When the veins in your legs stop moving blood efficiently toward the heart, it can cause swelling, aching, heavy legs, and varicose veins. Dr. Abdullah, MD, DABVLM evaluates and treats chronic venous insufficiency at our Georgetown clinic.
Book Free ConsultationMedically reviewed by Dr. Abdullah, MD, DABVLM — board-certified in venous & lymphatic medicine (DABVLM).
Chronic venous insufficiency (CVI) is one of the most common — and most under-recognized — causes of leg discomfort in adults. Many people live with aching, heaviness, or swelling for years, assuming it is simply a normal part of aging. Often, it is a treatable vein problem. This page explains what CVI is, the symptoms it can cause, how it is diagnosed, and the treatment options available at Lone Star Vein Clinic in Georgetown, TX.
Healthy leg veins carry blood upward against gravity, back toward the heart. Small one-way valves inside the veins keep blood from flowing backward between beats. In chronic venous insufficiency, these valves no longer close properly, so some blood leaks backward and pools in the lower legs. This backward flow is called venous reflux, and the increased pressure it creates is what drives most of the symptoms of vein disease.
It is important to know that not every ache or swollen ankle is caused by CVI. Leg symptoms can have many explanations, which is why an accurate diagnosis — rather than assumption — matters. A vein evaluation helps determine whether your symptoms are venous in origin and, if so, how significant the reflux is.
Chronic venous insufficiency can cause a range of symptoms, and they often worsen after long periods of standing or sitting and improve with walking or leg elevation. Not everyone experiences all of them, and the visible severity of veins does not always match how a person feels. Symptoms that may be associated with venous insufficiency include:
Restless, uncomfortable legs at night are sometimes reported by patients with venous disease as well, though restless legs can also have non-venous causes. If your symptoms are persistent or affecting your daily life, an evaluation can clarify what is driving them.
CVI develops when the vein valves or vein walls in the legs weaken and allow reflux. Several factors can contribute to this, and often more than one is involved:
The core mechanism — valves that no longer prevent backward blood flow in the leg veins.
A tendency toward vein disease often runs in families.
Vein walls and valves can weaken gradually over time.
Increased blood volume and hormonal changes can affect leg veins.
Occupations that involve long hours on your feet or seated can contribute.
A previous deep vein thrombosis can damage valves and lead to reflux in some patients.
These are contributing factors rather than guarantees — many people with one or more of them never develop significant venous disease, and treatment is guided by symptoms and ultrasound findings rather than risk factors alone.
Varicose veins — the rope-like, bulging veins many people notice first — are one of the most visible signs of chronic venous insufficiency. They form when reflux raises pressure in the surface veins, causing them to enlarge and twist. But varicose veins are not the whole story: some patients have significant reflux and symptoms with only minor visible veins, while others have prominent veins with few symptoms. Treating the underlying reflux, when appropriate, is what addresses the root cause. You can learn more on our varicose vein treatment page, and about smaller surface veins on our spider vein treatment page.
Yes — when leg veins do not drain efficiently, fluid can accumulate in the lower legs and contribute to swelling, often more noticeable at the end of the day or after prolonged standing. That said, leg swelling is not always venous. Heart, kidney, thyroid, lymphatic, and medication-related causes can also produce swelling, and swelling in only one leg can occasionally signal a blood clot. Because the causes overlap, new or persistent leg swelling deserves a proper evaluation rather than a guess.
Diagnosing venous insufficiency starts with listening. Dr. Abdullah reviews your symptoms, medical history, and any prior vein treatment, then examines your legs. When the history and exam suggest venous disease, the key diagnostic test is a venous duplex ultrasound.
A venous duplex ultrasound is a painless, non-invasive scan that shows how blood moves through your leg veins and whether it is flowing backward (reflux). The findings — combined with your symptoms — help determine whether treatment may be appropriate and, if so, which veins are involved. Not every leg symptom requires a procedure, and the ultrasound helps avoid treating veins that are not actually the problem.
There is no one-size-fits-all treatment for chronic venous insufficiency. The right approach depends on your anatomy, symptoms, ultrasound findings, disease severity, any prior treatment, insurance requirements, and Dr. Abdullah's assessment. For many patients, care begins conservatively and only advances to a procedure when it is warranted.
For milder disease — or as a first step — symptoms are often managed without a procedure. Conservative measures may include medical-grade compression stockings, regular walking and calf-muscle activity, leg elevation, weight management where appropriate, and avoiding long periods of immobility. These measures can relieve symptoms and are frequently required by insurers before a procedure, but they do not reverse the underlying valve reflux.
A thin catheter uses controlled heat to close a diseased saphenous vein so blood reroutes to healthy veins. Learn more about radiofrequency ablation.
A medical adhesive seals the diseased vein closed — a non-thermal option that typically needs no tumescent anesthesia. Learn more about VenaSeal.
An FDA-approved injectable microfoam that can treat larger or twisting veins, including some that are difficult to reach with a catheter. Learn more about Varithena.
Foam medication is injected under ultrasound guidance to close deeper veins that are not visible at the surface. Learn more about our ultrasound-guided procedures.
Direct injection of a sclerosing solution is used mainly for smaller surface veins and spider veins. It is often a finishing step after the underlying reflux has been addressed. Learn more about sclerotherapy.
No single procedure is right for every patient, and no treatment is presented here as universally better than the others. Dr. Abdullah recommends an approach based on your individual ultrasound findings and clinical evaluation.
Does insurance cover CVI treatment? Treatment for symptomatic, medically necessary venous disease may be covered by Medicare and many commercial plans — depending on your plan, symptoms, ultrasound findings, and your insurer's medical-necessity criteria. We verify your specific benefits before any procedure. Insurance details → · Treatment cost →
It may be worth having your legs evaluated if you have persistent aching, heaviness, or swelling; varicose veins that are enlarging or becoming uncomfortable; recurrent swelling in the lower legs; skin discoloration or thickening near the ankle; or any open sore or wound that is slow to heal. Early evaluation gives you the most options and can help prevent progression. A consultation does not commit you to a procedure — it simply clarifies whether one is needed.
Lone Star Vein Clinic serves patients in Georgetown, Sun City, and the surrounding Central Texas communities. Sun City residents are just a short drive away.
Schedule a free consultation with Dr. Abdullah at our Georgetown, TX clinic. We'll evaluate your symptoms and explain your options — with no obligation.