Understanding Chronic Venous Insufficiency

Senior man resting on couch, elevating legs.

Problems with the veins in the legs may lead to chronic venous insufficiency (CVI). CVI means that there is a long-term problem with the veins not being able to pump blood back to your heart. When this happens, blood stays in the legs and causes swelling and aching. 

Two problems that may lead to chronic venous insufficiency are:

  • Damaged valves. Valves keep blood flowing from the legs through the blood vessels and back to the heart. When the valves are damaged, blood does not flow as well. 

  • Deep vein thrombosis (DVT). Blood clots may form in the deep veins of the legs. This may cause pain, redness, and swelling in the legs. It may also block the flow of blood back to the heart. Seek medical care right away if you have these symptoms.

  • A blood clot in the leg can also break off and travel to the lungs. This is called pulmonary embolism (PE). In the lungs, the clot can cut off the flow of blood. This may cause chest pain, trouble breathing, sweating, a fast heartbeat, coughing (may cough up blood), and fainting. It is a medical emergency and may cause death. Call 911 if you have these symptoms.

  • Healthcare providers call the two conditions, DVT and PE, venous thromboembolism (VTE).

CVI can’t be cured, but you can control leg swelling to reduce the likelihood of ulcers (sores).

Recognizing the symptoms

Be aware of the following:

  • If you stand or sit with your feet down for long periods, your legs may ache or feel heavy.

  • Swollen ankles are possibly the most common symptom of CVI.

  • As swelling increases, the skin over your ankles may show red spots or a brownish tinge. The skin may feel leathery or scaly, and may start to itch.

  • If swelling is not controlled, an ulcer (open wound) may form.

What you can do

Reduce your risk of developing ulcers by doing the following:

  • Increase blood flow back to your heart by elevating your legs, exercising daily, and wearing elastic stockings.

  • Boost blood flow in your legs by losing excess weight.

  • If you must stand or sit in one place for a period of time, keep your blood moving by wiggling your toes, shifting your body position, and rising up on the balls of your feet.

Treating Ulcers

Chronic Venous Insufficiency: Treating Ulcers

82948If leg swelling because of chronic venous insufficiency isn’t controlled, an open wound (ulcer) can form. Although ulcers vary in size and shape, they usually appear on the inside of the ankle.

Treating an ulcer

  • Visit your healthcare provider. Ulcers need frequent medical care. Special dressings may be applied. You may be given antibiotics to fight infection.

  • Your healthcare provider may prescribe medicines, such as aspirin or pentoxifylline, to help the ulcer heal.

  • Your healthcare provider may prescribe compression hose to help with the swelling. 

  • Elevate your legs often to reduce swelling. The ulcer needs oxygen-rich blood to heal. This blood can’t reach the ulcer until swelling is reduced.

When to call your healthcare provider

Seek immediate medical attention if: 

  • You have an increase in pain

  • You develop a fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • The area around the ulcer becomes red, tender, or both

  • The ulcer oozes discolored fluid or smells bad

  • Swelling increases suddenly or the dressing feels tight


Erick Jose Guerra, MD

Family Medicine, Hospitalist

Jon R Mattson, DO

Hyperbaric Medicine, Family Medicine

Saint Luke’s Wound Care

Saint Luke’s Wound Care and Hyperbaric Chamber provides comprehensive wound management to treat hard-to-heal wounds. We use state-of-the-art technology to accelerate the wound-healing process and offer hyperbaric oxygen treatment to increase oxygen levels to tissue. Our team of professionals have advanced wound training and expertise.