What is venous insufficiency?

Anthony L. Komaroff, MD
Internal Medicine
Venous insufficiency means that some of your veins aren't working properly. This condition often develops after veins are damaged by an injury, surgery, or blood clot. Veins drain blood and fluid back to the heart, so people with venous insufficiency usually have symptoms caused by the buildup of fluid. Venous insufficiency most commonly occurs in the legs (varicose veins are one type of this condition), where its symptoms include:
  • swollen or painful veins
  • swelling that worsens with prolonged standing
  • a sense of heaviness in the legs
  • throbbing, achy, or cramping pain
  • redness and irritation of the skin
The treatment of venous insufficiency depends on why it has developed, where it has developed, and the symptoms it causes. In mild cases, simply elevating the legs appears to be helpful. Your doctor may recommend wearing support stockings, taking a diuretic (water pill) such as hydrochlorothiazide or furosemide, or using a mild steroid cream. Sometimes surgery is needed.

In severe cases, skin ulcers may form. These require careful attention. Special bandages and aspirin appear to speed the healing process. Antibiotic pills or creams may be needed if an ulcer becomes infected.
Venous insufficiency is a type of peripheral vascular disease that affects the veins, usually in your legs or feet. Your veins have valves that keep blood from flowing backward as it moves toward your heart. If the valves stop working, blood backs up in your body, usually in your legs. Venous insufficiency can cause pain and swelling in your legs, ankles, and feet. It can also cause discolored skin, leg sores, or varicose (enlarged, visible) veins.

Venous insufficiency is a chronic condition in which blood does not flow normally up through the veins in the legs toward the heart. In normal veins a series of specialized, one-way valves work together, opening to allow blood to flow upward, then closing to keep the blood from flowing back toward the feet. Venous insufficiency occurs when valves are damaged or not functioning properly. As the valves deteriorate, blood leaks or flows backward and pressure in the vein increases, stretching and dilating the vessel. Blood stagnates (pools) in the veins of the lower legs, increasing the blood pressure in the legs, and causing chronic inflammation in the veins.

People with long-term, untreated venous insufficiency sometimes develop open sores in the skin called venous ulcers. Ulcerations develop in areas where blood collects and pools, as swelling there interferes with the movement of oxygen and nutrients through tissues. Over time a visible ulcer develops on the skin. Venous ulcers usually appear just above the ankle on the inside of the leg. If they are not treated they can become quickly infected or even gangrenous.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.