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Embed code for: PTWH_446_Practical_Week7_60385
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By: Dr. Bassem Mamdouh
What is Varicose Veins ?!
Varicose veins are swollen and enlarged veins – usually blue or dark purple that usually occur on the legs. They may also be lumpy, bulging or twisted in appearance.
Why do varicose veins happen ?
varicose veins develop when the small valves inside the veins stop working properly.
In a healthy vein, blood flows smoothly to the heart. The blood is prevented from flowing backwards by a series of tiny valves that open and close to let blood through.
If the valves weaken or are damaged, the blood can flow backwards and collect in the vein, eventually causing it to be swollen and enlarged (varicose).
Certain things increase chances of developing varicose veins
Such as :
Varicose veins may not cause any pain. Signs you may have with varicose veins include:
1. Veins that are dark purple or blue in color
2. Veins that appear twisted and bulging; often like cords on your legs
When painful signs and symptoms occur, they may include:
An achy or heavy feeling in your legs
Muscle cramping and swelling in your lower legs
Worsened pain after sitting or standing for a long time
Itching around one or more of your veins
A painful cord in the vein with red discoloration of the skin
Varicose Veins During Pregnancy
Lower extremity varicosities occur in 40% or more of pregnant women
The varicosities of pregnancy usually appear as early as the sixth weeks, before the uterus is enlarged enough to fill the pelvis
The dilatation being produced by the effect of estrogen on the smooth muscle and collagen cells in the vein wall.
Uterus during pregnancy leaves its pelvic position.
As uterus grows, it puts pressure on the large vein on the right side of the body (the inferior vena cava), which in turn increases pressure in the leg veins
Veins are the blood vessels that return blood from extremities to heart, so the blood in the leg veins is already working against gravity.
During pregnancy, the amount of blood increases, adding load on veins.
Progesterone levels rise, causing the walls of your blood vessels to relax.
Varicosities may develop at any location in the superficial system. Most often a portion of greater or lesser saphenous vein or its tributaries are involved
A) Avoid- Prolonged standing - Prolonged sitting
B) Shower or bath in the evening
C) Apply well-fitted below the knee support stocking
(20-40 mmHg) before ambulating in the morning
D) Elevate the feet 10-15 minutes for 3-4 times daily.
2. Physical therapy management
The main aim of the physical therapy treatment is to assist venous return and avoid venous stasis and its complication though:
B) Intermittent compression
1. The patient should lie on the bed with both lower limbs elevated
2. The patient is asked to practice this method frequently for periods of 20 minutes at least twice daily.
3. Resting in this position may reduce edema by removing the gravitational effect and reducing venous hypertension
4. This position with moderate elevation can be used during bandaging or stocking wear or release during massage, air compression and exercises
B) intermittent compression
Pneumatic Units (compression pumps) are designed to reduce edema by giving controlled, alternating external pressure
intermittent compression reduces edema by moving excess interstitial fluid to sites of normal lymphatic or venous drainage.
Pressure needs to be higher distally and lower proximally
Pressure may decrease pain and improve range of motion (secondary by decreasing swelling).
Correct bandaging is very important in controlling edema by supporting muscle pump mechanism and poor veins, Also pressure should be higher distally and lower proximally