Chronic Venous Insufficiency Treatments: From Self-Care to Procedures

Chronic venous insufficiency treatments at a glance

Chronic venous insufficiency (CVI) happens when faulty valves let blood leak backwards in the leg veins. If you are new to the condition, start with our guide to chronic venous insufficiency. This page explains the chronic venous insufficiency treatments available and how doctors choose between them.

Treatment generally follows a stepwise path:

1. Self-care to ease symptoms and slow progression
2. Compression to support the veins from outside
3. Procedures to close or remove the leaking veins, when needed
4. Skin and ulcer care if the skin has been affected

Many people never need to go beyond steps one and two. Others benefit most from treating the vein itself.

Step 1: Everyday self-care

Food and weight can play a supporting role too; see our guide to diet for vein health.

These measures will not repair valves, but they help the calf muscle pump work better and reduce swelling. They are the most common venous insufficiency remedies that actually have support behind them.

• Walk regularly. Calf muscle movement is the natural pump for your leg veins. Short, frequent walks beat one long session.
• Move through long sitting or standing. Flex your ankles, rise onto your toes and change position often.
• Raise your legs. Resting with your feet above hip level for short periods helps fluid drain.
• Manage your weight. Less weight means less pressure in the leg veins.
• Look after your skin. Moisturise dry skin and treat cuts promptly.

For more on lifestyle habits, see how to prevent varicose veins.

Step 2: Compression

Graduated compression stockings are tighter at the ankle and looser higher up, which helps push blood upwards. The ESVS 2022 guidelines support compression for relieving symptoms and swelling in chronic venous disease, and it is an important part of treating venous ulcers. Compression does not treat the underlying leaking vein, and it only works while you wear it. Read our compression stockings guide for how they work, strengths and lengths, and fit.

Step 3: Chronic venous insufficiency medical procedures

When a duplex ultrasound shows reflux that is causing symptoms or skin changes, a procedure to treat the leaking vein is usually the most effective option. NICE guidance (CG168) advises referring people with symptomatic varicose veins or skin changes to a vascular service and offering endothermal ablation as the first-line procedure where suitable.

Common approaches include:

• Endothermal ablation (radiofrequency or laser): heat closes the faulty vein from the inside, usually under local anaesthetic.
• Non-thermal closure (such as medical adhesive or mechanochemical ablation): closes the vein without heat.
• Foam sclerotherapy: a foam solution injected into the vein causes it to close. It is often used for smaller veins or alongside other treatments.
• Surgery (high ligation and stripping, or phlebectomy): now used less often, but still helpful in selected cases.

Most modern procedures are done as day cases and many people return to light activity quickly. Our varicose vein treatments compared page sets each procedure side by side, so we won’t repeat that table here, and recovery after treatment explains what to expect afterwards.

What is the best treatment for venous insufficiency?

There is no single best option. A vein specialist will consider:

• Which veins are leaking. The duplex ultrasound maps this precisely.
• How severe your symptoms are, and whether the skin has changed.
• The size and shape of the vein, which affects which procedure is suitable.
• Your general health, medications and preferences.
• Practical factors such as recovery time and cost.

If you have only mild symptoms, careful self-care and compression may be entirely reasonable. If you have skin changes or an ulcer, treating the vein tends to give the best chance of healing and of keeping the problem from returning.

Can you reverse venous insufficiency?

Not completely. Valves cannot be rebuilt, so a leaking vein will not heal by itself. What you can often reverse or improve is the effect: aching, swelling and even skin changes can settle when pressure in the leg falls. Treating the vein, wearing compression where advised and staying active all contribute. Regular follow-up matters, because new veins can occasionally start to leak later.

Venous ulcers

An ulcer near the ankle needs specialist assessment. Care usually includes compression bandaging and treating the underlying reflux. Trial evidence suggests that treating the leaking vein alongside compression can lower the chance of an ulcer coming back.

Costs in Singapore

Cost depends on the procedure, hospital or clinic and whether MediSave or insurance applies. Our guide to varicose vein treatment cost in Singapore covers the main points.

What to expect from an assessment

Before any treatment plan, a clinician will usually:

1. Take a history, including family history, previous clots, pregnancies and how symptoms affect daily life.
2. Examine your legs while you are standing, looking at veins, swelling and skin.
3. Arrange a duplex ultrasound, which maps the leaking veins and checks that the deep veins are healthy.
4. Discuss options and trade-offs, including what happens if you choose to wait.

Questions worth asking include how long recovery takes, what the risks are, how likely the problem is to come back, and what follow-up you will need. Good care is shared decision-making, not a one-size-fits-all package.

When to see a doctor

See your GP or a vein specialist if:

• Swelling, heaviness or aching is part of most days
• The skin near your ankle is darkening, itchy or hardening
• You have a sore on your lower leg that is not healing
• A vein has bled
• Self-care and compression are not enough

To find out where you stand, try the vein symptom check or learn how to find a vein specialist.

This article is general information, not personal medical advice. Please speak to a doctor about your own symptoms. How we create our content.