Venous insufficiency occurs when a vein is unable to return blood properly to the heart. Veins contain valves that keep the blood from moving backward and pooling in the legs; sometimes, these valves are damaged or become weak, causing venous insufficiency that leads to varicose veins. Venous insufficiency may be genetic; a sedentary lifestyle also may contribute greatly, since movement helps return blood to the heart. As the heart beats, it moves blood through the circulatory system (blood vessels) The vessels are flexible, hollow tubes that carry blood to every part of the body and return the blood to the heart.
Veins are hollow tubes with flaps inside called valves. The veins return blood to the heart. The muscles of the body aid in the circulatory system. When the muscles contract, the valves open and allow blood to move through the veins. When your muscles relax, the valves close, keeping blood flowing in one direction through the veins. This is called the calf-pump system. Veins become larger and larger as they get closer to the heart. The two largest veins in the body are the superior vena cava and the inferior vena cava. The superior vena cava is the large vein that brings blood from the head and arms to the heart, and the inferior vena cava brings blood from the abdomen and legs into the heart.
If the valves inside your veins become damaged, the valves may not close completely, allowing blood to leak backward or flow in both directions. This is called venous reflux: impaired drainage of the venous blood from the legs is the result. This usually occures in the superficial veins. The largest being the great saphenous vein, which runs from the top of the foot to the groin where it attaches and drains into a deep vein called the common femoral vein.
Chronic venous disorders run a gamut from morphological and functional abnormalities of the venous system. They can be present in childhood or early onset acquired disorders which by adulthood are quite common. Vein-related problems may or may not be symptomatic and include a wide range of clinical signs varying from minimal superficial venous enlargement to chronic skin changes with ulceration.
Venous disorders present themselves in different ways. So a universal system has been created a comprehensive classification system, CEAP (clinical, etiology, anatomy, and pathophysiology) to allow for uniform diagnosis.
- C0 No clinical signs for chronic venous diease.
C1 Telangiectases, reticular veins or spider veins These can also develop on the legs, although when they occur on the legs, they often have underlying venous re flux or “hidden varicose veins”. When found on the legs, they are found specifically on the upper thigh, below the knee joint, and around the ankles.
C2 Varicose veins These are abnormal, dilated blood vessels caused by a weakening in the blood vessel wall. As they progress they appear to meander or follow a winding course.
C3 Edema Edema is swelling that is caused by fluid trapped in the tissues of the body. It happens most often in the feet, ankles, and legs, but can affect other parts of the body, or involve the whole body.
C4 Pigmentation, lipodermnatosclerosis and eczema Leakage of blood cells into surrounding tissue and activation of inflammatory cells are primarily responsible for the changes observed. These skin changes progress from mild pigmentation from haemosiderin deposits (rust stains), to areas of inflammation and eczema, and inflammation of the fatty tissue lying directly under the skin and hard tight skin which may be red or brown to atrophie blance (star shaped, white (ivory) break down of the skin surrounded by reddened areas, and finally ulceration of the skin.
C5 Healed venous ulcer Unless the underlying conditions that contributed to your leg ulcer are addressed and treated, you are at risk of developing other ulcers. Treatment options can include treatment for varicose veins (wearing your compression stockings), surgical intervention, quitting cigarettes, improving your diet and taking regular exercise (such as 30 minutes of walking every day).
- C6 Skin changes with active ulcer A venous ulceration is usually seen on the medial side of the ankle bone, but can also occur on the lateral aspect or the back or upper surface of the foot. Venous ulcers rarely occur without cause, but show themselves secondary to triggers such as cellulitis, dermatitis or rapid development of edema.
Chronic venous disease develops over time and in most cases can be controlled by wearing compression stockings or compression socks. If compression socks or compression garments are worn to correct swelling, progression of chronic venous disease can be slowed or halted. With all of the different styles available for both men and women, there is no reason for choosing not to wear support socks or support stockings. Why not call one of our Certified Fitters for assistance with the selection of garments to meet your diagnosis, lifestyle, activity and desired appearance.
Here’s to healthy legs,