15-07-2025
What Your Legs Are Trying to Tell You About Your Health
Leg pain and swelling often get dismissed as natural signs of ageing, but health specialists caution that they could indicate a more serious underlying issue. As Malaysia approaches aged-nation status by 2030, there is increasing concern about chronic venous insufficiency (CVI)—a common yet frequently overlooked condition that affects the veins in the legs.
According to Dr Syaiful Azzam bin Sopandi, Consultant General & Vascular Surgeon at Ara Damansara Medical Centre, when leg veins stop functioning properly, blood begins to pool in the lower limbs, placing pressure on the vessel walls and surrounding tissue. These symptoms can eventually lead to skin changes, ulcers, and infections if untreated.
Understanding how CVI develops and learning to recognise its early warning signs is essential, especially as more older Malaysians face symptoms that are too often mistaken for ordinary ageing.
More Than Just Tired Legs
CVI develops when the valves in the leg veins are weakened or damaged. These valves ensure blood moves upward to the heart. When they fail, blood pools in the lower limbs, increasing pressure and damaging surrounding tissue. Over time, this leads to swelling, skin changes, and even ulcers.
Venous hypertension, or increased pressure in the veins, can cause fluid and blood cells to leak into surrounding tissues, often resulting in a brownish skin discolouration—a visible sign of ongoing inflammation.
CVI often goes undiagnosed. Globally, chronic venous disease affects 20 to 40% of adults, and the numbers rise with age. In Malaysia, a 2021 Vein Consult Programme found that over 30% of people aged 50 and above show signs of the disease.
Among those over 60, the figure may be as high as 50%. Risk factors include obesity, sedentary lifestyles, prolonged standing, or a history of blood clots.
Know the Signs, Take Early Action
Chronic venous insufficiency (CVI) often develops gradually with overlooked symptoms. Early warning signs include leg pain that worsens with standing or walking, swelling around the ankles, and the appearance of varicose veins. As the condition progresses, the skin on the lower legs may darken, tighten, or become itchy.
In more advanced stages, slow-healing ulcers—typically near the inner ankle—may form. 'These signs shouldn't be ignored, especially if you're over 50,' says Dr Syaiful Azzam bin Sopandi, Consultant General & Vascular Surgeon at Ara Damansara Medical Centre. 'Early diagnosis makes a big difference.'
One reason these symptoms are so common in older adults is the natural decline in venous function that comes with age. Over time, vein walls lose elasticity, valves begin to leak, and calf muscles—key to pumping blood back to the heart—grow weaker due to reduced physical activity. This combination slows circulation and increases the likelihood of venous disease.
'Movement keeps blood flowing,' Dr Syaiful explains. 'When older adults become less active, it puts them at greater risk of developing vein-related complications.' Recognising the signs early and understanding why circulation slows with age are crucial steps toward preventing more serious outcomes.
Modern Treatments and Common Myths
Thankfully, diagnosis and treatment today are far less invasive than people assume. A quick and painless ultrasound can confirm if the veins are malfunctioning. If CVI is diagnosed, there are several treatment options.
The most common is endovenous ablation therapy. This therapy involves using heat, glue, or medication to close faulty veins. 'Patients are often surprised how quick and straightforward it is,' says Dr Syaiful. 'Most walk in and out on the same day.'
Misconceptions about vein health persist. Many believe varicose veins are purely cosmetic or that older adults are too frail for treatment. Dr Syaiful clarifies that age is not a barrier, and treatments are tailored to individual needs.
Removing or sealing a diseased vein does not harm circulation, as other veins compensate. While compression stockings can help manage symptoms, they do not address the root cause, and without proper treatment, CVI tends to worsen.
Home Care and Early Treatments
While medical intervention is key for advanced cases, lifestyle changes can help manage or delay symptoms. Regular walking, leg elevation, maintaining a healthy weight, and wearing compression stockings in the morning are all helpful.
Avoiding long periods of sitting or standing, quitting smoking, and moisturising the skin—especially around the ankles—also supports vein health.
If left untreated, CVI can cause lasting damage, including ulcers, infections, and even amputation in severe cases. It may also lead to cellulitis—a painful skin infection that may require hospital care. 'It's like ignoring a leaking roof,' says Dr Syaiful. 'It may seem minor, but it can turn serious.'
With Malaysia's elderly population growing rapidly, awareness around vein health must improve. Leg pain is not always a sign of ageing; it can be something more. Early intervention can lead to better mobility, less pain, and a higher quality of life. 'Healthy ageing is not just about living longer,' Dr Syaiful concludes. 'It's about staying active, independent, and pain-free.' Related