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Venous Diseases

Venous Diseases

Venous diseases

What are venous diseases? 

Veins in our legs carry blood back to our hearts. They have one-way valves that keep bleed from flowing backwards. If you have venous disease, the valves won’t work as they should, and some blood may go back down the legs. If veins cannot operate effectively, blood will pool in the legs, and various forms of venous disease can develop.
Chronic venous diseases are widespread. The predisposition is often genetically programmed, but factors such as standing or sitting a great deal at work, obesity and lack of physical exercise can also play a role. Tired and heavy legs, pins and needles or swollen ankles can all be signs of venous insufficiency. Preventative measures can be taken by interpreting venous insufficiency changes early. 

Examples of venous diseases

The venous system

While the arteries transport blood from the heart to the body, the veins transport the oxygen-deficient blood back to the heart – against gravity. This function is supported by the so-called muscle pump in the leg muscles and the venous valves. Like a valve, these prevent the blood from flowing back down the leg. If this system begins to fail, the blood pools in the legs. We can develop spider veins, varicose veins, venous inflammation and, in very advanced stages, venous leg ulcers, as a result.

Signs and symptoms

The first changes in your leg veins have normally already started long before you discover varicose veins or other visible signs. Tired or itchy legs, swollen ankles in the evening, pins and needles or pain in the legs are the first signals of changes in the veins. The so-called “warning veins”, a circle of distended veins at the ankle, is an important early sign to be aware of.
These are followed later by swelling due to the accumulation of water, so-called "thick legs". Consult a phlebologist so he/she can choose the best treatment that is most suited for you. Incidentally, the examination is completely painless and presents no risk at all.

The CEAP classification system 

(Rabe, Eberhard; Gerlach, Horst E. (2005): Praktische Phlebologie. 2nd revised version. A. Stuttgart: Georg Thieme Verlag.)

Stage   Changes
C 0 No visible or palpable signs of venous disease
C 1 Spider veins, telangiectasies, or reticular veins
C 2 Visible or palpable varicosis (branches and saphenous veins); possibly varicosis in pregnancy
C 3 Venous edema
C 4 Changes to the skin and the subcutaneous tissue in addition to CVD, divided into 2 subclasses:

C 4a 

Pigmentation or eczema

C 4b 

Atrophie blanche, dermatosclerosis


Resolved venous crural ulcer
C 6  Florid venous crural ulcers

Risk factors

Venous insufficiency is often genetic. But, other factors such as basic connective tissue laxity, pregnancies and hormonal changes can create venous disorders. Alcohol, which relaxes blood vessels, can also have an effect, as can obesity and persistent digestive problems. Habits such as standing or sitting a great deal and a lack of physical exercise are also factors in developing a venous disease.


Plenty of physical exercise and specific vein exercises keep your veins healthy and elastic. The alternating contraction and relaxation of the muscles in the legs really keep your blood on the move. 
If you are diagnosed with venous disease, you should start wearing compression garments regularly. This way, you will also prevent spider veins and varicose veins from occurring. In many cases, garments in the lower compression classes will suffice. Durable medical equipment retailers often sell trendy varieties that don't look like compression stockings at all.
In addition, it’s best to leave your high heels in the closet more often and wear flat shoes. In high heels, the muscles in the feet are fairly inactive and the pressure the muscles exert on the venous system is weaker. In flat shoes, in contrast, the foot can roll over easily, which, in turn, activates the calf muscle pump.

How can venous diseases be treated?

Venous diseases are not curable, but they do respond well to treatment. There are many treatment methods, even for advanced clinical pictures. The most important of these are compression treatment and vein surgery.

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