In the evening after many hours of work standing or sitting, especially during the hot season, leg disorders such as heaviness and swelling of the ankles can appear. The swelling is due to excessive accumulation of fluid in the crevices (edema). It is rarely a symptom of systemic diseases (heart, kidney, liver, hypothyroidism, etc.) especially when it occasionally appears in the evening and reduces at the end of the summer season.

The most common cause of bilateral swelling in the legs is venous insufficiency of the lower limbs, i.e. a difficult return of venous blood to the heart. Overweight, obesity and cellulite are often present.
It is precisely the autumn-winter season that is suitable to intervene in order to contain and avoid the worsening of symptoms with the arrival of heat.

What's venous insufficiency in the lower limbs?

When standing or sitting upright the venous blood goes from the bottom to the top, against the force of gravity; walking the muscle pumps of the foot and calf squeeze the veins and the blood proceeds upwards. The valves of the veins prevent the blood from flowing down.

In case of venous insufficiency, the blood slows down on the way back to the heart (e.g. defective valves, obstruction due to thrombosis, obesity and sedentariness), increases the pressure in the veins (with dilation of the same = varicose veins), and in capillariesFrom here, liquids flow out and accumulate in the interstitial tissues (edema) where they are not sufficiently drained by the veno-lymphatic system. The heat, causing vasodilation, aggravates the stagnation and accentuates the disorders.



An angiological examination, accompanied by ecocolordoppler, may highlight venous obstructions, valve incontinence and plan treatment of varicose veins and dilated capillaries to reduce the vascular bed, increase blood velocity and counteract venous stasis.


The strategy is to increase the speed of venous return from the lower limbs to the heart by moving the legs more and controlling overweight.

  • Wear elastic stockings with gradual compression: high at the ankle, descending towards the thigh.
  • Walk at least 45 minutes a day.
  • Correct changes in foot posture (e.g. flat foot) with appropriate insoles, wear comfortable shoes with a 3-5 cm heel;
  • Avoid overweight and obesity, which favor the flat foot, increase the load on the veins.
  • A low-calorie draining diet is useful.
  • Check constipation, avoid tight waist clothing that obstructs venous outflow;
  • Don't stand still for long.
  • When seated, lift the heel and toe alternately, and stand up frequently.
  • Sleep with your legs higher than your heart (lift under the mattress or better raise the feet of the bed).
  • Do not expose your legs to the heat, the sun during the hottest hours: hot baths, mud, etc. are not recommended. Useful cold water shower.
  • Don't smoke. Avoid alcohol (peripheral vasodilation);
  • Avoid, if possible, drugs that cause vasodilation (e.g. antihypertensives, estroprogestinics, corticosteroids, nonsteroidal anti-inflammatory drugs, some antidepressants).
  • Useful manual lymph drainage


Cycles of intradermal injections with vasoactive and draining drugs can relieve symptoms, e.g.: cynara scolymus extract; lymdiaral (homeopathic); glucosamine sulphate (Dona) aesculus hippocastanus (homeopathic); mesoglycan (Prism).

Cycles of superficial micro-injections of medical carbon dioxide induce a real rehabilitation of the microcirculation determining direct vasodilation, formation of new vessels, with an increase in blood flow and greater oxygenation of the tissues.

Oral medications

  • Phlebotonic drugs: based on diosmin, oxerutin. Antithrombotic drugs based on mesoglycan .
  • Diuretics are not useful since there is no plasma volume overload.

Natural phytotherapeutic extracts

on capillaropa-protective, antiedemigenous, oral or locally applied, e.g:

  • Centella asiatica (Centella asiatica L.); Horse chestnut (Aesculus hippocastanum); Red screw (Vitis vinifera) with draining action:
  • Dry extract of. Orthosifon (Java Tea) contains flavonoids type Sinensitin
  • Birch dry extract (flavonoids such as quercetin, hesperetin, etc.).