Our veins are tasked with returning de-oxygenated blood to the heart. You can think of them as being akin to one-way highways. Valves in the veins ensure the one-way flow of this bluish, purple blood (because it lacks oxygen). They prevent backflow. But in our legs, our veins have an entirely uphill route back to the heart. The muscles in your feet and calves help out by contracting with every step you take, helping to push the blood up through the veins.
This works well when we’re young and our muscles are strong and tissues firm and tight. But our vein walls weaken with age. Plus, our valves begin to leak and create some backflow; this allows the blood to pool in the veins. This happens in a condition called chronic venous insufficiency (CVI). CVI can lead to varicose veins, swelling in the legs and ankles, itching skin on the legs and feet, and even skin infections. It is estimated that 40 percent of the people of the United States population have some degree of CVI.
At our three Foot & Ankle Clinics of Utah locations, we take care of your feet when the power of your veins isn’t providing the oxygen and cleansing they need due to venous insufficiency.
What causes chronic venous insufficiency?
Chronic venous insufficiency (CVI) occurs when the valves in the veins become damaged, allowing blood to leak backward. Normally, these valves ensure that blood flows toward your heart, but when they fail, blood can flow in reverse and begin to pool in your legs.
This pooling can lead to a variety of symptoms, including:
- Pain
- Swelling
- Cramps
- Skin changes
- Varicose veins
- Leg ulcers
CVI can result from several factors, including a blood clot in the deep veins of the legs, a condition known as deep vein thrombosis. It can also develop due to aging, prolonged periods of sitting or standing, or obesity.
This condition is more prevalent in women and people over the age of 50. While CVI is not typically a serious health threat, it can be painful and disabling, affecting your quality of life if not managed properly.
Understanding these aspects can help in recognizing the signs and seeking timely treatment to mitigate its impact.
Effective Treatments for Chronic Venous Insufficiency
If you’re dealing with chronic venous insufficiency (CVI), understanding your treatment options is crucial. These plans are personalized based on factors such as your age, health condition, the severity of your CVI, and your personal preferences. Here’s a comprehensive look at effective treatments:
Enhancing Blood Flow
- Elevation and Compression: Elevating your legs can significantly reduce swelling and improve circulation. Compression stockings are also beneficial as they apply gentle pressure to support vein function. Regular physical activities are encouraged to keep the blood flowing smoothly.
Medicinal Interventions
- Medications: Certain medications can enhance blood flow and assist in healing any existing ulcers. While diuretics are used sparingly, they may be considered if swelling is associated with other conditions, like heart or kidney problems. Aspirin might also be prescribed to aid in ulcer recovery.
Minimally Invasive Procedures
- Endovenous Ablation: This procedure, involving laser or radiofrequency, delivers heat through a catheter to close off the malfunctioning vein, thus redirecting blood flow to healthier veins and alleviating pooling.
Advanced Techniques
- Sclerotherapy: In more severe cases, a special chemical is injected to scar and close the affected veins, rerouting blood through healthier veins. Over time, the body naturally absorbs the treated veins.
Surgical Solutions
- Surgical Intervention: In severe cases, surgery might be necessary. Ligation involves tying off the damaged vein to prevent blood flow through it, and vein stripping involves removing severely damaged veins entirely.
Each treatment plan is curated specifically to cater to the individual’s medical history and the progression of the disease. Consulting a healthcare professional to tailor the right mix of these options can ensure optimal management of chronic venous insufficiency.
Diagnosing Chronic Venous Insufficiency
Diagnosing chronic venous insufficiency involves a multi-step approach to ensure accuracy and treatment efficacy. Your healthcare provider will start by reviewing your medical history, paying close attention to symptoms that might indicate circulation issues.
Physical Examination
The initial step often includes a thorough physical examination. During this exam, your provider will look for signs of venous insufficiency, such as swelling, varicose veins, or changes in skin color.
Imaging Techniques
Once a physical examination is complete, your doctor may recommend an imaging test known as a Duplex ultrasound. This non-invasive test provides detailed images of your leg veins. It assesses both the structure and function of the blood vessels, checking how well blood is flowing and whether there are reverse flows, which are common in venous insufficiency.
Additional Tests
In certain cases, further testing might be required. These can include:
- Venography: A test where a dye is injected into the veins, and X-rays are taken to show how blood flows through the veins.
- Magnetic Resonance Venography (MRV): An MRI scan specifically focused on the veins, providing a clearer picture of the blood vessels and any potential blockages or reflux.
This thorough diagnostic approach ensures not only clear identification of chronic venous insufficiency but also aids in crafting a treatment plan tailored to your specific needs.
What are the risk factors for chronic venous insufficiency?
There are certain risk factors that make it more likely a person will develop CVI. These are the most important risk factors:
- Varicose veins
- Deep vein thrombosis
- Obesity
- Inactivity
- Extended periods of sitting or standing
- Being a female
- Being over the age of 50
- Pregnancy
- Smoking
How does venous insufficiency affect the feet?
The feet can be directly impacted by venous insufficiency, as the restricted blood flow impedes wound healing, and this typically occurs at the most distant lengths from the heart— the lower legs and feet. These are signs in your legs and feet to watch for:
- Persistent swelling of the lower legs
- Bluish discoloration of the skin at your ankles
- Venous ulcers that develop on the ankles and feet that don’t heal
- Heaviness in the legs and feet
In addition to these symptoms, chronic venous insufficiency can manifest in other ways:
- Tight feeling in your calves: You might experience itching or pain that doesn’t subside easily.
- Pain when walking: This discomfort typically eases when you take a rest.
- Brown-colored skin changes: Often noticeable near the ankles, this discoloration is a key indicator.
- Varicose veins: Swollen, twisted veins visible just under the surface of the skin.
- Restless legs syndrome: An uncomfortable feeling in your legs accompanied by a strong urge to move them.
- Leg cramps or muscle spasms: Painful episodes often referred to as charley horse.
If you have sores on your ankles and feet that seem to never heal, it could be venous insufficiency. These symptoms might resemble other health conditions, so it’s important to talk with your healthcare provider for a proper diagnosis.
Give us a call at any of our three locations in American Fork (801), 763-3885; Payson, (801) 765-1718; and Orem, (801) 765-1718.
