Having venous insufficiency can impact your life on a daily basis. Yes, it changes the way you look. But it can also cause serious discomfort, chronic pain, and potential long-term health issues if untreated. But what are the causes of venous insufficiency? And what do the symptoms of this condition do to your veins and body?


Close up on a leg with venous insufficiency.

Venous insufficiency happens when the veins within your legs cannot properly transport blood back to your heart. This subsequently weakens your valves and causes blood to pool up in your veins. A domino effect of pain, fatigue, swelling, and skin changes then occur. Clearly, this is not something you want to experience on an everyday basis. 


Today we’ll explain how to recognize the initial symptoms of this condition. We’ll also elaborate on the six phases of chronic venous insufficiency and why you should seek medical intervention when they come about. Our hope is that you can detect a case of this condition before it worsens so that you can return to a life of comfort and venous health.


What are the Initial Symptoms?


The symptoms of venous insufficiency can be different for everyone. But most cases are accompanied by the following symptoms: 

  • Ankle, feet, and leg swelling
  • Pain or aches that cause legs to feel heavy
  • Itchiness, dryness, and altered color of skin—often a reddish-brown tone
  • Developed varicose veins
  • Leg fatigue, cramping, or muscle spasms

In addition to knowing the symptoms, you should also be aware of the different types of veins. Your body is made up of deep veins, superficial veins, and perforating veins. When these veins do not operate properly, they can have varying impacts on venous insufficiency. 


Deep veins play a large role in transporting generous amounts of blood to your heart. They reside near the arteries and surround themselves with muscles. Superficial veins, on the other hand, are closer to the skin’s surface. Their job is to drain blood from your skin and tissues. Superficial veins can become noticeably enlarged, resulting in varicose veins. Perforating veins connect the other two types and allow blood to flow between them. They have one-way valves that stop blood from flowing in the opposite direction. When the valves of perforating veins are impaired, venous insufficiency occurs. 

Understanding the Six Stages of Venous Insufficiency


There are multiple stages of chronic venous insufficiency, or CVI. Though six phases exist, the Clinical, Etiologic, Anatomic, Pathophysiologic (CEAP) classification system numbers them as 0-5. As you might assume, each stage represents a higher severity of the condition. Let’s explain what happens in each one:


Stage 0: This is basically an undetected stage of venous insufficiency. No clinical symptoms or signs have popped up yet. But nevertheless, being in this stage means you are at risk of developing CVI.

Stage 1: This is when the real symptoms of CVI start to surface. Visible signs like telangiectasias or spider veins start to appear. This indicates a need for medical attention and intervention. 

Stage 2: This phase is characterized by the development of varicose veins. You’ll experience greater discomfort and pain than in the previous phases. 

Stage 3: Patients in stage 3 will experience swelling in their ankles and legs. This is called edema. It happens when excessive amounts of fluid get trapped within the body’s tissues.

Stage 4: In this stage, patients may develop skin ulcers or sores that recur frequently and do not heal. 

Stage 5: This stage is considered severe. It may involve the development of a condition called lipodermatosclerosis. This condition is characterized by hardened, fibrotic tissue in the skin and subcutaneous tissue.


Not all patients will experience every stage of CVI. And the progression and severity will vary from person to person. Nonetheless, it’s ideal to recognize CVI at an early stage and seek immediate treatment. 

What Are the Major Side Effects of CVI?


Venous insufficiency can lead to tissue inflammation and damage. This is caused by the accumulation of blood and fluid in the area affected. Since the veins are unable to transport blood back to your heart, pressure builds up. This releases inflammatory mediators. Their job is to induce blood vessel dilation, thus causing inflammation and damage to occur. 


Venous insufficiency can also cause your skin and underlying tissues to break down. This can result in venous ulcers on your lower legs. These ulcers are painful, recurrent, and take a long time to heal. Your skin may start to develop lipodermatosclerosis, causing dryness, itching, and scaling of the skin. 

What Are the Consequences of Untreated Venous Insufficiency?


There are several serious and unpleasant consequences of leaving venous insufficiency untreated. Here are some of the most prevalent ones:

  • Blood Clots: This is one of the most life-threatening side effects of venous insufficiency. Blood clots can form in your deep veins, causing a condition called deep vein thrombosis. Serious health issues like pulmonary embolism can then occur.
  • Infections: Venous insufficiency ups your risk of infection. This is especially true for the skin around your affected veins. There is a greater potential for fungal or bacterial growth. 
  • Impaired Mobility: You may have a harder time standing or walking for extended periods of time. This is due to the pain and blood pooling caused by this condition. Consequently, your ability to fulfill everyday activities may be hindered.
  • Lower Quality of Life: Swelling, changes in skin texture, and chronic pain caused by venous insufficiency can really take a toll on your life. Your ability to socialize, work, and pursue leisurely activities is compromised. This can cause you to develop a disability and inevitably impact your level of happiness. 

Recognize the Signs and Treat the Symptoms


Taking action in the early stages of venous insufficiency can prevent unpleasant cosmetic damage to your legs and skin. But more importantly, recognizing it from the start can help you impede the major physical and mental health issues that can accompany this condition. Luckily, there are surgical treatments for alleviating the pain and preventing CVI from worsening. 


Sclerotherapy, venous ablation, and other types of vein surgery can be used for treating the condition and are all available at Delaware Advanced Vein Center. Our vein specialists can also provide medications, non-medical treatments, and lifestyle plans to help with venous insufficiency. Whatever stage you’re at, know that there are solutions for treating and living with CVI. So there’s no reason to wait—seek solace from this venous condition today! 

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