Varicose veins in the lower extremities, commonly known as “fried legs”, are the most common disease of the venous system. The main reason for the formation of varicose veins is that the blood accumulates in the lower extremities due to the congenital weakness of the vessel walls or the maintenance of the same posture for a long period of time, and the venous valves are damaged over time, resulting in high venous pressure, which is a symptom of blood vessels protruding from the skin surface.
Varicose veins mostly occur in the lower extremities, manifesting as local redness, swelling and pain, hard lump formation, and pain affecting walking. Early varicose veins are varicose like earthworms, protruding significantly from the skin, and the varicosities are mass-like or nodular, with capillary dilation, reticular veins, and ankle flushing.
Etiology
Varicose veins in the lower extremities occur mostly in people who work permanently on their feet or do heavy physical work, such as salesmen, teachers and porters, military personnel, etc. They are also more common in women who have many children and in people who are obviously obese.
1.Sitting and standing for a long time
People who sit or stand for a long time, such as white-collar workers, civil servants, teachers, security guards, supermarket cashiers, etc., especially those who wear high-heeled shoes for a long time.
2, long-term heavy physical labor
People who are engaged in heavy physical labor need the participation of abdominal muscles when exerting force, as a result, the abdominal pressure increases, and the increase of abdominal pressure will make the veins of lower limbs temporarily or intermittently compressed.
3.Venous abnormalities
For example, drug addicts, people who use syringes to take drugs, the valves of deep veins are easily damaged.
4.Venous injury
Injuries to the veins of the lower leg may affect the elasticity of the wall and the function of the valve after healing due to the injury to the superficial vein wall and the valve of the vein wall, and thus varicose veins of the lower extremity occur at the injury.
5.Pregnant women
Pregnant women hormone will make the vein dilate, the valve can’t cover the vein, can’t stop the blood backflow; Pregnancy, the uterus enlarges, compress the iliac vein, cause the pressure in the vein to increase, and the varicose veins of lower extremity occur; At the same time, the blood flow in the pelvic cavity increases during pregnancy, which affects the blood backflow of lower extremity.
6.Congenital valve abnormality
There are also some congenital causes, the patient’s valves may have some small problems by birth, plus the acquired pressure, so varicose veins are formed.
Clinical manifestation
If it is simple lower limb superficial varicose vein, the clinical symptoms are generally light and slow progressing, mostly showing simple varicose, a few cases may have thrombophlebitis, venous ulcers and so on.
In case of deep vein valve insufficiency or even deep vein reflux obstruction, the condition is relatively serious, with heavy feeling when standing on the lower leg, easy fatigue, and even swelling and distension pain of the lower limb, and later on, nutritional changes of the skin occur, such as desquamation, atrophy, hyperpigmentation and eczema ulcer formation.
Superficial blood vessels are varicose like earthworms, protruding visibly from the skin, and the varicosities are in the shape of clusters or nodules.
Soreness and swelling of the legs, hyperpigmentation, desquamation and itching of the skin, and edema of the ankles.
unusual sensations in the limbs, pins and needles, strange itchiness, numbness, burning sensations.
Elevated epidermal temperature, with pain and pressure.
Local gangrene and ulcers.
Treatment
1.Physical therapy
The ulcer wound can be irradiated with ultraviolet light, helium-neon laser or small-dose X-ray, which can promote venous reflux and help the ulcer heal.
2.Surgery
Surgical treatment mostly adopts high ligation of saphenous vein or small saphenous vein and stripping of trunk and varicose vein, which is simple and easy to perform, but some discomfort or complications may occur after surgery, so postoperative rehabilitation training and guidance are especially important.
Postoperative rehabilitation
1.1-3d after surgery, the patient can lie down and lie on the side, and the affected limb can be elevated by 30° with soft pillow, and the knee joint can be slightly flexed to facilitate the venous return.
2, the correct use of elastic bandage, bottom-up wrapping, the elasticity is appropriate to touch the dorsal artery pulsation, does not impede joint movement and maintain the normal skin temperature of the foot is appropriate. The elastic bandage can be removed only after 2 weeks of general use. The elastic bandage should be flat, to avoid proximal curl compression too tight.
3. Patients should be encouraged to perform knee flexion and extension and ankle pump exercises in bed when they return to the ward after surgery. If anesthesia has not been eliminated, family members can be instructed to help with passive activities.
4, 24 hours after surgery, you can start to get out of bed to promote venous reflux in the lower limbs and prevent deep vein thrombosis in the lower limbs. Subsequently, the patient can gradually transition to casual activities, but should not stand for a long time, excessive activities or make the foot droop for a long time, and must have an elastic bandage when getting out of bed.
5. Perform straight leg raising exercises to strengthen quadriceps strength and improve lower limb circulation.
Home rehabilitation care – food (tomato) treatment
Tomatoes are a very simple and effective home remedy for varicose veins. Wash a few green tomatoes, cut them into round slices (or circles) and place them on the nodes of varicose veins and the capillary network of veins. If necessary, hold them in place with a bandage until a tingling sensation is felt on the skin. If the sensation is intolerable, remove the tomatoes as soon as the tingling sensation is felt, and then rinse with cold water.
Home rehabilitation care – compression stocking treatment
Varicose veins stockings are a product with the function of promoting venous blood return to the heart. By the action and distribution of force, the highest support pressure is established at the ankle and gradually decreases up the leg to 70%-90% of the maximum pressure value at the calf belly and 25%-45% of the maximum pressure value at the thigh.
This decreasing change in pressure encourages venous blood flow back to the lower extremities, effectively relieving or improving the pressure on the veins and venous valves of the lower extremities. Varicose vein stockings are effective in preventing and relieving varicose veins, but they are not curative. When the traffic valve is destroyed, symptoms such as mild swelling, itchy skin and hyperpigmentation in the upper part of the inner ankle need to be seen in a hospital.
Home rehabilitation care-exercise therapy
Varicose veins exercise therapy is based on posture and muscle contraction. The posture can be inverted or with both lower limbs above the level of the heart, so that the venous return of both lower limbs can be accelerated through the effect of the center of gravity, relieving the soreness and swelling of both legs. The muscle contraction then improves the venous return of the lower extremities through ankle pump and foot pads.
Horizontal padding position
Ankle pump exercise
Foot pad exercise
Prevention
1.Strengthen the lower limb strength exercises and make full use of the muscle pump.
A large amount of blood flows to the lower extremities due to the need for movement during whole-body exercise, and at the same time, due to the alternate contraction and diastole of the muscles of the lower extremities, the muscle contraction produces pressure on the blood vessels, thus promoting the return flow of blood from the lower extremities to the heart and reducing the blood pressure hoarding in the lower extremities, this phenomenon of the muscles is called “muscle pump action. Through exercise, strengthen the lower limbs, especially the calf muscle strength can effectively enhance the role of muscle pump, so as to prevent and relieve varicose veins in the lower limbs.
2, pay attention to the protection of the affected limbs, avoid collision damage, and use warm water to warm the legs every night.
3, maintain the ideal weight, wear elastic stockings with pressure gradient can delay the development of the disease.
Obese people should lose weight, although obesity is not the direct cause, but the excessive force pressed on the legs may cause poor venous reflux in the legs, making venous dilatation aggravated; people who are engaged in long-term heavy physical labor and long-term standing work (such as teachers, police, surgeons, nurses, salesmen, etc.), it is best to wear elastic stocking covers, so that the superficial veins are in a state of compression; women during menstruation and pregnancy and other special periods to give special leg Care, more rest, to often massage the legs, to help blood circulation, to avoid varicose veins.
4.Avoid long time standing or sitting posture.
Massage can promote venous reflux.
5.Hot water soaking feet and elevating lower limbs.
Promote blood return to the lower limbs, which can relieve edema and other symptoms.
6, maintain correct posture.
Squatting, cross-legged, cross-legged, “crossed legs”, pillow under the knee, long time using sitting position, etc., can affect the blood return to the affected limb, should be avoided as far as possible.
7, to develop good habits.
Strictly quit smoking, eat more fresh vegetables and fruits, keep your bowels open, and try to use a sitting flushing toilet when you have a bowel movement.
8.Avoid foot and calf bruises.
Because of varicose veins, the wall of the vein nodules is thin and often adheres to the atrophied skin, so a mild injury can cause rupture and bleeding, and because of the circulatory disorder, the rupture is easily infected and not easy to heal.