They tell you about varicose veins, they recommend varicose veins ablation or similar procedures to fix the problem. They probably tell you to wear compression stockings. Some may even advise you to exercise your calf pump, to walk every day. But what they almost always leave out is the slow, hidden progression of venous disease into something even more disruptive: lymphedema.
This isn’t just swelling. It’s stagnation. Fibrosis. Skin breakdown. And a lifetime of disfigurement, discomfort, social isolation, and relentless physical burden—if you’re lucky enough to even get a correct diagnosis.
Venous Disease: A Recap
Chronic Venous Insufficiency (CVI) starts when the valves in your leg veins fail, causing blood to pool instead of efficiently returning to the heart. This leads to pressure buildup, fluid leakage into surrounding tissues, and visible signs like leg swelling, heaviness, and skin changes.
Enter Lymphedema: When the Lymph System Gets Overwhelmed
If the pressure continues unchecked, the lymphatic system—which normally helps drain interstitial fluid and filter waste—gets overwhelmed. At first, you might not notice the shift. But over time, the lymph system breaks down under the load.
The lymphatic system is a critical complementary mechanism to the venous system. When overwhelmed by chronic venous insufficiency, lymphatic failure can occur, leading to a combined condition known as phlebolymphedema.
— Olszewski WL, Lymphatic Research and Biology (2003)
The result? Fluid becomes protein-rich and stagnant. This attracts inflammatory cells and triggers tissue fibrosis—the thick, woody skin texture that becomes irreversible.
This stage is sometimes called phlebolymphedema: Where chronic venous disease has overloaded and damaged the lymphatic system. It’s a hybrid monster, combining both vascular and lymphatic failures.
And it doesn’t just stay in the legs. The ripple effects can impair your immune response, increase systemic inflammation, and even affect glymphatic drainage—the brain’s own fluid-clearing system. As venous and lymphatic systems falter, toxins linger longer, and the burden on cognition and recovery grows.
Early Clues Most Miss
- Frequent swelling that doesn’t fully resolve overnight
- Skin that becomes firmer or starts to pit
- Recurrent cellulitis (infections)
- Increasing heaviness or discomfort in the legs
What You’re Not Being Told
Too many providers focus only on veins—or only on lymphatics—never connecting the two. Insurance often won’t cover treatments unless you fit into one box or the other. And by the time someone finally says “lymphedema,” the damage may already be permanent.
Early intervention is key—but only if someone recognizes what’s happening.
What You Can Do
- Don’t dismiss persistent swelling. Ask your provider about both venous and lymphatic causes.
- Insist on diagnostic imaging if your symptoms escalate—this includes duplex ultrasound and potentially lymphoscintigraphy.
- Learn manual lymph drainage techniques and consider compression strategies that support both systems (e.g., flat-knit garments).
- Watch for early skin changes, and treat them immediately.
- Consider a serious nutritional supplement program. Now. Investigating what else might help other than compression stockings and daily walks is worth your time and discussion with your health care provider or nutrition counselor: Address the endothelial cells, blood flow, and essential vitamins and nutrients to strengthen your circulatory systems and your cells.
- Investigate yoga. Swimming. Both of these can help you – on top of the daily walks.
- Don’t delay, this is serious and, should your lymph system begin to fail, it will dramatically impact your life.
The Vein Signal is here to shine a light on the blindspot: when venous disease isn’t just about veins—and the stakes go far beyond cosmetics.
If you’ve been told it’s “just swelling,” or worse, that it’s your fault—keep reading. Keep learning. And start fighting back.
References
- Olszewski WL. The Pathophysiology of Lymphedema. Lymphatic Research and Biology. 2003;1(1):43–52.
- Rabe E, Partsch H, Hafner J, et al. Indications for treatment of CVI. Phlebology. 2018;33(3):163–172.
- Mortimer PS, Rockson SG. New developments in clinical aspects of lymphatic disease. J Clin Invest. 2014;124(3):915–921.
- Warren AG, Brorson H, Borud LJ, Slavin SA. Lymphedema: A Comprehensive Review. Ann Plast Surg. 2007;59(4):464–472.
- Moffatt CJ, et al. The prevalence of lymphedema in chronic venous insufficiency. Phlebology. 2019;34(7):452–460.
- Alitalo K. The lymphatic vasculature in disease. Nat Med. 2011;17(11):1371–1380.
- Damstra RJ, Gloviczki P. Lymphedema diagnosis and treatment: Venous and lymphatic interface. Phlebology. 2016;31(1_suppl):40–48.