Chronic Venous Insufficiency (CVI) Management
In Chronic Venous Insufficiency the valves are faulty meaning that blood does not advance towards the heart, but instead pools in the legs.
The reason that this condition is called Ambulatory Venous Hypertension is that as we are up and walking (ambulatory) there is more downward pressure exerted on the veins.
Because this pressure is greater than what would be found in a normal vein due to the larger amount of blood that isn’t being returned to the heart it is referred to as “hypertension,” or excessive pressure.
This excessive pressure over time distorts the shape of the veins leading to the formation of varicose veins. These are the veins we can see through the skin that have a twisted and bulging appearance. Again, this bulging is due to them being under constant pressure from backflow that is happening due to valves above having failed..
Although a tendency to have varicose veins can be hereditary, people who are often on their feet, who regularly lift heavy objects, or who are or were pregnant are likely to develop varicose veins.
Let’s now take a look at what is going on at the microscopic level.
When blood rushes backwards in the veins (blue in the picture), more fluid diffuses (comes out of) the capillaries. The capillaries are the purple structures between arteries (red) and veins in the picture. Capillaries have “window-like structures” that allow things like nutrients to diffuse out of our bloodstream to feed the cells.
When there is excessive back pressure from blood that can’t make it up the veins in the legs, these capillaries become like a perforated garden hose and spray fluid out into the space between the cells.
This excess fluid between the cells is normally removed by the lymphatic system. The lymphatic system may be working fine, but there is simply too much fluid for the lymphatic system to keep up. We recognize this overabundance of fluid between the cells as a phenomenon we call swelling.
It is the job of the lymphatic system (pictured here in green) is to remove this fluid. However, Chronic Venous Insufficiency can produce more fluid than the lymphatic system can take up. This is similar to too much traffic trying to all take the freeway home at 5:00 PM. There are more cars than there is space on the road.
Although the cause of swelling related to CVI is not lymphatic in origin, Lymphatic Therapy reduces the swelling in the legs by painlessly removing the fluid caused by the backup of blood in the venous system.
Lymphatic drainage can significantly improve and often eliminate the symptoms (like venous ulcers) of CVI when performed regularly. It does this by improving lymphatic flow which reduces stagnation of fluid in the tissues.
Compression stockings for long-term wear are a great adjunct therapy to improve symptoms of CVI.
You can be fitted for appropriate stockings at Pain & Swelling Solutions.
Many people object to wearing compression stockings because they think that they are all ugly, but there is a surprisingly wide array of styles and colors available. There are many samples for you to see and touch when you come in for your appointment.
Also common among people with Chronic Venous Insufficiency is a condition known as Deep Vein Thrombosis, or DVT.
If you suspect you have a DVT you should seek immediate medical care. Signs of a DVT are: sudden swelling in the leg, pain or tenderness in the leg, warm skin on your leg, red or discolored skin on your leg, and veins that are swollen, tender, and/or hard to the touch.
If you have been told by your physician that your DVT is stable, your doctor likely prescribed compression stockings. Pain & Swelling Solutions can help you find the right stockings for you.
Note that Lymphatic Drainage is not advised for someone with a DVT.