Signs of Chronic Venous Disease

Did you know Medical Compression Stockings (MCS) can help relieve these common symptoms of Chronic Venous Disease (CVD)? MCS can also reduce your risk of these symptoms getting worse, as well as other, potentially life threatening complications of CVD.

Do you experience any of these common leg symptoms?

  • Tired, achy legs
  • Varicose veins
  • Spider veins
  • Heavy, swollen legs
  • Restless legs at night
  • Muscle cramps
  • Leg tingling
  • Skin discoloration
  • Thickening of skin tissue

Tired, Achy Legs

Leg discomfort, such as tired, achy and heavy feeling legs, are among the first symptoms of (CVD).

People often experience these signs towards the evening, especially after standing or sitting for prolonged periods of time. Leg discomfort caused by CVD generally resolves overnight or with leg elevation, however, it can become burdensome and often negatively impact a person’s quality of life.

Fortunately, the daily use of MCS, combined with intermittent movement, can reduce or totally prevent early symptoms of CVD.

Compression Dose – The compression recommendation for preventative measures is 15-20mmHg, however, 20-30mmHg can be considered during long distance travel or when standing or sitting for prolonged periods of time.

Symptoms Include:

  • Leg restlessness at night
  • Muscle cramps
  • Tingling
  • Itching

Heavy, Swollen Legs

Heavy, swollen legs are another early symptom of CVD, sometimes also referred to as evening edema.

People often experience heavy, swollen legs towards the evening, especially after standing or sitting for prolonged periods of time. Leg swelling caused by CVD generally resolves overnight or with leg elevation.

Compression Dose – Compression recommendation for mild swelling that develops gradually throughout the day is 15-20mmHg. However, 20-30mmHg may be beneficial for more moderate swelling, during long distance travel, or when standing/sitting for prolonged periods of time. Higher compression levels provide additional support for the legs. Typically, compression levels of 30-40mmHg require a physician prescription.

Symptoms Include:

  • Tired, achy legs
  • Leg fatigue
  • Leg restlessness at night
  • Muscle cramps
  • Tingling

Varicose Veins

Varicose veins often appear as twisted, enlarged or bulging veins, dark purple or blue in color.

It is important to note that one can experience symptoms without the outward appearance of varicose veins. If a person experiences one or more of the above symptoms, it is always recommended to get an assessment by a physician.

Varicose veins are generally managed through self-care measures first; this involves living a healthy lifestyle and daily use of MCS. If conditions do not improve, a physician may recommend one of many vein procedures. The use of MCS is a vital component pre and post vein procedure. They are proven to enhance post-operative side effects and improve clinical success and outcomes.

Compression Dose – Compression recommendation to manage varicose veins is 15-20mmHg or 20-30mmHg depending on severity. Post vein procedure the recommendation is 20-30mmHg or 30-40mmHg thigh high. There are contraindications to wearing a 30-40mmHg MCS. A person purchasing this dose should speak with their physician first and make sure it’s the right product for them.

Symptoms Include:

  • Achy, tired or heavy feeling in legs
  • Burning or throbbing
  • Muscle cramping
  • Swelling in lower leg
  • Pain that is worse after sitting or standing for a period of time
  • Pain that is worse towards the evening
  • Itching

Spider Veins

Spider veins appear as a network of thin, red, blue or purple lines on the surface of the skin. They often appear on the inside of the foot just below the ankle bone, where vein pressure can be higher. Spider veins are often a symptom of other problems deeper in the veins, so it is important to see a vein specialist for a full assessment rather than just improving the cosmetic appearance of spider veins.

Spider veins are primarily treated by the daily use of MCS. If they are painful, or for cosmetic reasons, a physician may recommend a treatment called sclerotherapy.

Compression Dose – For daily use to manage spider veins, 15-20mmHg is recommended, however, 20-30mmHg can be considered during long distance travel or when sitting/standing for prolonged periods of time. Post sclerotherapy, 20-30mmHg is recommended. Procedure outcomes are known to improve with direct compression on injection site. For example, if a person is being treated on the thigh, thigh length compression would be ideal.

Symptoms Include:

  • Swelling
  • Burning or throbbing
  • Leg cramping
  • Leg fatigue
  • Pain that is worse after sitting or standing for a period of time
  • Pain that is worse towards the evening

Skin Discoloration

Skin changes due to CVD often present as skin discoloration, known as hemosiderin staining. Lower legs may appear rusty or dark purple in color. This type of staining represents pressure so high in the venous system that red blood cells are forced out of the blood capillaries and into the skin tissues. The red blood cells then release iron deposits, called hemosiderin, which stain the skin. If left untreated, CVD may lead to skin breakdown, infection and chronic inflammation. This often results in the formation of a Venous Leg Ulcer (VLU).

Compression Dose – Generally, 30-40mmHg of compression pressure is recommended for more severe venous disease and is available via prescription by your physician. A full assessment by a vein specialist is recommended to determine the underlying causes of the vein problems and which corrective procedures may be right for you. If you are experiencing chronic symptoms, talk to your physician about your legs and request a referral to a vein specialist.

Symptoms Include:

  • Skin Discoloration
  • Visiable Iron Depositis

Skin Tissue Changes

Edema (swelling) is caused by excessive fluid trapped in the tissue of the body. Edema secondary to CVD slowly worsens throughout the day with prolonged sitting or standing and resolves overnight or with the legs elevated. Edema that persists is called chronic edema and is also referred to as lymphedema. Edema/lymphedema that persists in the tissues causes chronic inflammation that can change the way the skin looks and feels. While skin may feel flexible at first, it can progressively become thicker or firmer (fibrotic). This is a sign that the delicate lymphatic system is damaged and these areas of skin are more susceptible to infection.

Unresolved venous edema can lead to a more serious condition known as phlebolymphedema, a combination of venous hypertension and a failing of the lymphatic system. Once the lymphatic vessels are damaged, swelling generally does not resolve overnight. Usually, edema related to CVD does not include swelling of the foot. If swelling of the foot is present, it is usually caused by a compromised lymphatic system.

Compression Dose – For the best dose and type of compression garment, please speak with a healthcare professional.

Symptoms Include:

  • Swelling of the legs directly under your skin
  • Skin appearing shiny or stretched
  • When pressed for several seconds, skin will imprint (pitting edema)
  • Reddish or purple discoloration of the skin, usually between the knee and ankle
  • Swollen ankles with pooling of lymph fluid behind the ankle bones
  • Hamdan A. Management of varicose veins and venous insufficiency. Jama. 2012 Dec 26;308(24):2612-21.
  • https://www.mayoclinic.org/
  • Kaplan RM, Criqui MH, Denenberg JO, Bergan J, Fronek A. Quality of life in patients with chronic venous disease: San Diego population study. Journal of vascular surgery. 2003 May 1;37(5):1047-53.
  • Kern P, Ramelet AA, Wütschert R, Hayoz D. Compression after sclerotherapy for telangiectasias and reticular leg veins: a randomized controlled study. Journal of vascular surgery. 2007 Jun 1;45(6):1212-6.
  • Rabe E, Régnier C, Goron F, Salmat G, Pannier F. The prevalence, disease characteristics and treatment of chronic venous disease: an international web-based survey. Journal of Comparative Effectiveness Research. 2020 Sep(0).
  • Rabe, Eberhard, et al. “Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement.” Phlebology (2017): 0268355516689631
  • Agle CG, de Sá CK, Filho DS, de Medeiros Figueiredo MA. Evaluation of the efiectiveness of wearing compression stockings for prevention of occupational edema in hairdressers.
  • Bjork R, Ehmann S. STRIDE professional guide to compression garment selection for the lower extremity. Journal of wound care. 2019 Jun 1;28(Sup6a):1-44.
  • Hamdan A. Management of varicose veins and venous insufficiency. Jama. 2012 Dec 26;308(24):2612-21.
  • https://www.mayoclinic.org/
  • Kaplan RM, Criqui MH, Denenberg JO, Bergan J, Fronek A. Quality of life in patients with chronic venous disease: San Diego population study. Journal of vascular surgery. 2003 May 1;37(5):1047-53.
  • O’Meara S, Cullum N, Nelson EA, Dumville JC. Compression for venous leg ulcers. Cochrane database of systematic reviews. 2012(11).
  • Rabe E, Guex JJ, Puskas A, Scuderi A, Fernandez FQ. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. International angiology: a journal of the International Union of Angiology. 2012 Apr;31(2):105-15.
  • Rabe, Eberhard, et al. “Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement.” Phlebology (2017): 0268355516689631

Healthy legs with Medical Compression Stockings