What are the Stages of Chronic Venous Insufficiency?

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Each year, millions of people in the United States are impacted by chronic venous insufficiency. Chronic venous insufficiency, or vein disease, is the underlying cause of varicose and spider veins. 

Vein disease is a progressive condition that can lead to painful and uncomfortable symptoms like swelling, cramping, itching, or fatigue mostly in the legs, ankles, and feet.   If left untreated,  venous insufficiency can worsen symptoms and dangerous health conditions like blood clots and venous ulcers.

Chronic venous insufficiency or vein disease develops gradually over time in stages.  It’s important to recognize the progression of vein disease and seek treatment as early as possible to prevent further damage. The condition will progress if left untreated, and early diagnosis and intervention are the keys to long-term management. 

The good news is that our vein specialists perform a range of effective, minimally invasive chronic venous insufficiency treatments that can alleviate pain and discomfort, reduce your risk of developing complications, and quickly get you back to normal daily activities.

We recommend early intervention and treatment for best results, so it may be beneficial to consult a vein specialist at the first sign of trouble. Our experts are here to help from the initial diagnosis to recovery after treatment.

What Is Chronic Venous Insufficiency?

Chronic venous insufficiency can develop when one-way valves in the veins are placed under ongoing strain and begin to malfunction. Both genetics and lifestyle are contributing factors.

When vein valves are damaged, veins struggle against gravity to send blood back to the heart from your lower extremities.

Instead of circulating efficiently, blood flows backward or pools in the legs, ankles, and feet. Ultimately, this leads to the formation of varicose veins.

Common chronic venous insufficiency symptoms include:

  • Swelling in the legs and ankles
  • Tired, aching legs
  • Burning in the calf or thigh
  • Leg pain that feels better when you raise your legs
  • Itchy, dry, hardened or cracked skin
  • Numbness or tingling sensation
  • Difficulty standing for long periods
  • Non-healing wounds on your legs
  • Restlessness felt especially at night

Many people attribute these symptoms as signs of aging, and end up failing to seek treatment promptly.  What they first experience as mild pain or discomfort can become debilitating if left untreated.

Along with causing these symptoms, untreated vein disease can increase your risk for dangerous health conditions like blood clots and venous ulcers (open, non-healing wounds). If you have signs of chronic venous insufficiency, we recommend contacting your doctor or a vein specialist as soon as possible

Chronic Venous Insufficiency Causes

You should be aware that there are a range of chronic venous insufficiency causes and contributing risk factors. Some of these include:

Genetics: Vein disease tends to run in families. If you have a parent or close relative with varicose veins, you are more likely to develop them.

Age: Your risk for developing venous issues increases as you get older. Although varicose veins can appear at any age, you are more likely to get them after age 50.

Sex: Women are four times more likely to develop vein disease.

Pregnancy: Vein disease often develops during pregnancy due to increased blood flow and an influx of hormones.

Prolonged sitting or standing: If you have a job that requires long periods of standing or sitting, you are at higher risk for developing chronic venous insufficiency symptoms.

Excess weight: Being obese or overweight places additional strain on your veins and can cause damage, leading to venous insufficiency. For example,  if your BMI is 25.0 to more than 30, it falls within the overweight range. If your BMI is 30.0 or higher, it falls within the obesity range.

Inactivity: A sedentary life can affect blood circulation, contribute to weight gain, and lead to chronic venous insufficiency.

Smoking: Along with increasing your risks for serious health issues like heart and lung disease, smoking can weaken your veins and reduce blood flow.

High blood pressure: If you have high blood pressure, you are more likely to develop vein health issues.

Some of these risk factors are out of your control — others can be changed, such as smoking and inactivity. Your medical provider will work with you to make lifestyle changes that can positively impact vein disease.

Chronic Venous Insufficiency Stages

Chronic Venous Insufficiency Stages

Symptoms Quiz 5 Quick Questions to Evaluate Your Vein Health

We want you to understand the five main stages of chronic venous insufficiency, which include:

Chronic Venous Insufficiency Stages InfographicStage 1: Spider Veins

Your first sign of trouble may be the development of reticular veins that appear below your skin but don’t usually protrude followed by spider veins. Reticular veins are often blue or purple but do not bulge out.  Spider veins are tiny, colorful, web-like veins that appear on the skin’s surface. Like varicose veins, they most commonly impact the lower extremities; however, the face and other body areas can also be affected.

Although often considered a cosmetic issue, spider veins are early signs of chronic venous insufficiency. They can cause symptoms like leg swelling, restlessness, tingling, numbness, burning, itching, tenderness, or redness. Since these symptoms are a sign of the initial stage of venous insufficiency, they can be combated with lifestyle changes and using compression socks.

Stage 2: Varicose Veins

Although it may be easy for some to ignore spider veins, the appearance of varicose veins may get your attention as the second of the chronic venous insufficiency stages. Varicose veins are enlarged, twisted veins that rise above the skin’s surface. Besides being unsightly, varicose veins can cause painful and uncomfortable symptoms, including leg heaviness, swelling, itching, or burning. Although not all individuals experience pain or discomfort, symptoms can eventually develop and worsen.

Stage 3: Leg Swelling

When earlier vein symptoms are left untreated, additional ones are likely to occur. One chronic venous insufficiency symptom, edema or leg swelling, is a common sign of progressing vein disease. You may notice difficulty or pain when putting on your shoes or boots. Your legs and ankles may feel heavy, making climbing stairs more difficult. This type of swelling may become severe enough to limit mobility and impact your quality of life.

Stage 4: Skin Discoloration

As vein disease progresses, you may notice skin changes surrounding your varicose or spider veins. Some individuals develop thin, dry, or hardened skin; others a dark brownish or purplish discoloration. You may also see an itchy, red rash called venous stasis dermatitis. Since venous insufficiency is the underlying cause of these skin problems, lotions and creams are not usually effective. Skin discoloration can easily be ignored; however, seeking help from a vein specialist as soon as possible is essential.

Stage 5: Venous Ulcers

The final stage of chronic venous insufficiency is the development of venous ulcers. Venous ulcers, or stasis ulcers, are slow or non-healing wounds that tend to form on the legs and ankles near visible varicose veins. Their presence can leave you vulnerable to serious skin and blood infections. Cracked, dry, or hardened skin can easily turn into non-healing wounds that fester with time. Venous ulcers may start as a small wound that looks similar to a scratch and progress into a serious, open wound. If you notice redness or pus around the affected area, you may need to visit the emergency room to get treatment for possible infection.

No matter which stage of vein disease you are experiencing, we want you to know that help is available. One of our top vein specialists can help you explore your full range of minimally invasive vein treatment options.

At What Stages of Chronic Venous Insufficiency Should I Seek Treatment?

Unfortunately, your vein pain and discomfort are unlikely to disappear on their own. “When it comes to vein disease, early medical intervention can help you obtain the best health outcomes. “Treatment can also save you from a lot of needless suffering,” says Yan Katsnelson, M.D.

If you are at risk of developing chronic venous insufficiency, it may be helpful for a vein specialist to monitor your condition over time. If you already have varicose or spider veins, we recommend discussing the benefits of vein treatment with one of our experts as soon as possible.

The good news is that minimally invasive, outpatient vein treatment at USA Vein Clinics can alleviate painful and uncomfortable symptoms, reduce your risks of developing dangerous health issues, and improve your overall quality of life.

Chronic Venous Insufficiency Treatment at USA Vein Clinics

At USA Vein Clinics, we care about your vein health. Whether you have signs of early venous insufficiency or late-stage symptoms, minimally invasive vein treatment can help. Most of our state-of-the-art outpatient procedures can be performed in only 15 to 30 minutes. Afterward, you can leave immediately and return to most normal activities.

Our specialists are experienced in treating vein diseases and will discuss minimally invasive treatment options with you.

  • Endovenous Laser Therapy (EVLT): Using ultrasound guidance, a laser is inserted into the targeted vein and uses heat to close the vein. Blood flow reroutes to nearby healthy veins.
  • ClariVein®: This treatment requires a tiny catheter that is inserted into the vein where chemicals seal the vein.
  • Visual Sclerotherapy Injections: Used for treating spider veins, this treatment uses a tiny needle to inject a sclerosant solution to cause the inner lining to collapse.
  • Ultrasound-Guided Sclerotherapy: This treatment targets varicose veins close to the skin’s surface. Sclerosant solution is injected into the vein using ultrasound imaging to locate the entry point.
  • Varithena Vein Treatment: Used on the Great Saphenous Vein (the longest vein in the body) and other veins in the surrounding area, this treatment uses a catheter guided to the affected vein by ultrasound imaging. Foam is injected into the vein to close it.
  • VenaSeal™ Treatment: Designed for use with varicose veins, this treatment uses a medical adhesive that is specially formulated for this specific purpose. The adhesive is sent through the tiny catheter into the vein to seal it off.
  • Radiofrequency Ablation (RFA)Inserts a small catheter into the diseased vein through a small incision under ultrasound guidance for a live view. Consistent and uniform heat is delivered to contract collagen in the vein walls, causing them to collapse and close.

With all these treatments, blood flow redirects to healthy veins. Most patients can immediately return to work or their daily routines with no downtime or discomfort. You will need to avoid showering for the first 24 hours, swimming for the first week, and other strenuous activities until your doctor approves it.

You will notice less pain and swelling and be able to stand for a longer time or walk a greater distance. Enjoy an improved quality of life as a result of these non-surgical treatments.

To learn more about your treatment options, schedule an initial consultation today. We offer consultations at over 160 clinic locations across the country, along with virtual doctor appointments. No matter where you schedule your visit, we look forward to helping you regain happier and healthier legs.

CALL US 888.768.3476

Medically Reviewed by

Dr. Yan Katsnelson is a philanthropist, business owner, and highly skilled cardiac surgeon. He is the Founder and CEO of USA Vein Clinics, which is part of USA Clinics Group, the parent company of USA Fibroid Centers, USA Vascular Centers, and USA Oncology Centers with more than 90 facilities nationwide. Dr. Yan has established himself as a strong advocate for accessibility and affordability of the most advanced medical care close to home, and his mission is to create a positive experience for each patient with compassionate, personalized, and expert care.

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