Case 1: Master Zhang has been a car mechanic for more than thirty years, but two days ago, he was hospitalized because of varicose veins in his lower limbs. A few years ago, Master Zhang found that his calves were bulging with “veins”, but he didn’t take it too seriously. As a result, more and more “veins”, the color of the skin on the legs is also patchy, and a day of work, feeling bloated and painful. Case 2: In the counter work is a beautiful girl, work very hard, every day to stand five or six hours. Summer came, Li ran into a troubling thing, legs somehow crawled out a “earthworm”, are afraid to wear a skirt. The “tendons” on the legs of master Zhang and the “earthworms” on the legs of Xiao Li are medically known as varicose veins in the lower limbs, and varicose veins in the lower limbs are a common disease, and there is a patient in about every ten people in China. There are descriptions of varicose veins in Chinese medical texts, and it is recorded in “The Authentic Book of Surgery” that “the tendon tumor is firm and purple, and the base is green tendons, and the coiled one is even, and the knot is like an earthworm.” Varicose veins in the lower extremities are mostly seen in people who work on their feet for long periods of time, such as teachers, nurses, traffic police, and car drivers, etc. Other predisposing factors include obesity, pregnancy, chronic cough, constipation, and aging. The occurrence of varicose veins is somewhat related to physical and genetic predisposition; children of parents with varicose veins are twice as likely to develop them, while women have twice the rate of varicose veins as men. The body’s blood is transported throughout the body from the arterial system and then back to the heart through the venous system. Normal lower extremity veins have valves present at intervals within them, which act as a one-way valve to stop the backflow of blood back to the heart. Many factors, such as congenital weakness, blood flow impact, aging, etc. will affect the function of the valve, resulting in the “valve” is not tight, the blood will backflow downward backflow, pressure on the vein wall, expansion, over time, the vein expansion is obvious and tortuous, the formation of varicose veins. Long-term standing, heavy labor, pregnancy, chronic cough, long-term constipation, etc. can increase the pressure in the veins, intensifying the pressure of the blood on the vein walls, more likely to appear varicose veins in the lower limbs. Long-term varicose veins and blood stagnation will eventually lead to local skin inflammation, pigmentation and even ulcer formation in serious cases. Early varicose veins do not have any other symptoms and pain besides affecting the appearance, but if treatment is not carried out early, the condition will worsen and symptoms such as swelling, pain and itching in the lower limbs will appear. At this point, the veins crawl all over the legs like worms and even swell and protrude so much that even socks can’t cover them up. In severe cases, eczema, ulcers, inflammation of veins and even bleeding from ruptured veins may appear. So, don’t wait for the symptoms to worsen before seeking medical attention. Treatment of varicose veins in the lower extremities can be divided into two categories: non-surgical treatment and surgical treatment. Patients with mild symptoms can receive good results through active non-surgical treatment. Regularly moving the lower limbs, elevating the affected limbs properly, not standing and sitting for a long time and avoiding heavy loads are important measures to prevent varicose veins in the legs. Make the habit of exercising legs properly every day, such as walking, brisk walking, cycling, running, etc. Lying down and resting with your legs above your chest and your knees slightly bent can improve the circulation of the veins in your legs. Wearing elastic stockings can also help blood return to the lower extremities and reduce symptoms, and they are generally available in medical stores. If the varicose veins are small, they can also be treated with sclerotherapy injections in the hospital, but they are prone to recurrence and sometimes inflammatory reactions. The fundamental treatment for varicose veins in the lower extremities is surgery. The routine surgery is not complicated, it is done by cutting and ligating the superficial veins of the lower extremities from the root of the thigh and stripping the varicose veins, the procedure is called high ligation and point stripping of varicose veins of the lower extremities. There may be five to six surgical incisions, the longer one is located on the inner thigh root, about 2 cm long, and the rest of the incisions are located on the lower leg, each about 0.5 cm long. You can be discharged from the hospital in 3 to 4 days after the surgery if the recovery is smooth, and the sutures can be removed in about 2 weeks. Some people may ask, if the varicose veins are removed, how will the blood from the legs return to the heart? Don’t worry, there are deep veins in the lower extremities in addition to superficial ones. The varicose veins that cause symptoms are just a pathway to return to the heart, and blood can still return to the heart through the deep veins. Those who like to wear skirts may be concerned about the aesthetic impact of the surgical scars. Some hospitals can now treat varicose veins in the lower extremities with a laser, which eliminates the need for an incision at the base of the thigh. However, laser treatment is only available for patients with mild, less tortuous varicose veins and is relatively more expensive. Not all patients with varicose veins are suitable for the aforementioned surgical treatment, and a few patients with complex conditions, such as simultaneous deep vein obstruction, cannot take the conventional surgery. Therefore, some preoperative tests should be performed to clarify the condition of the veins in the lower extremities, and the treatment plan should be decided by a specialist. In conclusion, varicose veins in the lower extremities is a common disease, so don’t worry too much when you get it, but don’t take it lightly and get treatment in vascular surgery as soon as possible.