Chronic Venous Insufficiency

drawing showing the difference between Chronic Venous Insufficiency - spider veins and varicose veins in the leg.
Varicose veins in the human body

Chronic Venous Insufficiency (CVI) is a condition that affects 25-40 percent of women and 10-15 percent of men, respectively. It is commonly known as spider veins or varicose veins. CVI is a disease of the lower limbs where the valves of the Saphenous vein stop working, which leads to the backward flow and subsequent pooling of blood in the lower extremities. The blood in turn has no where to go and will increase the venous blood pressure; preventing new oxygenated blood from circulating back. The symptoms that are experienced are: lower leg edema, changes to skin and nails, muscle cramping, pins and needles, muscle fatigue, pain and ulceration.


The one-way valve mechanisms are located within the walls of the veins. They allow blood to be directed towards the heart by opening when blood flow is pushed centrally and close to prevent blood from moving peripherally (see images). Blood needs to return to the heart and lungs for gas exchange and recirculation, however, in Chronic Venous Insufficiency the veins are distended and valves can no longer close completely. Venous statis (pooling) leads to fibrotic changes that damage the vein’s structure and function creating a negative feedback loop. Overtime, body tissues in the lower limbs become hypoxic and will start to break down, leading to ulcers.

medical diagram of valve mechanism in veins showing blood flow.
Valve mechanism

Chronic Venous Insufficiency Management

Prevention is key, early diagnosis and treatment can help prevent disease progression.

Compression stockings are the gold standard for treatment of CVI. They are purchased over-the-counter. Stronger grade stockings need to be medically prescribed.

Surgical options are available and can be discussed with a medical doctor.

Physiotherapy management focuses on early diagnosis, prevention, education, lifestyle modification, exercises and manual therapy. Our Physiotherapists will assess you and determine which course of treatment is appropriate for you.

We are evidence-based and result driven. Give our Winnipeg Physiotherapy clinic a call or book online to schedule your appointment!


Freepik 2022, Varicose Vein, digital image accessed November 28, 2022,

Freepik 2022, Varicose Vein, digital image accessed on November 28, 2022

Patel SK, Surowiec SM. Venous Insufficiency (last accessed 28.11.2022)

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