Understanding how the veins of the legs work
Arteries and veins are the body's transportation system. They carry blood, with its vital cargo of oxygen and nutrients, to every part of the body. Arteries move blood from the heart, and veins bring it back to the heart.
The pumping of the heart helps push blood through the arteries. But on the return trip, this force is much weaker in the veins. What's more, blood flow in the veins of the lower body must move upwards, against gravity, pumped by leg muscles.
To keep blood in the veins flowing in the right direction, veins have one-way valves–like flaps–that open to let blood flow upwards, then shut to keep blood from draining back downwards toward the feet. When these valves weaken, the stage is set for Venous Insufficiency (commonly called poor circulation) and venous hypertension.
This is a chronic disease in which the valves of the legs are damaged, letting blood leak backwards toward the feet. The excess blood stretches the vein, causing it to widen abnormally (dilate). Finally, blood stagnates in the veins of the lower legs, increasing blood pressure in the legs, and causing chronic inflammation in the veins, skin changes and possibly ulcers.
When venous insufficiency goes untreated for a long time, blood continues to collect and pool in the veins. The pressure of the non-moving blood causes veins to swell, which, in turn, prevents the normal movement of blood carrying oxygen and nutrients to the tissues of the leg. The lack of essential nourishment to tissues can cause an open sore (ulcer) on the skin, usually right above the ankle or on the inside of the leg. Untreated ulcers can quickly become infected or even gangrenous.
The chance of developing venous insufficiency goes up with age, as well as a family history of varicose veins, a sedentary lifestyle, pregnancy or spending many hours on one's feet. It can also be caused by a partial blockage of the veins, for example, by a blood clot.
The common early symptom is chronically swollen ankles, however, the feet and calves may also swell. A person can also feel a dull aching, cramping, or feeling of heaviness in the legs and feet that gets worse after long periods of standing. Down the road, patches of brown discoloration as well as flaking or hardening of the skin can appear around the ankles. If untreated, venous ulcers may develop.
An imaging test called a duplex ultrasound reveals if there is structural damage to the veins.
Most common treatment is conservative management with leg elevation and compression stockings. There is no surgery to correct venous insufficiency.