How to relieve varicose veins

Varicose veins (commonly known as "floating tendons") are the most common disease of the venous system. The main reason for the formation of varicose veins is that blood accumulates in the lower limbs due to maintaining the same posture for a long period of time with very little change, which destroys the venous valves and produces high venous pressure, resulting in varicose veins. Varicose veins mostly occur in the lower limbs, where the skin of the legs develops red or blue, twisted veins like spider webs, earthworms, or hard nodules like tree tumors, and the veins become abnormally enlarged and swollen and varicose. According to statistics, about 25-40% of women and 20% of men in Taiwan suffer from varicose veins. Teachers, surgeons, nurses, hair stylists, counter ladies, chefs, restaurant waiters and other occupations that require long hours of standing are at high risk. Varicose veins are also associated with heredity, oral contraceptive pills and pregnancy. Varicose veins are irreversible as the human body does not have the mechanism to repair its own membranes, but conservative treatment (e.g., use of elastic stockings, exercise, dietary and lifestyle changes) can be used to prevent varicose veins from expanding and to reduce their symptoms. Gentle exercise such as walking, swimming, bicycling, etc. can improve circulation and reduce the rate of new varicose veins. In terms of diet, one should eat a high-fiber, low-fat diet and take vitamin C and E supplements. In daily life, weight control, avoiding birth control pills, tight clothing and high heels, stooping, and sitting or standing for long periods of time should be avoided. Elevate your legs for a period of time before going to bed, and sleep on your left side to reduce the pressure on the pelvic veins. Smoking increases blood pressure and damages the arteries and veins, so patients with varicose veins should stop smoking immediately.

Most of the patients with varicose veins are not serious and do not need treatment, health care and prevention is the most important. However, if the varicose veins are too serious, they are prone to recurring ulcers, infections and bleeding, and the symptoms of varicose veins can be aggravated by misbelieving in traditional remedies and using wrong treatments. Therefore, the best way is to consult a specialist for proper advice. The treatment of varicose veins includes the following:

Compression therapy: the use of elastic stockings, which utilize external compression to reduce edema during exercise. Theoretically, the compression of an elastic stocking is greatest at the ankle and gradually decreases upward. It is usually best to wear elastic stockings up to the thigh. Elastic stockings are best worn early in the morning before getting out of bed, and then removed at night after going to bed. If the patient has developed leg ulcers as a result of venous hypertension, antibiotics and diuretics should be administered and supplemented with special herbs, as directed by the physician.

Sclerotherapy: A hypertonic solution (such as highly concentrated saline or sclerosing agent) is injected into the varicose vein, destroying the lining of the blood vessel and causing it to seal and disappear. However, it can only treat small varicose veins, and there may be severe pain, pigmentation, even inflammation, redness, swelling, ulceration and other sequelae during the treatment, and it is easy to recur and difficult to deal with after recurrence, so it is only suitable for a small number of patients.

Extravascular laser or pulsed light: The same principle of laser cosmetic surgery as that of spot removal, the advantage is that only local anesthesia is needed, the treatment time is short, the pain is low, the wound is quite small, and it will not leave unsightly scars, so you can walk immediately. However, it is only for fine spider veins, which require several treatments at your own expense.

Surgical extraction surgery: An incision is made in the groin to cut off the saphenous vein to ligate or extract it, which requires half body or general anesthesia and hospitalization for 2-3 days. If the varicose veins are too strong, several small wounds may be needed to remove the varicose veins in sections. The treatment is complete but has the disadvantage of bruising under the skin and more painful wounds.

Endovascular cauterization: A small incision is made on the inside of the knee or ankle, a very thin catheter is inserted, and high-frequency waves (or radiofrequency) or laser beams are used to cauterize and block the blood flow to the varicose vein. Simple endovascular cauterization has the advantages of being performed under local anesthesia, no need for hospitalization, less scarring and pain, and a high success rate as the procedure can be performed with an elastic bandage on after the treatment. However, it is not covered by health insurance and has to be paid out of pocket, and most of the patients may not be solved by this method alone, but need to be treated with other modalities such as minimally invasive varicose vein rotational dissection system to have a more complete treatment.

Minimally invasive varicose vein rotational dissection endoscopic system: It uses endoscope and suction rotational dissection to crush and suck out the earthworm like veins, the wound is smaller and more beautiful than traditional surgery, but there is need of anesthesia and hospitalization and out of pocket expenses for consumables.

Varicose veins are the result of excessive pressure on the veins, which causes soreness, numbness, even swelling and pain in the legs, and finally itching, rotting and inflammation to the extent that the wounds do not heal.

1. Avoid standing or sitting for a long time, you should always let your feet do elevation and lowering exercises or take a small walk if possible.

2. Wear elastic stockings and exercise your legs for one hour a day, such as walking, brisk walking, cycling, running or treadmill.

3. Lying down and lifting the legs above the heart several times a day and keeping the knees bent can promote venous circulation in the legs.

4. Maintain normal weight and do not be overweight because overweight will increase the burden on leg veins.

5. Avoid lifting more than 20 pounds (about 10 kilograms) of heavy objects.

6. Make sure you quit smoking.

7. Keep your feet and legs clean and avoid injuries.

8. If the skin on your legs is dry, apply medication as prescribed by your physician.

9. Check your calves every night for swelling.

10. Sleep with your legs about 6 inches higher and in the most comfortable position possible, and don't let your legs stiffen up, which is counterproductive.

11. Patients with high venous pressure before treatment should continue to wear the elastic stockings prescribed by the physician during the daytime at work. Please put on the elastic stockings every day before waking up and do a few minutes of repetitive leg lifting and stretching. Swelling of the legs usually occurs within a few minutes of standing after getting out of bed.

12. Keep your stockings clean and watch for changes in their elasticity. A pair of good quality elastic stockings can last for about six months, so when they lose their elasticity, they should be replaced immediately.