Venous Disease of the Legs

© Steven C. Immerman, MD, FACS, 2000.

Every part of the body has an artery bringing fresh blood in, and a vein returning the used blood to the heart. The veins in the legs have valves that only allow the blood to flow from the feet upward. If theses valves are faulty, the blood has a tendency to settle toward the feet (because of gravity) and slow the flow of blood through your legs.

This situation can cause several problems such as:

• Swelling and tiredness of the feet and legs.
• Brown discoloration of the ankle
• Enlarged (varicose) veins may be visible on the legs.
• Sores above the ankles.

Unfortunately, there is no simple operation or "cure" for this problem. However, with proper care the problems related to this can be kept at a minimum. The important concepts to understand in treating this are:

• The more the feet are elevated during the day, the better.
• The skin around the ankles is fragile.
• Good compression stockings put pressure on the veins, and promotes proper blood flow through the legs.

• Keep the legs elevated higher than the heart for as many hours of the day as practical. A lazy-boy type of reclining chair or a sofa with pillows is the best for this.
• Elevate the foot of the bed at night. The best way to do this is to place three or four inch high wooden blocks under the feet of the bed. This will raise it a few inches and keep the legs elevated all night.
• Wear good quality compression stockings whenever up and walking. The kind that you can buy without a prescription at the pharmacy often do not apply enough pressure to be useful. Insurance will usually pay for the proper kind of stocking. 
• Be very careful not to injure your lower legs. This is particularly important if you spend a lot of time outside or with pets. Keep your ankles and lower legs covered and protected. The most trivial type of scratch or injury can turn into a large sore that will take months to heal.
• Do not put any creams, ointments, or other medications on your lower legs, or on sores if they form. In particular, avoid steroid (cortisone) creams, since they make the skin even weaker with prolonged use. At the first sign of a sore, see a vascular surgeon.