Understanding Venous Insufficiency: Why Your Legs May Feel Heavy and Swollen

Have you ever noticed aching, swelling, or a heavy sensation in your legs—especially at the end of the day? These symptoms may be more than just fatigue; they could be signs of venous insufficiency, a common yet often overlooked vascular condition.

What Is Venous Insufficiency?

Venous insufficiency occurs when the veins in the legs struggle to return blood to the heart efficiently. This is often due to damaged or weak valves within the veins, leading to blood pooling in the lower extremities (Eberhardt & Raffetto, 2014). Over time, this can cause symptoms such as:

✅ Leg swelling (edema)
✅ Varicose veins or spider veins
✅ Skin discoloration (brownish pigmentation around the ankles)
✅ Ulcers or slow-healing wounds

How Common Is It?

Chronic venous insufficiency (CVI) affects up to 40% of the U.S. population, with prevalence increasing with age (Meissner et al., 2007).

How Vascular Ultrasound Helps Diagnose Venous Insufficiency

As a vascular sonographer, I use venous duplex ultrasound to assess how well blood is flowing through the veins. This non-invasive test allows us to:

🩸 Detect valve dysfunction – Are the valves properly closing, or is blood flowing backward (reflux)?
🩸 Evaluate vein compression or blockages – Is there an obstruction preventing normal circulation?
🩸 Identify deep vein thrombosis (DVT) – A clot in the deep veins can lead to serious complications like pulmonary embolism (American College of Phlebology, 2015).

What Can You Do About It?

If you’ve been experiencing symptoms of venous insufficiency, there are steps you can take to improve circulation and manage discomfort:

🦵 Wear compression stockings to support venous return (O’Donnell et al., 2014)
🏃 Stay active – walking and leg exercises help pump blood upward
🛌 Elevate your legs when resting to reduce swelling
💧 Stay hydrated and maintain a healthy weight to reduce pressure on veins

For more advanced cases, treatments like sclerotherapy, endovenous ablation, or vein stripping may be recommended by a physician (Gloviczki et al., 2011).

Why Early Detection Matters

Venous insufficiency is progressive, meaning it can worsen over time if left untreated. By catching it early with vascular ultrasound, patients can take steps to prevent complications and improve their quality of life.

🔹 Have you or someone you know experienced symptoms of venous insufficiency? Share your thoughts in the comments!

References

American College of Phlebology. (2015). Venous Disease Overview. Retrieved from phlebology.org
Eberhardt, R. T., & Raffetto, J. D. (2014). Chronic venous insufficiency. Circulation, 130(4), 333-346.
Gloviczki, P., Comerota, A. J., Dalsing, M. C., et al. (2011). The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. Journal of Vascular Surgery, 53(5 Suppl), 2S-48S.
Meissner, M. H., Moneta, G., Burnand, K., et al. (2007). The hemodynamics and diagnosis of chronic venous disease. Journal of Vascular Surgery, 46(Suppl S), 4S-24S.
O’Donnell, T. F., Passman, M. A., Marston, W. A., et al. (2014). Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. Journal of Vascular Surgery, 60(2 Suppl), 3S-59S.