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INTRODUCTION

Symptoms from venous insufficiency are the result of distention of the veins and accumulation of fluid within the surrounding tissue. They include swelling and various forms of discomfort of the legs. In the later stages of the condition, damage to the skin results in discoloration and the formation of ulcers. This syndrome in varying stages of severity is common in the predominantly upright activities of humans. Epidemiology studies tell us of the high prevalence of the condition worldwide, most especially in the Western countries [1]. Yet numerous scientific articles on the subject begin with the statement that those cases of venous insufficiency are largely underdiagnosed and undertreated. Treatment to prevent progression of the disease is often long delayed because of overlooking the cause of early symptoms [2].

For some, the symptoms of venous insufficiency are an inconvenience. For others, venous insufficiency is disabling and disfiguring. Typically, there is an inexorable progression of the disease over the years [3]. Left untreated, the condition tends to progress slowly with increasing discomfort and swelling. Eventually, the skin may break down, leaving a treatment-stubborn ulcer. These symptoms can bring daily misery to the farmer, nurse, barber, store clerk, teacher, surgeon, waitress, teller, hairdresser, mother of young children, and others who must spend many hours a day on their feet.

The central offenders in the production of venous insufficiency are defective valves within the veins of the legs. Normally, these valves are delicate flaps which perform as a one-way gate for blood passing from the lower body to the heart. Damaged valves permit reflux of venous blood back into the leg; they no longer protect the legs from persistent excessive pressure during standing, sitting, or walking. It is this overload of pressure from gravity when exerted over a long time that causes the symptoms of venous insufficiency.

Coping with the symptoms of venous insufficiency requires a basic understanding of the physiology of the veins and of the valves within them. The symptoms can be successfully treated with various interventions of lifestyle meant to cope with the burden of gravity.

TERMINOLOGY

By “venous insufficiency” is meant a condition in which symptoms are caused by the force of gravity acting on a defective anti-gravitational system in the veins. The name “venous valvular reflux syndrome” is most descriptive anatomically and functionally of the disorder. There are a number of synonyms, including “chronic venous insufficiency,” “post-phlebitis syndrome,” “veno-stasis,” or “leaky valves disease.” Actually, most of our patients first come complaining of “poor circulation” (and almost always with little grasp of what the expression means).

The term “varicose veins” applies only to those visible, dilated veins just beneath the skin. The condition is a form of venous insufficiency (caused by valve reflux), but it is not as likely to produce symptoms and complications as the much larger and much more ...

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