What stages are there?
According to Widmer, chronic venous insufficiency is divided into three stages. The classification is based on the patient’s symptoms. In the first stage reversible water retention occurs.
This means that the water retention, which manifests itself in the form of swelling of the legs, varies depending on the ambient temperature and time of day, for example, and sometimes disappears completely. In addition, some dark blue veins on the side of the foot become visible in the first stage. In the second stage, the water accumulation in the legs remains permanently and the subcutaneous fatty tissue hardens.
Furthermore, veins can become inflamed due to the irritation. This causes the leg to swell further, become red and warm. The skin may feel dry and tense.
In addition, small veins can become inflamed and lead to scars on the skin surface. These then appear as white spots, for example on the back of the foot. In addition, yellowish to brown spots appear on the skin, which are probably caused by deposits of blood decomposition products.
In the third and most serious stage, the damage to the legs is already so severe that ulcers appear especially on the lower legs (leg ulcers). This can lead to a so-called open leg. Inform yourself about the therapy and prognosis of the open leg.
Accompanying symptoms of chronic venous insufficiency
The amount of blood accumulated in the leg veins also flows into the smaller side branches of the veins, which also expand. This is how so-called broom tears are initially created. In them you can see the sacked blood in the small vessels and they shine through the skin like thin spider webs.
The accumulated blood in the somewhat larger veins forms protruding varicose veins. If the chronic venous insufficiency progresses further, some accompanying symptoms appear. These are caused by the blood accumulating in the leg veins.
Consequently, the legs become thick, heavy and tired more easily. Unpleasant sensations such as a feeling of tension, itching or pain in the form of calf cramps may occur. The tension in the veins also causes fluid to leak from the vessels and accumulate in the tissue of the lower leg.
These water accumulations are usually found at the ankles. On warm days, the veins expand even further and more blood can collect in them. This can also worsen the symptoms and the pain.
If the affected person is standing or sitting, the blood flows back to the heart less easily than when lying down. Therefore, the symptoms usually worsen during the day and reach their pain maximum in the evening. In contrast, the pain improves quickly when the legs are elevated.
Find out which other diseases can cause pain in the calf. Water retention in the tissue is called oedema. In chronic venous insufficiency, large quantities of blood accumulate in the leg veins.
This creates a very high pressure in the vessels and they dilate. However, if the blood accumulation worsens, the pressure rises steadily. This causes fluid to leak from the veins and collect in the surrounding tissue.
These water retention occurs initially at the ankles, as the fluid is pulled downwards by gravity. In the course of the disease, the edema can be distributed over the entire lower leg. Depending on the stage of chronic venous insufficiency, the edema is of varying severity and occurs repeatedly or permanently.
