Venous insufficiency is a condition that occurs when the valves in the blood vessels in your legs are not working optimally or there is an obstruction that impacts blood flow. This causes blood to not return to your heart from your legs as efficiently. People with venous insufficiency may experience swelling and tenderness in their lower legs, and may notice a dusky red appearance in this area, just above the ankles. Over time and in more severe cases people may develop ulcerations in the skin in the lower legs.
Diagnosis of Venous Insufficiency
Venous insufficiency can sometimes be diagnosed based on history and appearance but often it is diagnosed with a duplex ultrasound that looks at the flow of blood in the veins of your legs, and looks to see if the blood refluxes back through the valves in these blood vessels.
Differences between venous insufficiency and lipedema
Unlike lipedema, venous insufficiency does affect the feet and can cause pitting edema (lipedema alone is typically non-pitting). It can also be associated with discoloration of the lower legs or ankles and other skin changes.
How Does Venous Insufficiency Impact Lipedema?
Lipedema is not primarily a vascular disorder, but even though venous insufficiency is different from lipedema, it can sometimes cause similar symptoms and can occur at the same time as lipedema. Both lipedema and venous insufficiency involve edema in the legs, can cause pain, and both happen more often in women.
In one study, 86.2% of advanced stage lipedema patients also had venous insufficiency. One theory is that the progressive adipose accumulation and chronic inflammation from lipedema eventually affects venous function in some people. (1)
Clinical implications
A vascular evaluation is a critical diagnostic crossroads. For some, it reveals venous insufficiency as the primary driver of ‘lipedema-like’ symptoms; for others, a clear scan provides the definitive evidence needed to confirm a lipedema diagnosis. Regardless of the underlying cause, identifying a venous component allows for a more targeted treatment plan. By addressing vascular health early, patients can alleviate symptoms that mimic or exacerbate lipedema while proactively preventing long-term complications.
Sources
- Clinical Characteristics, Comorbidities, and Correlation With Advanced Lipedema Stages: A Retrospective Study From a Swiss Referral Centre. PloS One. 2024. Luta X, Buso G, Porceddu E, et al.
