Chronic venous insufficiency is a long-term condition. It is most commonly due to malfunctioning incompetent valves in the veins. It may also occur as the result of a past blood clot in the legs.
If you have dull, aching, or cramping pain in your legs, and pain that gets worse when you stand, you may have a condition called venous insufficiency. In venous insufficiency, the veins in your legs have trouble sending blood back to your heart. Normally, valves in your legs keep your blood flowing back towards your heart so it doesn't collect in one place. But the valves in varicose veins are either damaged or missing.
This causes your veins to remain filled with blood, especially when you're standing. A blockage in your vein from a blood clot, called a deep venous thrombosis, can also cause this problem. So, how do you know if you have venous insufficiency? Well, you'll probably feel a dull aching, heaviness, or cramping in your legs. Your legs will swell up when you're on them too long.
Your legs may itch or tingle. Pain will get worse when you stand, and better when you raise your legs. Your legs and ankles may also be red. You may notice skin color changes around your ankles. You may see varicose veins on the surface of your legs. You may feel thickening and hardening of the skin on your legs and ankles.
So, what can you do about venous insufficiency? Well, your doctor will tell you to use compression stockings to decrease the swelling in your legs. You'll probably have to avoid long periods of sitting or standing. Vascular surgeons possess formalized training backgrounds in the management of vascular disease, both arterial and venous. Vascular surgeons must complete 5 years of general surgery training followed by 2 years in sub-specialty training for vascular medicine.
In doing so, vascular surgeons undergo rigorous training in the diagnosis and management of surgical disease including endovascular, minimally invasive techniques. Cardiology and interventional radiology fellowships often work in collaboration with vascular surgery programs to provide in-depth training for trainees. With the completion of the training program, vascular surgery fellows will be tested for ABMS American Board of Medical Specialties board-certification to demonstrate their competency in the management of venous and arterial disease.
This includes recognition as a board-certified expert to diagnose and treat varicose vein disease. Phlebologists have varied backgrounds including general surgery, internal medicine, pain management, cardiologists and even vascular surgery. The American Board of Phlebology was only recently established in with the goal of setting standards of practice, establish training programs in venous disease, but is not ABMS recognized.
As stated above, vascular training can only be formally obtained during a fellowship in vascular surgery, cardiology or interventional radiology. During these programs, trainees undergo supervised education over several years learning technical competency and safe practices for endovascular procedures. Other residency programs including internal medicine, pain management, and family medicine simply do not provide this level of training as it is outside the scope of their practice.
Phlebologists without training in either vascular surgery, cardiology or interventional radiology should not be automatically assumed as vascular specialists.
In many instances, the procedural training for phlebologists may be limited to just weekend development courses hosted by industry. Vein specialist is used by many practicing vein doctors with varied backgrounds similar to phlebologists. Again, it should be emphasized that a vein specialist should have ABMS recognized board-certification in one of three specialties: Invasive cardiology, vascular surgery or interventional radiology to demonstrate the highest level of competency in vascular disease management.
Self-care — such as exercising, losing weight, not wearing tight clothes, elevating your legs, and avoiding long periods of standing or sitting — can ease pain and prevent varicose veins from getting worse. Wearing compression stockings all day is often the first approach to try before moving on to other treatments. They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently.
The amount of compression varies by type and brand. You can buy compression stockings at most pharmacies and medical supply stores. Prescription-strength stockings also are available, and are likely covered by insurance if your varicose veins are causing symptoms.
If you don't respond to self-care or compression stockings, or if your condition is more severe, your doctor may suggest one of these varicose vein treatments:. In this procedure, your doctor injects small- and medium-sized varicose veins with a solution or foam that scars and closes those veins.
In a few weeks, treated varicose veins should fade. Although the same vein may need to be injected more than once, sclerotherapy is effective if done correctly. Sclerotherapy doesn't require anesthesia and can be done in your doctor's office. Varicose veins that develop during pregnancy generally improve without medical treatment within three to 12 months after delivery. There are some self-care measures you can take to decrease the discomfort that varicose veins can cause.
These same measures can help prevent or slow the development of varicose veins, as well. They include:. Though they haven't been well-studied, a number of alternative therapies claim to be helpful treatments for chronic venous insufficiency, a condition associated with varicose veins in which leg veins have problems returning blood to the heart.
While it may not be a serious condition at first, it could lead to serious complications later on such as venous stasis ulcers and other circulatory system problems. Another sign of possible vein disease is vein discoloration. The discoloration indicates that the blood is pooling due to venous insufficiency. This sign is most common to those with varicose veins and spider veins. The discoloration usually occurs in the abdomen, legs, and feet when blood pools in the vessels instead of flowing back to the heart.
Because of the blood pooling, the pressure inside the blood vessels tends to build up until a vessel leaks. Vein discoloration can be a result of other vascular diseases aside from varicose veins and spider veins. Skin discoloration changes associated with any vein disease include:.
Ask your trusted vein doctor for the diagnosis and treatment options if you noticed any discoloration in your veins. Blood pooling can cause fluid to leak out of the vein and into the surrounding tissues and cause swelling. Swelling is one of the common symptoms of varicose vein conditions. Individuals with vascular diseases may experience swelling on either one side or both sides of the body.
The doctor can also diagnose other vascular conditions related to your swelling symptoms. Prolonged pain is common for people with vein diseases.
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