Written by
michael cumming, m.d., M.B.A.

Venous insufficiency (VI) is a condition in which blood has difficult traveling from the extremities (usually the legs) back to the heart.  The movement of blood from the extremities to the heart relies on 2 components: an open conduit and an intact pump.  When any other components fails, blood stagnates in the extremity causing a variety of symptoms:


  • swelling of the legs or  ankles (edema)
  • leg pain with standing that gets better with leg elevation
  • leg aching, throbbing, or heaviness
  • itchy legs
  • weak legs
  • thickening and darkening of the skin on your legs or ankles
  • leg ulcers
  • varicose veins
  • restless legs syndrome


There is common misconception that if a patient does not have obvious varicose veins then they do not have significant VI.  This is incorrect and results in the under treatment of patients that have VI.


Varicose veins are a sign of VI.  The absence of varicose veins does not mean a patients does not have significant venous disease.


55 year old female with a non healing leg ulcer after skin biopsy

More Signs & Symptoms

Pelvic Venous IncompetencePelvic Venous Congestion: Needless Suffering

Pelvic congestion syndrome (PCS) is a condition that causes significant pain and discomfort for women.

ClaudicationExtertional Leg Pain

Leg pain when walking is common patient compliant. Evaluating patients for a cause is often a complex process.

Peripheral Arterial DiseaseClinical Evaluation of the Foot for Peripheral Arterial Disease

Peripheral arterial disease (PAD) and its more severe variant critical limb ischemia (CLI) can be notoriously difficult to diagnose.