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Living with Chronic Venous Disease

You can find all the necessary information to understand Chronic Venous Disease (CVD), its global impact, its causes and consequences, and how to get Chronic Venous Disease (CVD) under control.

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Chronic Venous Disease

Heavy, painful legs

Legs that feel heavy, painful and swollen can be a result of a build up of fluid in the legs due to the blood not circulating as well as it should. This increased fluid leads to the symptoms of Chronic Venous Insufficiency (CVI), a condition affecting leg vein health that worsens over time.¹

What is poor blood circulation

Venous valve

Blood flow

Veins with normal reflux

Healthy veins

Healthy veins have small valves which prevent blood flowing backwards.

Venous valve

Blood flow

Veins with normal reflux

Unhealthy veins

When the internal walls of the veins are damaged, and these valves don’t work as they should, blood can flow back into the veins, resulting in pooling in the lower leg and leading to uncomfortable symptoms that can worsen over time.

Symptoms of poor blood circulation

A range of signs and symptoms can point to poor blood flow in the legs. If you’ve been experiencing any of the following symptoms in your legs or ankles you should seek treatment as they can worsen over time.^1,2

Heavy, painful or swollen Legs

Tired Legs

Cramping or Leg pain

Spider or Varicose veins

Looks familiar?

If you regularly suffer from at least one of these symptoms, start the self-assessment quiz and use your result to help guide your next steps.

Treat Your Symptoms Early

Heavy, painful legs and swelling can be early symptoms of Chronic Venous Insufficiency. Left untreated, these symptoms can increase in severity, leading to spider veins, varicose veins, and leg ulcers. The different stages of Chronic Venous Disease are described as grades C0s*-C6 depending on the severity of the symptoms as shown here:

Stage 0

Heavy, Painful Legs

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Stage 0

The first stage, with no visible signs of venous disease. However, damage may already be starting to accumulate inside the vein. This leads to venous reflux and is why you should start treating, even if your only symptoms are heavy and painful legs.

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Stage 1

Spider/Reticular Veins

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Stage 1

Ignoring initial symptoms can cause the condition to worsen, leading to broken blood vessels or “spider veins” and visible veins. They aren’t usually painful but are an important indicator of leg vein problems. It’s important not to ignore this early sign as the condition can rapidly progress.

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Stage 2

Visible varicose veins

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Stage 2

Left untreated, stage 1 turns to stage 2 with the veins becoming unusually dilated, stretched out and sinuous. These obvious, bulging veins on the legs and ankles are a clear sign of chronic venous insufficiency.

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Stage 3

Swelling of the ankle and leg

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Stage 3

Edema (swelling) may appear in stage 3 caused by increased pressure and leakage as a result of further deterioration of the venous walls and valves.

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Stage 4

Skin changes

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Stage 4

Continued poor circulation can lead to stage 4, characterized by darkening of the skin around your ankles (hyperpigmentation), redness, dryness, itchiness (venous eczema), hardening of soft tissues and the development of whitish patches.

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Stage 5

Healed ulcers

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Stage 5

Stage 5 is defined by the presence of open but healed areas of skin called ulcers. These can be painful and affect your quality of life, making it difficult to move around.

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Stage 6

Active ulcers

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Stage 6

If you reach stage 6, you will have open wounds called ulcers on your legs. Internally at this stage there is more deterioration in circulation and increased leakage in the capillaries.

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Important

Only a doctor can advise you regarding your diagnosis and treatment.

*s: symptomatic

By recognising the symptoms and taking action, you can significantly reduce the likelihood of your condition progressing and lessen the impact on your day-to-day life.

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Factors affecting blood circulation

There are several key risk factors for Chronic Venous Insufficiency (CVI), some of which may be beyond your control, but others you can take steps to modify²

Women are typically more at risk, and a family history, as well as simply growing older can increase your chances of developing symptoms.

Age

Gender

Heredity

Pregnancy

Height

Unbalanced Diet

Lifestyle factors you can take steps to negate, such as being overweight and inactive, can also increase your risk of developing problems with your veins. Those who stand or sit as part of their occupations, such as nurses, teachers and those in the service industry, are particularly at risk.

References

Guidelines according to scientific evidence. Part I. Int Angiol. 2018;37(3):181-254.1 Bergan JJ et al. N Engl J Med. 2006;355:488-4981.

Adapted from Nicolaides A, Kakkos S, Baekgaard N, et al. Management of chronic venous disorders of the lower limbs.

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The content is not intended to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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Last modified date: 6/30/2023

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