Venous diseases

A venous disorder can have many triggers

Venous diseases - Venous diseases

What is a venous disorder?

Venous disorder is a common disease. Signs of venous diseases can be changes in the legs that are initially only cosmetically noticeable but do not cause any discomfort, such as spider veins. If left untreated, this can lead to serious diseases. If varicose veins develop, medical experts speak of varicose vein ailment or varicosis.

Many men and women in Germany suffer from chronic venous disorders. There is often a genetic predisposition. However, factors such as predominantly standing or sitting activities, overweight and too little exercise also play a role.

Heavy, tired legs, a tingling sensation or swollen ankles can indicate vein weakness. But: Those that correctly interpret the symptoms and take timely action can effectively counteract vein changes.

The venous system

The venous system - The venous system


While the arteries transport blood from the heart to the body, the veins transport the oxygen-deficient blood back to the heart – against gravity. This function is supported by the so-called muscle pump in the leg muscles and the venous valves. Like a valve, these prevent the blood from flowing back down the leg. If this system begins to fail, the blood pools in the legs. We develop spider veins, varicose veins, venous inflammation and, in very advanced stages, venous leg ulcers.

Venous diseases: Different characteristics

Chronic venous diseases:

Spider veins:
These are dilated veins, which are small but clearly visible veins in the uppermost layer of the skin.

Varicose veins:
Varicose veins are dilated superficial leg veins that appear as bluish, twisted protrusions under the skin.

Vein weakness:
Chronic venous insufficiency (CVI) is a clinical condition due to a permanently impaired venous function. The veins on the legs are particularly affected. Typical signs of CVI may be swelling and skin discolouration.

Acute venous diseases:

Vein inflammation:
Phlebitis is often associated with varicose veins in the leg veins. It manifests itself through marked redness, swelling, a strong feeling of warmth and severe pain along the vein.

Deep leg vein thrombosis occurs when a blood clot (thrombus) blocks a deep leg vein, so that little or no blood can flow through the vessel. Thrombosis can manifest itself in swelling, pain and reddish or bluish discolouration of the skin. However, in many cases, thrombosis does not cause any symptoms at the beginning, which can promote secondary diseases.

Causes of venous problems

If the function of the venous valves decreases, for example, due to old age or hormones (pregnancy), then the blood flows back into the veins and settles there. The vein wall relaxes and dilates: This leads to spider veins, varicose veins and – in the highly advanced stage – a lower leg ulcer (ulcerated leg).

Risk factors

Experts distinguish between factors that cannot be influenced and factors that can be influenced:

Non-influenceable factors (e.g.):

  • Advanced age
  • Genetic predisposition
  • Gender
    (Women are more often affected than men)
  • Hormones
    (e.g. during pregnancy)

Influenceable factors (among others):

  • Lack of exercise
    (e.g. in standing or sedentary occupations)
  • Overweight
  • Alcohol consumption
  • Excessive heat
  • Tight clothing and high heels

Symptoms and signs – how to recognise venous diseases?

The first signs are usually be felt long before varicose veins or other changes become visible: Feelings of tension and heaviness, tired, tingling or aching legs – especially in the evening. In addition, swelling may also occur due to water retention. This leads to so-called “thick legs” or “swollen ankles".

If these signs occur, those affected should see a doctor so that the doctor can initiate early treatment.

Stages of chronic venous disease – the CEAP classification

Doctors define the severity of chronic venous diseases using so-called CEAP classification1 from C0 (no signs) to C6 (severest form):


C 0
C 1
C 2
C 3

C 4a
C 4b
C 5
C 6 


No visible or palpable signs of venous disease
Telangiectasies or reticular veins
Varicose veins without clinical signs of chronic venous insufficiency
Varicose veins with oedema
Varicose veins with trophic skin changes divided into:
Pigmentation or eczema
Lipodermatosclerosis or atrophie blanche
Varicose veins with healed venous ulcer
Varicose veins with an active venous ulcer

A vein disorder should not be underestimated. Varicose veins are more than just a question of aesthetics: If left untreated, they can lead to serious diseases. Adequate therapy can alleviate symptoms and possibly slow down the progression of the disease.

Prevention of venous disorders: You can do it yourself

"Better to walk and lie down than sit and stand.” This is the rule of thumb of the German Veins Registered Society (Deutschen Venen-Liga e.V.) Movement keeps the veins elastic and healthy. The alternating tension and relaxation of the leg muscles really get the blood flow going. Targeted vein gymnastics supports the veins. 

Hot/cold showers are also a relief for your legs.

Vein patients should, if possible, avoid or at least alter the “influencing factors” described above so that they can have a positive influence on the therapy: a healthy diet, an acceptable weight, sufficient exercise (for example walking, swimming, cycling) and moderate alcohol consumption are good starting points. 

Replace your high heels more often with flat shoes: On high heels, the foot only exerts very limited muscle activity, so that the muscle pressure on the venous system decreases. The foot can roll better with flat shoes, which in turn activates the calf muscle pump. 

Treatment of chronic venous disease

A venous disorder is not curable, but is very treatable. There are numerous treatment options even in advanced clinical conditions. Talk to your doctor. 

Your GP may refer you to a specialist for venous diseases (phlebologist). He or she will make a diagnosis through a detailed examination of your state of health and your medical history (anamnesis) as well as through visual and physical examinations (inspection and palpation). Doctors are happy to use further imaging methods such as ultrasound. The doctor will initiate appropriate therapy measures depending on the degree of severity and patient-individual criteria.  What’s more: The examination is painless and risk-free!

The most important therapy options include compression therapy and invasive surgery:

  • Wearing medical compression stockings on a regular basis promotes vein function, relieves strain on the legs and relieves discomfort. Compression stockings prevent the blood from settling into the legs and support the return transport to the heart with a gradual pressure distribution that decreases from the ankle upwards. 
  • There are different – sometimes minimally invasive – procedures for the removal of varicose veins. The best known are vein stripping and sclerotherapy. Afterwards, medical compression stockings should be worn consistently.

So start wearing medical compression stockings regularly. The external pressure of the stocking is applied to the muscles. At rest, the muscles are relaxed. During movement, however, the muscles become tense, the veins between the muscles are compressed, and the venous valves close better. As a result, the blood is purposefully pumped to the heart: This relieves discomforts such as pain, swelling and feelings of tightness. Medical supply stores offer very fashionable models in many colours and designs. They gently shape the silhouette and visually conceal vein disorders and discolouration of the legs. 

medi products for venous diseases

Compression stockings offer high wearing comfort for men and women thanks to the breathable and elastic material: Modern medical compression stockings are optically indistinguishable from classic fine stockings or knee socks for men, but have the additional vein-supporting function.

Find out more information about the compression stockings from medi here.

Health personnel will make the diagnosis and can prescribe compression stockings, e.g. from medi if necessary.

Your medical retailer will fit them individually for you.


1 Rabe, Eberhard; Gerlach, Horst E. (2005): Praktische Phlebologie. 2. überarb. A. Stuttgart: Georg Thieme Verlag.

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