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What is Chronic Venous Insufficiency? Causes, Symptoms, and Treatments

Oct 09, 2023

Chronic Venous Insufficiency

Do you have varicose veins and experience numbness and tingling? There is a good chance you have a chronic venous insufficiency (CVI). Read more to learn about CVI and how the specialists at Garden State Pain and Orthopedics can help.

What is Chronic Venous Insufficiency? 

Chronic Venous Insufficiency (CVI) is a medical condition that occurs when the veins in the legs and sometimes other parts of the body have difficulty returning blood to the heart effectively. Veins in the circulatory system are responsible for carrying blood back to the heart, and they have one-way valves that prevent blood from flowing backward. When these valves become damaged or weakened, it can lead to chronic venous insufficiency. If you are experiencing any of the symptoms from chronic venous insufficiency seeing a specialist like Dr. Jahnna Levy can help improve your lifestyle and comfort. 

 

What causes Chronic Venous Insufficiency? 

Chronic Venous Insufficiency (CVI) is primarily caused by problems with the veins in the legs, which prevent blood from flowing back to the heart efficiently. Several factors can contribute to the development of CVI:

  • Valve Dysfunction: The primary cause of CVI is often malfunctioning or damaged valves in the veins. Normally, these valves help blood flow against gravity back to the heart, but when they don't work properly, blood can pool in the veins.
  • Deep Vein Thrombosis (DVT): A blood clot in a deep vein, known as DVT, can damage valves and lead to CVI.
  • Varicose Veins: Enlarged and twisted varicose veins can put extra pressure on the valves, leading to valve dysfunction and CVI.
  • Aging: As people age, the valves in their veins may naturally weaken, increasing the risk of CVI.
  • Obesity: Excess body weight can put additional pressure on leg veins, potentially leading to CVI.

You should consider seeing a provider if you experience symptoms or risk factors related to Chronic Venous Insufficiency (CVI). Early diagnosis and management can help prevent the progression of the condition and improve your quality of life. Symptoms of chronic venous insufficiency can include:

  • Swelling in the legs and ankles, especially after standing for extended periods.
  • Pain or aching in the legs.
  • Feeling of heaviness or fatigue in the legs.
  • Skin changes, such as darkening or thickening.
  • Ulcers or open sores, particularly in advanced cases.

How is Chronic Venous Insufficiency treated?

The treatment of Chronic Venous Insufficiency (CVI) aims to alleviate symptoms, improve blood circulation, and prevent or manage complications. Treatment options vary depending on the severity of the condition, and your healthcare provider at Garden State Pain and Orthopedics will create a personalized plan based on your specific needs. Here are some common approaches to treating CVI:

Lifestyle Modifications: 

  • Elevating the Legs: Keeping the legs elevated above heart level whenever possible helps reduce swelling and improve blood flow.
  • Regular Exercise: Physical activity, especially walking, can promote better circulation and strengthen the calf muscles, which assist in pumping blood back to the heart.
  • Weight Management: Maintaining a healthy weight can help reduce pressure on the veins in the legs.
  • Compression Therapy: Wearing compression stockings or bandages can provide external pressure on the veins, helping to improve blood flow and reduce swelling. These garments should be prescribed and fitted by a healthcare professional.

Medications: Your doctor may prescribe medications such as diuretics to reduce fluid buildup (edema) and anti-inflammatory drugs to manage pain and inflammation.

Minimally Invasive Procedures: In some cases, minimally invasive procedures may be recommended to treat CVI. These include:

  • Endovenous Laser Treatment (EVLT): A laser fiber is inserted into the affected vein to seal it shut, rerouting blood flow to healthier veins.
  • Radiofrequency Ablation (RFA): Similar to EVLT, this procedure uses radiofrequency energy to close off the problematic vein.
  • Sclerotherapy: A chemical solution is injected into smaller varicose or spider veins, causing them to collapse and gradually disappear.
  • Venaseal Closure: A medical adhesive is used to seal the problematic vein.
  • Ambulatory Phlebectomy: Involves the removal of smaller varicose veins through tiny incisions.

Surgery: Surgical options are typically reserved for severe cases or when minimally invasive procedures are not effective. Surgical interventions may include vein ligation (tying off the problematic vein) or vein stripping (removing the vein).

Wound Care: If CVI has led to the development of ulcers or open sores, specialized wound care may be necessary to facilitate healing and prevent infection.

 

Is Chronic Venous Insufficiency a medical emergency?

Chronic Venous Insufficiency (CVI) itself is not typically considered a medical emergency. It is a chronic condition that develops gradually over time due to problems with the veins in the legs or other parts of the body. While CVI can cause discomfort and lead to complications if left untreated, it is not an acute, life-threatening condition.

However, there are situations related to CVI that may require immediate medical attention:

  • Ulcers or Open Sores: If CVI progresses and leads to the development of ulcers or open sores on the legs or ankles, these can become infected. Infected ulcers should be treated promptly to prevent the spread of infection.
  • Deep Vein Thrombosis (DVT): Although CVI and DVT are separate conditions, they can sometimes be related. A DVT is a blood clot in a deep vein, and it can lead to CVI if not treated. DVT itself is a medical emergency and requires immediate medical attention to prevent serious complications, such as a pulmonary embolism.
  • Cellulitis: CVI can make the skin more vulnerable to infections like cellulitis. If you develop signs of cellulitis, such as redness, swelling, warmth, and pain in the affected area, you should seek medical care promptly.
  • Severe Symptoms: In some cases, people with CVI may experience severe pain, swelling, or other symptoms that significantly affect their quality of life. While not an emergency in the traditional sense, these symptoms should be discussed with a healthcare provider to explore treatment options and improve the individual's comfort and well-being.

It is essential for individuals with this condition to work closely with their healthcare providers to manage their symptoms and prevent complications. Regular monitoring and appropriate treatment can help improve the overall quality of life for people living with CVI.



Understanding Chronic Venous Insufficiency is a vital step towards improving your overall health. At Garden State Pain and Orthopedics, we are committed to providing you with the latest medical technology, expert guidance, and comprehensive medical care for CVI and related conditions.

If you or a loved one are experiencing symptoms or have concerns about CVI, don't hesitate to reach out to our experienced team of healthcare professionals. We are here to help you find the most effective treatment options, manage your symptoms, and improve your quality of life. Early detection and intervention can make a significant difference in your journey in treating CVI. For personalized care and more information about, CVI, pain management, and orthopedic concerns, select “Book now” to schedule an appointment with one of our expert physicians Garden State Pain and Orthopedics.



Meet Dr. Jahnna Levy

Dr. Jahnna Levy practices physical medicine and rehabilitation at Garden State Pain & Orthopedics, where her expertise contributes a vital component to each person’s treatment and recovery. As an osteopathic physiatrist, she believes in a multifaceted and holistic approach to pain management. She treats each person as an individual, formulating a systematic treatment plan to restore function, reduce pain, and improve their quality of life when they receive care at one of four office locations: Edison, Clifton, Hazlet, and Jersey City, New Jersey. 

Dr. Levy attended medical school at Touro College of Osteopathic Medicine in New York City. During this time, she became proficient in musculoskeletal medicine and co-founded the Osteopathic Orthopedic Organization. Upon graduation, Dr. Levy completed her internship at North Shore-LIJ Plainview Hospital and her residency in physiatry at the prestigious Rusk Institute at New York University Hospital in New York City. During her residency, Dr. Levy received extensive training at the Hospital for Joint Disease and was elected Chief Resident at both the Manhattan Veterans Affairs Hospital and Bellevue Hospital. 

During her fellowship, Dr. Levy was trained to perform a variety of nonsurgical orthopedic procedures and fluoroscopically-guided injections for neck, back, and joint pain. She’s also trained in spinal cord stimulator placement, EMGs, diagnostic musculoskeletal ultrasound, and percutaneous tenotomy for tendon injuries. Additionally, she received training in medical acupuncture and migraine management. 

Dr. Levy is board certified in physical medicine and rehabilitation and fellowship trained in interventional pain management and sports medicine. She’s an active member of the North American Neuromodulation Society, American Society of Interventional Pain Physicians, and American Academy of Physical Medicine and Rehabilitation. 

Dr. Levy is a contributing author on Spine-health.com where she has written patient education content about spinal conditions and treatments. Her most recent pieces include: Common Causes of Back Pain and Neck Pain When she’s not working with patients, Dr. Levy enjoys dancing, traveling, and spending time with her family and friends