A Common Cause of Leg Pain

If you can't sit or stand for long without pain, heaviness and cramping in your legs, you may suffer from “venous insufficiency.” Venous insufficiency can manifest in different ways, but the root cause is the same: veins that have stopped doing their job correctly, leading to abnormal blood flow. Left untreated, it can lead to blood clots or even death.

How CVI Develops
Picture an oil pipeline or, better yet, the conduit of pipes under your kitchen sink. Your arteries and veins work just like them, transporting blood to and from your heart. The main distinction is that arteries transport oxygen-rich blood from your heart to all your organs, while veins return oxygen-poor blood back to your heart. The other important difference is that, unlike arteries, your veins have no muscular walls. As a result, they depend on surrounding muscles to help them pump blood back to your heart. As you walk, calf and foot muscles act as a pump squeezing your veins to push the blood upwards, while the valves in those veins open and close to keep blood flowing in the right direction. Any damage to your veins –or their valves- can therefore upset normal blood flow and cause your blood to accumulate in your lower legs. The scientific term for this is stasis. The weaker your veins and valves, the more blood pools in your legs and the higher the blood pressure in your veins rises. Keep this process going on long enough, and you'll be said to have “chronic venous insufficiency,” or CVI.

Symptoms of CVI
As blood pools in your legs because of CVI, your veins enlarge. The result is chronic leg swelling, a heaviness, cramping or dull ache. You may also experience:
•    Itching, tingling, or burning sensation
•    Redness to your legs and ankles
•    Skin color changes
•    Leg and ankle ulcers
•    Varicose veins, which are visibly enlarged and twisty veins
•    Pain that worsens with prolonged standing or after walking
•    Pain that improves with legs raised
•    Thickening and hardening of your skin

Risk Factors
Your risk of developing CVI can increase with the following:
•    Older age
•    Previous blood clot
•    Family history of blood clots or CVI
•    Obesity
•    Physical inactivity
•    Muscle weakness
•    Pregnancy
•    Injury to the legs
•    Cancer
•    Being female
•    Being tall
•    Prolonged sitting or standing

Ideally, a doctor should help you design a prevention program, but you can get a head start with the following steps:
•    Lose weight if you are overweight.
•    Exercise regularly.
•    Quit smoking, if you smoke.
•    Protect your legs from injury.
•    Avoid prolonged sitting or standing. During long trips, for instance, move your legs and feet every 30 to 60 minutes. For prolonged standing, take periodic breaks to sit and elevate your legs.

Getting Screened for CVI
If you’re experiencing any of the above symptoms, get screened for CVI. A number of tests are available, which do not require any cut or injection and can help detect valve damage or blockages in your veins.

Advanced case of chronic venous insufficiency
Credit: Magnus Manske