Symptoms & Conditions
Venous reflux and Chronic Venous Insufficiency
Normal leg veins work against gravity taking blood from the legs back to the heart. One way flow valves in leg veins help prevent blood from flowing backwards, or refluxing, toward the feet. When these valves malfunction and backward flow occurs, it is called venous reflux. When blood begins to pool in the legs causing varicose veins to distend, bulge and become symptomatic, it is called Venous Insufficiency. If venous reflux is long standing, it is sometimes called Chronic Venous Insufficiency. The pooling causes legs to be heavy, achy, tired and other symptoms above, especially at the end of the day. After years and years of reflux, the pressure in the veins actually increases and may cause skin changes, pigmentation and in severe cases, even venous ulcers. normal valves | abnormal reflux flow
Tired, Achy, Heavy, Swollen legs
Pain occurs as the varicose vein and the vein valves become more abnormal. The venous reflux allows blood to pool in the veins, distends and stretches the veins and causes legs to feel: tired, aching, heavy, cramping, swollen, tired, throbbing, restless and itchy. The pooling causes increased pressure inside the veins, stretching the pain fibers which results in pain. Leg pain is caused not only from the direct effects of vein wall stretching, but also from the effects of congestion or pooling in the tissue and muscles. The symptoms usually feel worse at the end of the day. Swelling (edema) is also caused from venous reflux. Blood pooling causes increased pressure in the distended varicose veins and causes veins walls to become “leaky.” This allows fluid inside the veins to leak outside the vein into surrounding tissue causing swelling (edema.) The swelling can cause the legs to ache and feel heavy.
Leg Skin changes
The skin changes associated with chronic venous insufficiency are sometimes called venous stasis dermatitis and are the result of long term venous reflux, swelling and increased pressure in the veins. Eventually the constant increased pressure and swelling causes the skin to become damaged and inflamed (cellulites) The skin eventually becomes reddish brown, hard, thick, leathery, dry and itchy. Although treatment will probably not reverse all of the skin changes, treatment aimed at relieving the swelling and decreasing the pressure in the veins will improve symptoms and prevent progressions to skin ulcerations.
When venous disease and blood pooling become severe, venous stasis ulcers can occur in the skin. These ulcers usually occur around the ankles and are thought to be caused from long term (chronic) blood pooling and congestion in the affected leg. It is thought chronic congestion causes obstruction in the blood flow which then causes changes in the skin pressure. This increased pressure with other changes, in turn, causes inflammation and skin ulcers begin to form. These venous ulcers can be painful, and treatment can be lengthy and frustrating. In many cases, if a varicose vein is diagnosed and considered a cause for the venous ulcer, treating the varicose vein with endovenous laser ablation and/ or other treatments will help redirect the blood flow to healthier veins, relieve the venous congestion and improve the leg ulcer.
Pregnancy and Varicose Veins.
Varicose veins are a common occurrence during pregnancy and they will become larger and more painful with each pregnancy. Many women say that one of the first signs of pregnancy is a feeling of discomfort in the legs with enlargement of the veins. After childbirth, most of the pain and swelling will subside, however the varicose veins will never return to normal. Almost 70 percent of women develop spider veins during pregnancy. They begin to develop within a few weeks of conception. The majority of these spider veins will disappear between three and six months postpartum. Because of the hormonal changes and the increased risk of blood clots from those hormonal changes of pregnancy, it is generally recommended to wait and treat varicose veins approximately 4 months after delivery.