Venous insufficiency or vein weakness refers to a disturbed function of the veins, which is usually caused by obstructed blood flow. As a rule, the veins on the legs are affected by weak veins. Venous insufficiency can be acute or chronic. Women and the elderly are often affected. Three stages of the disease are distinguished. Prevention of venous insufficiency can be done through sufficient exercise and a healthy diet.
- What is venous insufficiency?
- Development of the complaints
- Blood circulation
- Failure of the venous valves
- Who gets it?
- Stages of vein weakness
- Stage 1
- Stage 2
- Stage 3
- Symptoms of venous insufficiency
- Phenomena
- Hypostatic eczema
- Open leg
- Causes and risk factors
- Sedentary lifestyle and obesity
- Heredity and old age
- Systemic diseases or inflammation
- Pregnancy
- Examination and diagnosis
- Treatment of venous insufficiency
- Lifestyle changes
- Compression therapy
- Medicinal support
- Sclerocompression therapy
- Prevention
What is venous insufficiency?
Venous insufficiency refers to the deficiency of the venous system, the veins. The leg veins in particular can no longer sufficiently provide the return flow of blood to the heart. As a result, blood accumulates in the legs and causes the typical symptoms due to insufficient drainage of fluid and waste, ranging from fatigue to non-healing wounds.
Venule / Source: Public domain, Wikimedia Commons (PD)
Development of the complaints
Blood circulation
Veins transport oxygen-poor blood from all parts of the body to the heart. After the blood has delivered oxygen and nutrients to the tissues and organs, it first reaches the venules (small blood vessels in the microcirculation) from the capillary network, the so-called capillaries. The venules merge into veins and the initially superficial veins of small size lead the blood to deeper veins of larger diameter. Finally, the body’s two largest veins, the superior vena cava (superior vena cava) and the inferior vena cava (the inferior vena cava), return the deoxygenated blood to the heart. The heart pumps it into the pulmonary circulation, where it is reoxygenated (oxygenated blood = oxygenated blood) before flowing back to the heart and then through the arteries to the tissues and organs.
Varicose veins / Source: Self, Wikimedia Commons (Public domain)
Failure of the venous valves
Because the veins located under the heart must transport blood to the heart against gravity, they have a special structure. Inside there are so-called venous valves that prevent the blood from flowing back. The venous weakness usually begins with a gradual failure of these venous valves. If these no longer close properly, the blood drains and accumulates. Over time, the vein wall yields more and more due to the pressure exerted by the accumulated blood, and the vein dilates. Such dilated veins eventually appear on the skin’s surface as fine cobweb-like veins or as bluish, serpentine, clearly visible varicose veins. As this process progresses, chronic venous insufficiency may develop. This is usually accompanied by severe swelling and skin changes.
Who gets it?
Up to roughly 5% of the Western population suffers from venous insufficiency. Chronic venous insufficiency is one of the most common venous diseases. The risk groups include women aged 40 and over and men aged 70 and over.
Normal vein and venous insufficiency (right) / Source: Decade3d – anatomy online/Shutterstock.com
Stages of vein weakness
Venous insufficiency is common. Often, swollen legs after standing for a long time or veins that become more visible indicate that the veins are no longer functioning properly. The vein weakness develops slowly and, if left untreated, progresses gradually. It can be divided into different degrees of severity.
Stage 1
At this stage, bluish discoloration often appears on the edges of the feet. Edema also forms, but this may disappear again.
Stage 2
The lower legs and feet are bluish in color and the edema does not diminish. Skin changes are noticed.
Stage 3
The circulation disorders are so advanced that an open leg (ulcus cruris) develops.
Symptoms of venous insufficiency
Phenomena
If varicose veins, thrombosis or venous vascular malformations lead to impaired blood drainage in the legs, blood pressure in the venous system of the legs rises. This increased blood pressure and the lack of blood flow causes the typical symptoms:
- swollen legs and ankles
- tight feeling in the calves
- itchy, painful legs
- pain when walking that stops with rest
- brown colored skin, often near the ankles
- varicose veins
- leg ulcers or ulcers that are sometimes difficult to treat
- restless leg syndrome
- painful leg cramps, muscle spasms or tingling in the legs
Hypostatic eczema
Hypostatic eczema (varicose vein eczema) occurs on the lower legs and ankles in patients with a less well-functioning venous system in the legs (chronic venous insufficiency). Blurred red spots with flaking appear on the lower legs that can be very itchy, causing scratching effects.
Open leg
In the advanced stages of the disease, pathological skin changes occur to open areas on the leg (ulcus cruris).
Because the heart is involved in the proper functioning of the arteries, these symptoms should always be borne in mind that heart disease may also be the cause.
Causes and risk factors
There are several risk factors that can negatively affect the performance of your veins.
Being overweight promotes venous insufficiency / Source: Kurhan/Shutterstock.com
Sedentary lifestyle and obesity
The deep veins are located in the muscles and when the leg muscles are tense, for example while walking or running, the blood in the deep veins is pushed upwards in the direction of the heart. People who do not use their muscle pumps properly due to insufficient exertion, thereby hindering the return of blood, are at a particularly high risk of venous insufficiency. In addition, lack of exercise often leads to obesity, which increases the pressure on our legs and makes it more difficult for the veins to return the blood. Excess weight hinders the return flow of blood to the heart.
Heredity and old age
In addition, the risk of venous insufficiency is greater if relatives already have this condition, as there is always the risk of inheritance. Furthermore, age plays an important role, because your blood vessels and surrounding tissue also age. As we get older, the risk of venous disease increases enormously.
Systemic diseases or inflammation
In addition, systemic diseases or inflammation of the blood vessels can cause permanent damage to the venous valves, thus causing chronic venous insufficiency.
Pregnancy
Last but not least, pregnancy is also one of the risk factors.
Examination and diagnosis
Based on the external symptoms, the doctor can usually assess whether there is (chronic) venous insufficiency and what stage it is in. An ultrasound can also reveal the condition of the blood vessels. If heart disease is behind the symptoms, further investigation and possibly a visit to the cardiologist is needed.
Treatment of venous insufficiency
Lifestyle changes
The treatment focuses firstly on lifestyle changes through less alcohol, more exercise, change in diet, weight reduction and avoiding inappropriate loads such as standing for long periods of time. It has been shown that taking these factors into account at an early stage reduces the chance of the complaints progressing. If the disease is in the first or second stages, these lifestyle changes often mean that the condition does not worsen and you prevent further complications, such as wounds that are difficult to heal.
Compression therapy
Another important pillar in the treatment of venous insufficiency is compression therapy. With this therapy, special support stockings prevent the blood from sinking into the legs. Since the stockings should not be too loose or too tight for effective treatment, obtaining sound advice is essential before using them. In addition to support stockings, compression bandages can also be used to relieve the complaints. In bedridden patients, the legs can be bandaged. The muscle pump is supported by bandaging with pressure.
Medicinal support
A number of venous vasoactive medications can relieve the symptoms, especially in the early stages of venous insufficiency. These medications partly work on the wall of the blood vessels.
Sclerocompression therapy
Sclerocompression therapy is suitable for the treatment of small to medium-sized varicose veins. With this treatment, the varicose vein is injected with a liquid or foam.
Quit smoking / Source: Dmytro Zinkevych/Shutterstock.com
Prevention
Avoid alcohol and smoking, a sedentary lifestyle and prevent overweight/obesity. The most important preventive measures are:
- avoid excessive use of alcohol
- not smoking or quitting smoking
- make sure you get enough exercise
- eat a balanced, healthy, fiber-rich diet
- avoid obesity or ensure you lose weight if you are overweight
- avoid improper loading, such as standing for long periods of time
read more
- Blood vessels: function, location, types and structure of blood vessels
- Hypostatic eczema: symptoms of eczema on legs and ankles
- Tired legs: symptoms, causes, treatment & prognosis
- Painful veins: causes, symptoms, treatment & self-care
- Blue hands and feet: causes of peripheral cyanosis