(Varicose Veins / Venous Insufficiency)
What is Chronic Venous Disease?
Chronic venous disease is a condition affecting the veins in the legs. These veins normally carry blood back to the heart. Inside the veins are small valves that keep blood flowing in one direction.
When these valves become weak or damaged, blood flows backward and collects in the legs. This increases pressure inside the veins and causes symptoms.
This condition may also be called:
- Venous insufficiency
- Varicose veins
- Venous hypertension
- Venous stasis disease
What causes Venous Disease?
Common causes include:
- Previous blood clots (DVT)
- Family history
- Pregnancy
- Obesity
- Standing for long periods
- Sitting for long periods
- Leg injury or surgery
- Aging
- Weak vein valves
Anything that increases pressure in the leg veins can lead to venous disease.
Symptoms
Symptoms vary from mild to severe and may include:
Early symptoms
- Heavy legs
- Aching or throbbing
- Leg tiredness
- Burning sensation
- Itching
- Mild swelling
Visible vein changes
- Spider veins
- Varicose veins
- Bulging veins
Advanced symptoms
- Persistent swelling
- Skin darkening (brown/red)
- Dry itchy skin
- Thickened skin
- Leg cramps
- Rest pain
Severe disease
- Venous ulcers
- Non-healing wounds
- Recurrent infections
- Bleeding from veins
Venous ulcers usually occur around the ankle and may take months to heal.
How is it diagnosed?
Your doctor may perform:
- Clinical examination
- Duplex ultrasound scan
- Venous reflux assessment
- Deep vein assessment
- Arterial circulation check
Ultrasound helps determine valve function and whether veins are blocked.
Treatment Options
Treatment depends on severity.
Conservative Treatment
This is the first step for most patients.
Compression therapy
- Compression stockings
- Compression bandages
- Multilayer wraps
- Compression pump
Compression improves blood flow and reduces swelling.
Leg elevation
- Elevate legs 30 minutes
- 3–4 times per day
- Improves venous return
Exercise
Walking activates the calf muscle pump and improves circulation.
Recommended:
- Walking
- Calf raises
- Ankle flexion exercises
Skin care
- Moisturizers
- Avoid harsh soaps
- Wound care if ulcers present
Interventional Treatment
If conservative treatment fails, procedures may be recommended.
Vein Ablation
The diseased vein is sealed so blood flows through healthy veins.
Types include:
- Radiofrequency ablation
- Laser ablation
- Glue ablation
- Foam sclerotherapy
- Mechanochemical ablation
These procedures close the abnormal vein.
Phlebectomy
- Small incisions
- Removal of varicose veins
- Outpatient procedure
Surgical Treatment
Used for advanced disease:
- Vein ligation
- Vein stripping
- Ulcer surgery
Goals of Treatment
Treatment aims to:
- Reduce swelling
- Improve symptoms
- Heal ulcers
- Prevent progression
- Improve appearance
- Prevent complications
Possible Complications if Untreated
Venous disease may worsen and lead to:
- Severe swelling
- Skin damage
- Permanent discoloration
- Lipodermatosclerosis
- Venous ulcers
- Infection
- Bleeding veins
- Reduced mobility
Lifestyle Advice
Do
- Walk daily
- Elevate legs
- Wear compression stockings
- Lose weight if overweight
- Moisturize skin
- Stay active
Avoid
- Standing long periods
- Sitting long periods
- Crossing legs
- Tight clothing
- High heels
- Inactivity
When to seek urgent medical attention
Seek urgent care if you develop:
- Sudden leg swelling
- Severe pain
- Red hot leg
- New wound
- Bleeding vein
- Fever
- Pus from wound
- Skin turning black
- Sudden worsening swelling
Recovery After Treatment
After vein treatment patients are advised to:
- Walk regularly
- Wear compression stockings
- Avoid heavy lifting
- Elevate legs
- Keep wounds clean
- Attend follow-up ultrasound
These measures help prevent clots and improve healing.
Prognosis
Chronic venous disease is long-term but manageable.
With proper treatment:
- Symptoms improve
- Ulcers heal
- Progression slows
- Quality of life improves
Without treatment the condition usually worsens.
Follow-Up
Regular follow-up is important to:
- Monitor healing
- Adjust compression
- Prevent recurrence
- Assess need for procedures
