10/31/2025
Chronic Venous Insufficiency (CVI): Why It Affects the Inside of the Lower Leg:
Chronic venous insufficiency (CVI) often appears on the inner (medial) side of the lower leg, between the foot and knee. This happens because of how the veins are structured and how blood drains from the leg. The main vein responsible for this drainage is the great saphenous vein (GSV), along with several perforating veins that connect the surface veins to the deeper ones.
When the valves in these veins become weak or damaged, they can no longer prevent blood from flowing backward. This causes blood pooling and increased pressure in the lower leg — a condition known as venous hypertension.
Over time, the increased pressure stretches the veins and allows fluid to leak into the surrounding tissue. This leads to swelling (edema), skin discoloration, and sometimes open sores or ulcers, most often on the inner side of the legwhere these veins are located.
The great saphenous vein runs along the inside of the leg from the ankle to the groin. It’s a key pathway for returning blood toward the heart. The perforating veins act as small bridges, connecting the superficial veins to the deep venous system. Under normal conditions, their valves keep blood flowing in one direction — upward. When these valves fail, blood flows backward, increasing pressure and causing the visible and painful signs of CVI.
While deeper vein problems, such as those caused by deep vein thrombosis (DVT), can also contribute, most CVI changes on the medial leg are related to superficial vein valve failure in the GSV and its perforators.
In summary:�CVI most often affects the inside of the lower leg because of how the veins are arranged. When the valves in these veins stop working properly, blood pools, pressure rises, and the skin and tissue begin to show signs of damage.
Prevention and Care Tips:
* Avoid standing or sitting for long periods.
* Elevate your legs when resting.
* Wear compression stockings as recommended.
* Keep skin moisturized and protect it from injury.
* Maintain a healthy weight and stay active to support circulation.
For More Information:
* Mayo Clinic - Chronic Venous Insufficiency: mayoclinic.org
* Cleveland Clinic - Venous Insufficiency Overview: clevelandclinic.org
* Johns Hopkins Medicine - Venous Insufficiency: hopkinsmedicine.org
