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Chronic Venous Insufficiency (CVI)

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What is chronic venous insufficiency (CVI)?

Chronic venous insufficiency (CVI) is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return to the heart from the legs. CVI causes blood to “pool” or collect in these veins, and this pooling is called stasis.

What causes CVI?

Veins return blood to the heart from all the body’s organs. To reach the heart, the blood needs to flow upward from the veins in the legs. Calf muscles and the muscles in the feet need to contract with each step to squeeze the veins and push the blood upward. To keep the blood flowing up, and not back down, the veins contain one-way valves.

Chronic venous insufficiency occurs when these valves become damaged, allowing the blood to leak backward. Valve damage may occur as the result of aging, extended sitting or standing, as a complication of blood clots, as a result of pregnancy, or for unknown reasons. When the veins and valves are weakened to the point where it is difficult for the blood to flow up to the heart, blood pressure in the veins stays elevated for long periods of time, leading to CVI and swelling and discomfort in the lower leg.

Who is affected by chronic venous insufficiency?

An estimated 40 percent of people in the United States have CVI. It occurs more frequently in people over age 50, and more often in women than in men.

What are the symptoms of CVI?

  • Swelling in the lower legs and ankles, especially after extended periods of standing

  • Aching or tiredness in the legs

  • New varicose veins

  • Leathery-looking skin on the legs

  • Flaking or itching skin on the legs or feet

  • Stasis ulcers (or venous stasis ulcers)

How is CVI treated?

CVI can be managed by a combination of treatments and therapies done in coordination with your Physical Therapist and doctor. We provide specialty treatments including:


  • lower extremity massage to improve circulatory return

  • custom fitting for compression garments

  • education on self massage techniques and skin care

  • exercises specifically designed to improve blood circulation through the lower extremities

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