5 Signs You Can’t Ignore

Leg Swelling (Edema):

• Description: Chronic leg or ankle swelling that gets worse after extended periods of standing or sitting indicates advanced CVI (stage 3 or higher according to Cleveland Clinic). Increased venous pressure and blood pooling trigger this condition.
• Why It Matters: Untreated edema can result in skin damage and formation of ulcers. The 2023 study in BMJ Best Practice recognizes edema as the main indicator for venous hypertension.
• Action: Consult with a vascular specialist if swelling continues and additional symptoms present themselves.

Achy, Heavy, or Painful Legs:

• Description: The presence of leg pain combined with heaviness or cramps that worsens after standing during the day indicates CVI. Nocturnal cramps are common, per StatPearls.
• Why It Matters: These symptoms show poor circulation that might result in severe pain or the formation of ulcers. Research from 2014 published in Circulation indicates a connection between calf muscle pump dysfunction and leg pain.
• Action: Elevate legs and monitor for worsening discomfort.

Skin Changes (Discoloration or Texture):

• Description: Skin near the ankles turns reddish-brown and becomes leathery or flaky when high venous pressure causes red blood cells to leak into tissues. According to WebMD venous dermatitis or lipodermatosclerosis can develop.
• Why It Matters: The appearance of skin changes in stage 4 CVI marks advanced disease and leads to heightened risk for ulcer formation. ResearchGate reported in 2021 that CVI brings about 150,000 new diagnoses each year with associated skin complications.
• Action: Get a duplex ultrasound exam for evaluating vein damage.

Varicose Veins:

• Description: Visible twisted veins that bulge beyond 3 mm in width indicate faulty valves in stage 2 CVI according to Cleveland Clinic. They may cause burning or itching.
• Why It Matters: Varicose veins do not always indicate CVI but they can develop into serious conditions such as ulcers or thrombophlebitis according to Vascular Cures. The 2025 X post from @Vascular_India demonstrates their connection to DVT.
• Action: Inform your physician about any new or advancing varicose veins.

Venous Ulcers:

• Description: CVI reaches stage 5–6 when open sores that won’t heal develop near the ankles. Cleveland Clinic explains that these sores can lead to pain and cellulitis infections.
• Why It Matters: Compression therapy assists in healing 90% of ulcers within 5.3 months according to Circulation. Untreated, they risk infection or DVT.
• Action: A person needs to seek medical treatment right away to avoid serious health problems.

How to Treat Chronic Venous Insufficiency

Conservative Treatments

Compression Therapy:

• Description: Graded compression stockings which exert 30–50 mm Hg pressure improve blood circulation while minimizing swelling. According to a 2024 study from the New England Journal of Medicine patients who adhere to compression therapy at a rate of 70–80% see better outcomes in pain reduction and ulcer healing alongside decreased edema.
• How to Use: Wear daily, as prescribed, per Johns Hopkins. Unna boots may be used for ulcers.
• Benefit: Reduces venous reflux and prevents ulcer recurrence.

Lifestyle Changes:

• Elevate Legs: Patients should elevate their legs above the heart for periods of 15–30 minutes 3–4 times per day to lessen swelling according to Cedars-Sinai.
• Exercise: According to NYU Langone, low-impact activities performed for thirty minutes daily across five days each week can enhance calf muscle strength and improve blood flow.
• Weight Management: A weight reduction of 5–10% lowers vein pressure according to UPMC.
• Diet: WebMD states that following a low-sodium heart-healthy diet helps prevent fluid retention.
• Avoid Prolonged Sitting/Standing: Move every 30–60 minutes, per Healthline.
• Evidence: @Heal_And_Go posted on X in 2025 about managing CVI symptoms through proper hydration and regular movement.

Medications:

• Options: Medical News Today states that diuretics combat swelling while pentoxifylline enhances circulation and anticoagulants stop blood clot formation. Aspirin aids ulcer healing, per Johns Hopkins.
• Use: Medical professionals determine prescriptions by evaluating disease severity and checking for risk factors such as a history of DVT.

Medical and Surgical Treatments

Minimally Invasive Procedures:

• Sclerotherapy: UPMC states that injections close varicose and spider veins which enhances symptom control.
• Endovenous Ablation: The Endovenous Ablation treatment utilizes radiofrequency or laser heat to close faulty veins and patients typically recover within days according to UCSF.
• Stab Phlebectomy: Small incisions allow doctors to remove superficial veins during this procedure according to UPMC.
• Evidence: StatPearls reports that 80% of patients experience symptom reduction from these outpatient procedures.

Surgical Options (<10% of cases):

• Vein Stripping/Ligation: Novus Spine procedures involve the removal or ligation of damaged veins through vein stripping.
• Angioplasty/Stenting: The procedure to open blocked veins uses a balloon along with a stent according to Rush.
• Vein Bypass: In severe cases, vein bypass surgery reroutes blood through a healthy vein according to Healthline.
• Evidence: The UCSF reports surgery as an effective treatment for non-healing ulcers and severe CVI.

Why Act Now?

Untreated CVI progresses to cause ulcers, infections, or DVT as reported by StatPearls. The U.S. faces 150,000 annual diagnoses alongside $500 million in care expenses which makes early intervention essential. As projected by the United Nations (UN), urban living will encompass 68% of the world population by 2050 which will lead to more sedentary lifestyles and higher risks for chronic venous insufficiency (CVI). Posts from X in 2025 emphasize the need for prompt intervention to avoid future health problems.

Tips for Patients

• See a Specialist: Patients should get a duplex ultrasound from a vascular surgeon when they notice symptoms according to Cedars-Sinai.
• Stay Consistent: Patients should wear compression stockings every day while implementing lifestyle modifications as recommended by NYU Langone.
• Monitor Symptoms: WebMD instructs patients to report any new ulcers, pain, or changes to their skin without delay.