As a vein specialist, I often meet patients who have been experiencing tired, achy legs for months or even years before seeking help. Many struggle with unexplained fatigue despite getting enough rest. If this sounds familiar, you might be dealing with a condition called Chronic Venous Insufficiency (CVI). It affects millions of Americans, yet many remain undiagnosed.
The name sounds complicated, but the concept is actually quite simple.
Chronic venous insufficiency occurs when damaged or weakened valves in your leg veins fail to properly push blood back to your heart, causing blood to pool in your legs and leading to symptoms like swelling, pain, and fatigue.
These valves are responsible for keeping blood flowing in one direction, toward your heart. When they become weakened or damaged, blood becomes trapped in your lower extremities, your legs, and pools there. Over time, the increased pressure against the vein walls from a steadily increasing amount of trapped blood leads to a variety of symptoms.
In CVI, this pooling of blood can cause swelling, pain, and discomfort in the legs. It may also lead to varicose veins - those bulging, twisted veins that are often visible on the surface of the skin. Over time, if left untreated, CVI can even lead to more serious conditions such as deep vein thrombosis (DVT) or venous ulcers.
I like to explain to my patients that veins are like a highway system for your blood. Normally, blood flows upward from your legs back to your heart, working against gravity with the help of one-way valves inside your veins. These valves open to let blood flow toward your heart, then close to prevent it from flowing backward.
When these valves become weak or damaged, they can't close completely. This allows blood to leak backward and pool in your veins, especially in your legs where gravity makes the problem worse. We call this backward flow "venous reflux."
When blood pools in your legs instead of efficiently circulating back to your heart, it creates pressure. This pressure doesn't just cause visible symptoms like varicose veins—it triggers an inflammatory response in your body.
In my practice, I emphasize that inflammation is beneficial when it's helping you heal from an injury or fighting an infection. However, when inflammation persists day after day without an endpoint, it becomes harmful to your body.
The most common pattern I see with CVI is that symptoms worsen as the day progresses. By evening, discomfort peaks and often continues into the night, potentially disrupting sleep. This happens because inflammatory substances build up throughout the day and take time to clear from your system, even when you're resting.
In my clinic, I regularly see patients with Chronic Venous Insufficiency who experience:
That last symptom—fatigue—deserves special attention. Many people don't realize that leg vein problems can affect their overall energy levels. I explain to my patients that the inflammatory response triggered by CVI can impact your entire body, including the tiny energy-producing components in your cells called mitochondria. These inflammation molecules are like poison to your body's energy centers.
While CVI is primarily a condition in adults age 50+, it’s not at all uncommon for it to be present in younger adults and even teenagers. However, I see that women experience Chronic Venous Insufficiency more frequently than men. Several factors contribute to this higher risk, including:
I find that many women dismiss their symptoms as "just part of getting older" or the inevitable result of busy lives. However, recognizing CVI for what it is opens the door to effective treatment.
Here's what I tell my patients, and it's encouraging: Chronic Venous Insufficiency is highly treatable. Modern vein treatments are minimally invasive and can dramatically improve symptoms, often with little to no downtime.
The majority of my patients experience significant relief after treatment. Not only do leg symptoms improve or completely resolve, but overall energy levels typically increase as well. This energy boost happens because treating the vein problem reduces inflammation throughout the body.
Perhaps most exciting is how treatment can create a positive ripple effect in your life. Many of my patients who had become less active due to discomfort find they can return to exercise and regular activities. This renewed mobility often leads to weight loss, improved fitness, and better overall health. It's truly rewarding to see patients regain their active lifestyle after treatment.
If you recognize yourself in the symptoms of a vein condition described above, I encourage you to speak with your primary care practitioner about your concerns. They can help determine whether you might benefit from seeing a vein specialist like me for evaluation.
Diagnostic testing for Chronic Venous Insufficiency is typically quick and painless, usually involving an ultrasound examination of your leg veins to assess blood flow and valve function.
Whether you're currently experiencing symptoms or simply want to maintain good vein health, I recommend these practices to all my patients:
I want to emphasize that vein health is an important part of your overall well-being. By understanding conditions like Chronic Venous Insufficiency and seeking appropriate care, you're taking an important step toward living your most comfortable, energetic life.