What Causes Venous Stasis to Develop?
Keeping it simple, keeping legs in a bent position, lying down in a bed too long and structural changes to the venous system over time cause blood to pool in the veins of the lower extremities. Long car rides, flights or a long hospitalization can cause venous stasis. When you are on a long flight or car ride, your legs remain bent for a long period of time. Sitting in these positions, slow the blood down within the veins. Another way venous stasis forms is when valves inside the veins function poorly. The damaged veins struggle to pump blood back up toward the heart, causing blood flow to slow and pool in the extremities. Increasing fluid in a space-limited container, like your legs, causes swelling (edema). There are other ways a person can develop edema, like from a blood clot or from long periods of standing or sitting down.
Swelling and Venous Hypertension
Prolonged lower-extremity edema can increase the pressure and tension inside of the vein. Venous hypertension damages the inside lining of the vessel wall, which increases the vessel wall’s permeability and allows for fluids and small molecules to flow in and out of the vein. The lymphatic system is responsible for removing this fluid, but is unable to compensate for the increased inflow of fluid.
Risks of Venous Stasis
It is hard for your veins to pump blood back up toward your heart when sitting or standing for long periods of time. When blood moves slowly through your veins, the blood can form clumps or a blood clot within the vessel and block blood flow. Prolonged periods of inactivity, like taking a 5-hour flight, can increase your risk of developing a blood clot. If you sit or stand for long periods or travel a lot for your job, it is key that you get up and move at least once an hour for 15-minutes to decrease your risk of developing a blood clot. If you’re unable to leave your desk or work station, exercise your lower-extremities while sitting down at your desk! Bring a footrest to work and use it to elevate your feet to help reduce swelling! Split your lunch break in half; taking 15 minutes to eat and the remaining 15 minutes to go for a brisk walk. Whatever it is, look for a safe activity that gets you up and moving and does not ruffle any feathers at work.
Venous stasis and leg edema increase the skin’s vulnerability to ulcerate and allow bacterial agents easy entry. Stasis dermatitis is often a sign that the skin is fragile and susceptible to breakdown. Lipodermatosclerosis is a medical term that describes some of the skin changes that typically accompany venous stasis dermatitis and is often a sign of progression of venous disease.
Venous stasis at times can progress to a more serious condition—venous stasis ulcers. Stasis ulcers are open sores on the skin that are extremely tender to the touch. Stasis ulcers are tough to manage as poor blood circulation slows wound healing, and the proximity of ulcers to the feet, ankles, and legs increases the exposure to bacteria and possible infection.
Signs and Symptoms of Venous Stasis
Edema in your feet, ankles, and legs is generally the earliest sign and symptom of venous stasis. Edema or swelling can also be thought of as water retention. Generally, the venous and lymphatic systems work together to remove excess water and molecules from your tissues. However, venous stasis affects both systems, and thus, your veins are unable to effectively remove excess water from your feet and legs. Edema usually does not cause pain, but severe swelling can overstretch the skin and cause discomfort. Some people with venous stasis may experience pain.
Edema may also cause some people to experience the following feelings:
- Fatigue and exhaustion
- Achiness in the legs
What to Expect During the Exam
Typically, your health care provider will examine your skin’s appearance for signs and symptoms of venous insufficiency such as varicose veins, edema, and inflammation. Your provider may ask about your family history. For example, whether your mother or father have varicose veins or spider veins and if they received any treatment for them. It’s quite common for providers to use an ultrasound to examine how fast or slow your blood is moving, to provide a map of your veins, and to evaluate the overall health of your venous system. There are other tests that your physician or nurse practitioner may perform, as there are other medical conditions and medications that can also cause lower-extremity edema. Congestive heart failure, chronic kidney disease, deep vein thrombosis (blood clot) and certain medications like chemotherapeutics can also cause venous stasis and swelling.
If you are experiencing the following signs and symptoms, schedule an appointment to see your health care provider as soon as possible.
- Itchy and scratchy legs
- Skin color and texture changes to your legs
- Swelling in your feet and legs
- Bluish veins bulging just underneath your skin’s surface
- Swollen, twisted, red or purple veins closely located to the skin’s surface
Venous Stasis Care and Management
Conservative management with compression stockings is the cornerstone of venous stasis treatment. If you are taking a flight or long car ride you should consider wearing compression stockings. Gradient compression stockings promote forward blood flow to the heart and enhance wound healing. So, if you are someone with varicose veins, compression stockings can help prevent further progression of vein disease; and if you are someone with stasis ulcers, compression hosiery can assist with healing. Another cost-effective, traditional method to treat sluggish blood flow is to get up and move around every 30 minutes or so. Putting it simply, rest reduces the amount of strain placed on your feet and legs, and elevation helps circulation. It is important to mention that not all vein hosiery is equally made and some non-gradient compression ACE bandages can actually worsen venous stasis. Reach out to a phlebologist (vein specialist), as they can help you select the right compression stocking for your venous stasis treatment.
Minimally Invasive Vein Treatment
Sometimes minimally invasive vein therapy is the only effective method to manage and care for damaged valves within the leg veins. If you are considering such treatment, consult with a vein specialist as they can provide you with the most up-to-date information in their field to help you find the treatment your veins need.
Medically reviewed by Dr. Susanne Woloson on 5-01-2020.
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