​What's wrong with the calf muscle pain

Some people find pain around their calves. If it is just muscle pain caused by excessive fatigue or standing for too long, it is often just a muscle strain and muscle pull. As long as the soreness improves after massage, it means there is no big problem. However, if the pain is not relieved and the pain is in the calf muscles, we must pay great attention to it. So, what is the cause of calf muscle pain in this case?

1. Concept of calf peroneal vein thrombosis Venous thrombosis is an acute non-suppurative inflammation of the veins, accompanied by secondary intravascular thrombosis. The lesions mainly involve the superficial veins of the limbs or the deep veins of the lower limbs. 2. Causes In the mid-19th century, RLK Virchow proposed the three elements of deep vein thrombosis - slow venous blood flow, hypercoagulable state of blood and venous intimal damage, which are still recognized by the vascular surgery community.

Symptoms

The calf muscles are characterized by persistent pain, tenderness, and soreness. The clinical features are localized swelling and pain in the affected limb, tender cord-like objects palpable under the skin, or venous obstruction such as superficial varicose veins distal to the lesion.

IV. Hazards

1. When there is no obvious damage to the venous intima, thrombosis often occurs in the venous valve pocket. The thrombus is not tightly adhered to the blood vessel wall and is easy to fall off and may cause pulmonary embolism. In the early stages of deep vein thrombosis in the lower extremities, it is easy to fall off. If the embolus is large and emboluses the left or right pulmonary artery trunk, it may cause a large pulmonary embolism, which is often one of the causes of sudden death.

2. After venous thrombosis occurs, a few cases spread upward to the femoral vein or iliac vein, eventually developing into chronic venous insufficiency of the lower limbs, and limb swelling is difficult to subside. Cellulose accumulates in the tissues, adipose connective tissue hardens, the skin develops changes such as stasis dermatitis, and even venous stasis ulcers occur, causing a certain degree of disability of the limbs.

5. Treatment

1. In the acute phase, you need to rest in bed and elevate the affected limb to relieve pain and promote the disappearance of local inflammation. To prevent the spread of blood clots, anticoagulation therapy is used. To prevent thrombosis from causing venous dysfunction, thrombolytic therapy should be started in the early stages of the disease.

2. To prevent pulmonary embolism, venous thrombectomy can be performed within 48 hours after iliac vein thrombosis. For patients with a longer course of illness, when thrombi are difficult to remove and who are at risk of pulmonary embolism, a filter device can be placed inside or outside the inferior vena cava to prevent pulmonary embolism.

5. Diagnosis

1. During local examination, attention should be paid to whether the affected limb has tenderness, the location of tenderness, swelling, skin color and temperature, whether the distal pulse of the limb has changed, whether tender cord-like objects can be felt on the body surface, whether there are any infected lesions, and nutritional changes in the foot and boot area.

2. When diagnosis is difficult or to clarify the scope of the lesion, ultrasound examination, pulsed Doppler spectrum examination, and venography can be performed.

3. Venous pressure measurement: perform dorsal venous puncture and connect the needle to a pressure sensor or a transparent plastic tube with a scale (filled with heparin-saline solution) to measure the venous pressure. The normal pressure is generally 12.7 kPa (130 cmH20). When the ankle joint is flexed and extended, the gastrocnemius muscle contracts and the pressure drops significantly, generally to 5.9 kPa (60 cmH20). The pressure rises after stopping the activity, and the recovery time exceeds 20 seconds. In patients with thrombosis and blockage in the main veins, the pressure increases significantly regardless of rest or activity, and the recovery time increases rapidly, generally not exceeding 12 seconds.