The Stages of Chronic Venous Insufficiency

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According to the National Center for Biotechnology Information (NCBI), “chronic venous disease (CVD) is one of the most prevalent diseases worldwide.” However, since it works in stages and doesn’t always start with signs that it’s a bigger issue, many people aren’t aware that they suffer from it.

Varicose veins, chronic vein disease, and venous insufficiency are all terms that go hand-in-hand and refer to different stages of vein problems you may be suffering.

In order to better understand the different levels and stages of vein disease, we are dedicating this article to familiarizing you with chronic venous insufficiency (CVI) including:

  • Early signs of CVI
  • Risk factors of CVI
  • The stages of vein disease, or stages of chronic venous insufficiency

Everything you need to know about Chronic Venous Insufficiency

The first step in learning more about chronic venous insufficiency is learning the early signs to look out for.

Early signs of chronic venous insufficiency

NCBI states that varicose veins are present in 25-40% of adults, depending on risk factors, whereas the more serious condition of chronic venous insufficiency has a prevalence of 17-20%. While you likely know of someone who suffers from varicose veins, and see it to be quite a common thing, CVI is much more common than people think.

The early signs of chronic venous insufficiency include:

  • Swelling
  • Muscle fatigue
  • Cramps
  • Itching
  • Aching
  • Heaviness
  • Throbbing

Early stages are also when varicose veins will likely begin to form, so be on the lookout for those. How do you know if you have varicose veins?

The Mayo Clinic shares some information about varicose veins: “Signs you may have varicose veins include veins that are dark purple or blue in color, and veins that appear twisted and bulging; they are often like cords on your legs.”

They also note some common symptoms of varicose veins such as:

  • An achy or heavy feeling in your legs
  • Burning, throbbing, muscle cramping and swelling in your lower legs
  • Worsened pain after sitting or standing for a long time
  • Itching around one or more of your veins
  • Skin rash or discoloration at or just above the ankle

If you’re showing any of the above signs of varicose veins and/or chronic venous insufficiency, schedule an appointment with a vein specialist near you to nip the problem in the bud before it turns into something more serious.

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Risk factors of chronic venous insufficiency

There are a number of reasons someone may develop vein issues, but there are some risk factors that put you at a higher risk of suffering from chronic venous insufficiency.

The added pressure that all that extra weight puts on veins is a lot to handle for your body, but especially for your veins. This weight and pressure makes it hard for your veins to return the blood back to your heart, leaving it to pool and cause issues.

Though you don’t have to be older to have vein issues, it is more common as you age. Since venous insufficiency is progressive, the signs and symptoms worsen with aging.

Unfortunately some vein disease runs in the family and you may find yourself a victim of CVI simply because someone in your gene pool had it. However, knowing that ahead of time can help you pay attention to the early signs and catch it before it gets bad.

Jobs that require standing
Standing all day for your job adds an extra stress to the veins and can contribute to the development of vein disease.

Hormone changes
Pregnancy is a major time of hormone changes and that is when we see development of varicose veins for many. During pregnancy there is more pressure on your veins, causing a higher chance of them to become weakened or damaged. In addition, symptoms are often at their worst just before a menstrual period.

Sedentary lifestyle.
Lack of movement wreaks havoc on your body, but especially your veins. When it is activated during walking, the calf muscle acts as the primary pump for veins in the legs. The more time spent sedentary, the harder it is for your body to do its job of pumping your blood, especially when your veins are fighting gravity to get the blood back up to your heart.

Chronic venous insufficiency stages

Though vein disease isn’t exactly the same for everyone, there are enough cases of it that we have been able to determine a general timeline of what the stages look like. Below is a look at the various stages of venous insufficiency.

Examples of Vein Disease

Stage 1: Spider veins
The first stage sees the formation of spider veins in your legs. These tend to look unsightly but don’t always cause pain or discomfort. However, they should never be ignored.

Stage 2: Varicose veins
When you see those big, bulging veins show up on your legs and feet, that means varicose veins. Some people don’t experience discomfort with varicose veins, but many do.

Stage 3: Swelling
If you don’t treat your varicose veins at first sight, they tend to get worse. One of the things that happen when treatment doesn’t occur is swelling. This is a result of the poor circulation in your body, and can be a major hindrance on your quality of life. Swelling may also contribute to damage of your lymphatic system.

Stage 4: Skin discoloration or rashes
When the veins are left untreated, the blood continues to pool in the area surrounding the damaged vein, which can lead to a change in color of the skin. The pooling blood at the surface can trigger an inflammatory response indicated by a red, itchy rash called venous stasis dermatitis.

Stage 5: Ulcers
If left untreated, venous insufficiency could progress to venous stasis ulcers, which are open sores that occur as a result of the skin tissue breaking down on your leg. These ulcers and sores can be extremely painful and make it difficult to move around. You do not want to get to this stage of CVI. If you have progressed to this stage, it is imperative that you have your veins evaluated and treated as soon as possible. Treatment helps to heal the wounds and prevent their recurrence.

Interested in reading more about chronic venous insufficiency? Explore our collection of topics.

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Medically Reviewed by

Dr. Satish Vayuvegula
Dr. Satish Vayuvegula is the National Medical Director at Vein Clinics of America. Certified by the American Board of Venous & Lymphatic Medicine, Dr. Satish Vayuvegula is recognized as a physician who has met rigorous standards of knowledge and extensive training in phlebology, the diagnosis and treatment of varicose vein disease and related disorders. Dr. Satish also shares his passion and expertise by serving as a board member of the American Vein and Lymphatic Society, the predominant national organization for venous and lymphatic disease.

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