Older age 1, 3
- History of blood clots in your legs 1, 3
- Multiple pregnancies 1, 3
- Obesity 1, 3
- Jobs requiring prolonged standing 1, 3
Why Treatment Matters
Venous insufficiency is a chronic, progressive condition that worsens over time without treatment. 2, 6 The persistently high pressure triggers inflammation and tissue damage that can lead to permanent skin changes and ulcers. 2 Early intervention with compression therapy or procedures to correct the valve dysfunction can prevent progression to these more severe stages. 1, 7