What is the Best Treatment for Venous Insufficiency, a common cause of leg pain and swelling?

Venous insufficiency is a common condition affecting millions of people worldwide. It occurs when the veins in the legs cannot properly pump blood back to the heart, healthy veins over a period of time weaken leading to symptoms such as leg pain and swelling. Skin discoloration and skin ulcers, or venous leg ulcers, can also occur as a result of this circulation issue. .

While this condition can be debilitating, there is hope. In this article, we will take an in-depth look at the best treatment options available for venous insufficiency, giving you the information you need to make an informed decision about your health.

Millions of people around the globe suffer from Chronic Venous Insufficiency (CVI), a medical condition where blood is not efficiently being returned to the heart through the veins in your legs.

This arises when your leg veins become weakened or injured, leading to a range of symptoms such as swelling, pain, and skin discoloration. The condition can be caused by a number of factors including genetics, obesity, trauma, and pregnancy. Venous diseases like CVI can have serious consequences if left untreated, so it is important to recognize the signs and seek medical attention if you think you may be suffering from this condition.

What Is Venous Insufficiency?

Venous insufficiency is a pathological condition characterized by an impaired capability of the veins in the lower extremities to transport blood efficiently toward the heart. The resultant stagnant blood flow can cause the manifestation of symptoms such as edema, discomfort, cutaneous hyperpigmentation, and in severe cases, even ulceration.

Recent studies suggest that approximately 70% of patients have primary chronic venous insufficiency, and 30% have a secondary disease. Varicose veins have an estimated prevalence between 5% and 30% in the adult population, with a female-to-male predominance of 3:1.

What Causes Venous Insufficiency?

The development of venous insufficiency is a complex phenomenon that can be attributed to a multitude of contributing factors. Every individual case is unique, and it is crucial to seek the professional guidance of a medical doctor for a precise diagnosis and a tailored treatment strategy. Venous insufficiency can be caused by several factors, including:

  • Valve damage: Veins have one-way valves that help regulate blood flow. If these valves become damaged, blood can flow backward and pool in the veins, causing swelling and other symptoms.
  • Age: As people age, their veins can lose their elasticity and become less efficient at pumping blood back to the heart.
  • Genetics: Some people are more prone to developing venous insufficiency due to their genetic makeup.
  • Obesity: Being overweight puts extra pressure on the veins in the legs, making it more difficult for them to pump blood effectively.
  • Prolonged standing/sitting: People who stand or sit for long periods can increase their risk of developing venous insufficiency, which can cause blood to pool in the legs.
  • Pregnancy: Pregnant women are at an increased risk of developing venous insufficiency, as the extra weight and pressure from the growing uterus can strain the veins in the legs.
  • Deep vein thrombosis: Blood clots in the deep veins can cause venous insufficiency by obstructing blood flow and damaging the veins.

What Are the Symptoms of Chronic Venous Insufficiency?

It’s vital to understand that each case of chronic venous insufficiency is unique, and not all individuals will exhibit the same symptoms, though the most common ones are leg pain and swelling. The manifestation and severity of symptoms can vary greatly from person to person. Some common symptoms include:

  • Swelling: Chronic venous insufficiency can cause swelling in the legs, especially after standing or sitting for extended periods.
  • Pain or aching: People with chronic venous insufficiency may experience pain or aching in the legs, especially after standing or sitting for long periods.
  • Skin discoloration: Over time, chronic venous insufficiency can cause the skin on the legs to become discolored, thickened, or itchy.
  • Skin ulcers: In severe cases, chronic venous insufficiency can lead to skin ulcers, which can be painful and difficult to heal.
  • Leg cramps: People with chronic venous insufficiency may experience leg cramps, especially at night.
  • Fatigue: Chronic venous insufficiency can cause leg fatigue, making it difficult to perform daily activities.

How Common Is Chronic Venous Insufficiency?

Chronic venous insufficiency (CVI) is a very common medical condition, particularly among the elderly. According to research by the American College of Phlebology, about 1 in 50 adults with varicose veins develop CVI. Additionally, a family history of varicose veins and venous ulcers was strongly linked to severe forms of CVI, with the risk increasing with age. It is estimated that CVI affects more than 1.5 million people in the United States and is even more prevalent in developed countries.

What Are the Stages of Chronic Venous Insufficiency?

Stage 1: Visible blood vessels, including spider veins

In the first stage, individuals may notice visible leg veins, including spider veins, which are small, superficial veins with a web-like appearance. In this stage, there may be little or no swelling in the legs, and skin changes are minimal. The individual may notice some mild discoloration or itching in the affected areas. This stage is usually considered the earliest and mildest form of the condition, and prompt treatment can prevent the progression of the condition and the development of more severe symptoms.

Stage 2: Varicose veins at least 3 millimeters wide

In Stage 2 of chronic venous insufficiency, individuals may notice the presence of varicose veins in their legs, which are at least 3 millimeters in width. These veins are larger and more pronounced than spider veins, and their presence may be accompanied by swelling in the legs, especially after standing or sitting for long periods. The skin over the affected areas may also show more pronounced changes, including discoloration, thickening, and itching.

Stage 3: Edema (swelling) but no skin changes

Individuals may experience swelling in their legs, known as edema. This swelling may be present even when lying down and may worsen throughout the day, especially after standing or sitting for long periods. The affected legs may feel heavy or tired, and the individual may experience pain or cramping. It is important to note that the presence of edema in Stage 3 indicates a more advanced form of the condition, and prompt treatment is crucial. Although there are no significant skin changes at this stage, the swelling may lead to discomfort and mobility issues, impacting daily activities and quality of life.

What Is the Treatment For Chronic Venous Insufficiency?

Treatment for chronic venous insufficiency involves lifestyle changes, minimally invasive procedures, surgery, and medications to improve blood flow and alleviate symptoms such as swelling, pain, and skin changes. Compression therapies are commonly used to reduce swelling and pain, while minimally invasive procedures, such as endovenous laser therapy (EVLT), radiofrequency closure, and foam sclerotherapy, may be used to treat varicose veins and improve blood flow.

In severe cases, surgical treatment may be necessary to remove or repair affected veins, and medications, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and anticoagulants, may be prescribed to help improve blood flow and reduce inflammation. A doctor should be consulted for an accurate diagnosis and personalized treatment plan.


Venous insufficiency is a common condition that affects many individuals and can lead to various symptoms and complications. The best treatment for venous insufficiency depends on the individual case, but a combination of lifestyle changes, minimally invasive procedures, surgery, and medications can help alleviate symptoms and improve blood flow.

If you are experiencing symptoms of venous insufficiency, it is important to seek medical attention for an accurate diagnosis and personalized treatment plan. If you live in the East Bay area, consider scheduling a consultation with East Bay Vein Specialists. Our team of expert vein specialists will work with you to develop a comprehensive treatment plan to help improve your quality of life and alleviate the symptoms of venous insufficiency.

Contact us to book an appointment today.


How do you cure chronic venous insufficiency completely?

Chronic venous insufficiency can be managed with lifestyle changes (such as exercise, weight management, and wearing compression stockings), medical treatment (such as medications and skin care), and, in severe cases, surgery. Complete cure is rare, but improvement is possible with proper treatment.

How can I improve venous insufficiency in my legs?

To improve venous insufficiency in legs, some tips include exercising regularly, maintaining a healthy weight, avoiding long periods of standing or sitting, elevating the legs when resting, and wearing compression stockings.

Is there surgery for chronic venous insufficiency?

Surgical options for chronic venous insufficiency include endovenous thermal ablation, vein ligation and stripping, and microphlebectomy. The choice of surgery depends on the severity of the condition and the patient’s needs.

What is the best doctor for venous insufficiency?

A vascular surgeon or a phlebologist (vein specialist) is the best doctor to consult for venous insufficiency.

What is the best medicine for chronic venous insufficiency?

The best medicine for chronic venous insufficiency will depend on the severity of the condition and the patient’s needs. Medications for this condition include pain relievers, anti-inflammatory drugs, and medications to improve blood flow.

Does alcohol make venous insufficiency worse?

Alcohol can worsen symptoms of venous insufficiency by causing fluid retention and increasing inflammation.

Does venous insufficiency improve with weight loss?

Yes, weight loss can improve venous insufficiency by reducing the pressure on the legs and reducing inflammation.

Dr. Albert Malvehy

Dr. Albert Malvehy

M. Albert Malvehy, MD, RVT, dABVLM is a top-rated East Bay vein doctor serving the East Bay and greater San Francisco, California area. One of the few physicians in the country who devotes his practice exclusively to vein disease, Dr. Malvehy performs over 500 major varicose vein treatments using laser vein treatment and 1,000 spider vein treatments with sclerotherapy every year.

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