• 20 June 2018
  • Dr. Obinna Nwobi

If your legs feel achy and sore pretty much all the time, you may have chronic venous insufficiency, also known as CVI. CVI is a chronic health condition in which the valves in your veins, usually your legs, don’t work properly. In healthy veins, blood is boosted up from your legs to your heart, with valves preventing it from flowing back down and away from your heart. When the valves are damaged, they don’t do their job of preventing blood from flowing back down, and the blood collects in your veins.

Over time, this pooled blood builds up and puts pressure on your vein walls, causing pain, swelling, cramps, and other health conditions such as varicose veins and leg ulcers. Anyone can get CVI, but certain people are more at risk.

Risk Factors for Chronic Venous Insufficiency

In general, CVI is more widespread in older people and women. It’s a common condition for adults, affecting about 40% of the U.S. population. Other risk factors include:

  • Pregnancy or multiple pregnancies
  • Sitting or standing for prolonged periods of time
  • A family history
  • Being overweight
  • Smoking
  • Having a deep vein thrombosis
  • Inactivity
  • History of varicose veins

Symptoms of Chronic Venous Insufficiency

Symptoms of CVI are mild at first, so people sometimes brush off those symptoms because they resemble other conditions. You may think your legs are achy and tired because of your day. But, if you suspect you have CVI, you shouldn’t ignore your symptoms or expect that they will go away. The longer you wait for treatment, the more severe your symptoms become. Common symptoms include:

  • Swelling in your lower legs and ankles
  • Achy legs
  • Tired legs
  • Itchiness
  • Dry skin
  • Varicose veins
  • An open sore or ulcer

CVI is associated with varicose veins, which are purplish, twisted, raised veins on your legs. They, too, are caused by damaged valves in your veins. If CVI is not treated, small blood vessels in your legs may burst because of the pressure. As a result, the ruptured blood vessel creates a reddish-brown hue on your skin and can lead to ulcers and open sores. These sores called venous stasis are difficult to heal and may become infected.

Diagnosing Chronic Venous Insufficiency

At Vein Health Clinics, vascular surgeon Dr. Obinna Nwobi takes a medical history and performs a physical exam. He may also conduct an imaging test called a Duplex ultrasound to look at blood flow and the quality of your vein structure.

Chronic Venous Insufficiency Treatment Options

Treatment options for CVI range from lifestyle modification and medications to lasers or surgery. It depends on the severity of your CVI symptoms. Treatment options include:

Lifestyle changes

These include countering the risks by avoiding standing and sitting for long periods of time, exercising regularly, and losing weight. Other lifestyle factors that help involve elevating your legs while sitting or standing, practicing good skincare, and wearing compression stockings.


Medications to treat CVI are aimed at getting the blood flowing through your veins, preventing blood clots, and healing the ulcers. Some medicines help manage the symptoms while others treat the underlying cause of CVI.

Noninvasive procedures/lasers

The two main noninvasive treatments are sclerotherapy and endovenous thermal ablation. Sclerotherapy involves an injection into the problem vein, causing it to collapse and fade. Endovenous thermal ablation is a high-frequency laser to target the problem vein with high heat in order to seal it off.

Surgical treatments

Surgery is reserved for the most severe cases. Ligation and vein stripping are the two main types that are often performed together.  In both cases, small incisions are made so that the surgeon can either tie off the vein (ligation) or remove it (stripping).

If your legs are feeling tired, achy, and swollen,  call Dr. Nwobi at Vein Health Clinics with offices in Oviedo and Winter Haven, Florida, or make an appointment online to learn more about CVI.

About The Author

Dr. Obinna Nwobi

Dr. Obinna Nwobi is a board certified vascular surgeon, who chose to practice in an underserved area in Florida. In a field that graduates only 100 new vascular surgeons a year, Dr. Nwobi is an exemplary vascular surgeon who worked for the Indian Health Services, Veterans Affairs Hospital, and large private and public hospitals.


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