Varicose veins (varicose veins of the lower extremities)– this is damage to the walls of the veins of the lower extremities, weakening of the venous valves, which causes impaired blood flow and blood stagnation. The function of the venous valves is affected, causing blood to back up and stagnate. The walls of the veins expand, thin and burst. Over time, blood clots form that can block a vessel and cause a stroke or heart attack. Women are at higher risk for varicose veins, but men can get them too. The age of the disease is from 20 years old, sometimes varicose veins can appear in adolescence. Varicose veins are usually caused by a sedentary lifestyle and professional characteristics, but the disease can also start due to other factors.
Causes of varicose veins
The veins of the body are essential for blood circulation and the transport of nutrients from the tissues to the heart. In the area of the lower extremities, this network occurs in the form of deep or superficial veins, which are connected to each other by an emergency blood discharge system. Basically, most of the load falls on the deep veins, since they are larger and stronger. The superficial veins do about 15% of the work.
The heart is necessary to pump and move blood through the veins, and some of the blood moves through the veins against gravity due to the work of the surrounding muscles during walking and other movements. When the muscles are relaxed, the person moves little or stands up, the blood returns downward under the influence of gravity. But thanks to special valves it stays in place.
If the valves do not fulfill their function, the veins begin to expand and become inflamed; They can't hold blood. For this reason, stagnation of blood circulation occurs, the veins expand and rise above the skin.
Blood circulation is disturbed and varicose veins appear. The causes of varicose veins can be:
- absence, defect or damage of venous valves: the reverse flow of blood to the legs is interrupted, blood stagnates in the veins and they stretch;
- constant stay in an upright position - most often, hairdressers, teachers, salespeople and other high-cost people suffer from varicose veins;
- overweight and obesity - excessive weight puts pressure on the lower extremities, as a result of which the veins dilate and varicose veins appear;
- intestinal diseases, constipation - create intra-abdominal pressure, which leads to the appearance of varicose veins;
- flatfoot;
- pregnancy - the uterus with the fetus creates additional pressure on the legs, which causes varicose veins;
- lifting weights - excessive physical activity causes dilation of veins and stretching of blood vessel walls;
- Professional sports (running, jumping, tennis) cause varicose veins due to constant stress on the lower extremities.
Varicose veins in the legs can be caused by previous injuries and surgeries in the lower extremities. In old age, almost everyone suffers from varicose veins, as the valves weaken and function poorly. They become inelastic and stretch a lot.
Symptoms
At the initial stage, the veins located under the skin expand. If you establish venous circulation immediately, no further complaints will arise.
If the disease progresses, the following symptoms appear.
- rapid fatigue;
- feeling of heaviness in the lower extremities;
- cramps in the calf muscles (appear most often in the afternoon and evening);
- There is a sensation of tingling and numbness in the legs.
With the further development of this disease, trophic disorders begin, which are most often concentrated in the area of the inner surface of the lower leg.
Symptoms of trophic disorders
- a thickening of the walls of the veins is formed;
- hyperpigmentation of the skin occurs in some places;
- skin atrophy;
- Dermatitis is a disease characterized by inflammation of the skin;
- In the later stages of the disease, a trophic ulcer may progress, which is practically untreatable.
In the chronic form of varicose veins, symptoms manifest themselves in the form of swelling of the lower extremities when standing for a long time. After a night's rest, the swelling usually disappears completely.
Varicose veins in the legs of men.
Varicose veins in the legs of men occur in 32% of cases. Most often, the disease is observed from the age of 45. Male varicose veins appear for the same reasons as female ones: due to a large load on the lower extremities. It is less common, as it is due to the peculiarities of the structure of the male body. However, due to smoking and intense stress, varicose veins in men are observed already in middle age.
The development of varicose veins in the legs of men is associated with a loss of elasticity and tone of the vascular wall for several reasons:
- professional features: inactive work, staying in one position for a long time, working while standing, lifting weights;
- overweight;
- fatty and unhealthy foods that negatively affect the walls of blood vessels;
- liver diseases: hepatitis and cirrhosis;
- metabolic diseases, diabetes;
- active sports, bodybuilding, intense physical activity;
- arterial hypertension;
- hereditary factor;
- smoking and alcohol.
The disease can last for several years. At first, a man may experience pain and swelling in the legs at night or after a long stay in an upright position. In later stages, varicose veins in men on the legs cause hair loss and burning in painful areas, itching in the venous nodes. Due to poor nutrition of the skin, itchy and painful trophic ulcers occur. The patient finds it more difficult to walk and then the mobility of the limbs disappears. There is loss of sensation and numbness in the legs.
Leg ulcers due to varicose veins.
Leg ulcers are the most dangerous consequence of varicose veins. They are located on the inner surface of the lower third of the leg, in the supramalleolar region. Before its appearance, dermatitis occurs, which is accompanied by eczema and severe itching. Ulcers can be single or multiple, most often flat, the bottom is smooth, the edges are uneven, flat, the discharge is scanty, serous or purulent. Trophic ulcers are difficult to heal and can increase in size. They become more painful when they trap fiber. Over time, the induration of the subcutaneous tissue increases.
Trophic ulcers occur with characteristic symptoms; They are hard to miss. At the site of the future ulcer, the skin becomes dense, reddish and swollen, and increased pigmentation may occur. A leg ulcer with varicose veins itches and itches, causing pain. It can be dangerous due to blood poisoning and amputation of limbs. A phlebologist must decide how to treat an ulcer with varicose veins after a comprehensive diagnosis of the veins.
Symptoms of varicose veins in the legs.
The manifestation of symptoms of varicose veins of the legs depends on the stage of development of the disease:
- Stage 1: some cosmetic defects are noticeable, the pain practically does not bother.
- Stage 2: feeling of heaviness, fullness, pain, cramps during sleep.
- Stage 3: formation of edema, feeling of fullness, thickening of the skin and subcutaneous tissue, formation of dark spots.
- Stage 4: the appearance of trophic ulcers, burning and itching, severe pain, protruding veins, changes in gait, difficulty walking.
The most common symptoms of varicose veins in the legs include the following:
- heaviness and fatigue in the legs, cramps in the calf muscles during sleep and after waking up;
- dull, arching pain in the calves, which intensifies when standing for a long time and disappears when lying down;
- burning and itching sensation in the legs at night;
- severe fatigue with light loads and short walks.
Another prominent symptom of varicose veins is that the veins become less noticeable when a person lies down or raises their legs and enlarge when standing, especially when standing for a long time.
Varicose veins in the legs cause swelling of the soft tissues of the feet, ankles, and lower legs. Most often it is noticeable in the evening after a day of work. Swelling can occur in people who spend a lot of time on their feet and in people who are overweight. Comfortable shoes begin to squeeze at night and become tight. When you stay in one position for a long time, your legs immediately swell or swell. You can check for swelling in your legs yourself. To do this, you need to measure the circumference of your shins with a tape measure: the narrowest part of the shin, the place above the ankles, and the widest part, the calf muscle. You should measure 2 times a day: at night, before going to bed and immediately after waking up. If in a few days the circumference of the calf changes by more than 1 cm, then there is a reason to check the vessels and veins.
If varicose veins are not treated, the disease progresses and new symptoms appear. Due to poor nutrition of the tissues of the lower extremities, trophic ulcers occur on the skin of the legs and feet. First, the skin begins to thicken and spots appear in the form of dark freckles. The skin becomes dry, bluish in color and swelling may occur. With the development of varicose veins, trophic ulcers may appear, which are unpleasantly itchy and itchy.
Complications
Varicose veins are a serious disease, as they can cause a number of consequences: eczema, skin ulcers, severe venous hemorrhages from injuries to the lower extremities, thrombophlebitis.
Thrombophlebitis is especially dangerous because blood clots form in the vessels and can break loose at any time. Obstruction of the pulmonary artery is fatal.
Varicose veins in the lower extremities can cause diseases such as
- hemorrhoids – a disease characterized by varicose veins of the rectum;
- varicocele – varicose veins of the spermatic cord;
- Portal hypertension is a syndrome in which pressure increases in the portal vein system.
With varicose veins in the legs, it becomes difficult to walk and in later stages the person becomes disabled.
Treatment of varicose veins in the legs.
The nature of treatment for varicose veins in the legs depends on the stage of the disease and symptoms. There are many procedures by which enlarged veins are glued, sealed and removed. The most common methods are:
Sclerosis
A procedure in which doctors glue together small vessels to remove "stars. "A special substance is injected into the vein to glue the walls of the vein together. After a while, this vein forms a cord and resolves. Sclerotherapy is a painless method and is performed without anesthesia in 15 minutes.
Phlebectomy
If varicose veins require radical treatment, surgical intervention is used. Varicose vein surgery involves removing the veins. To do this, a procedure called phlebectomy is performed: it is a surgical operation in which the saphenous veins are removed. This helps prevent tension in the deeper venous layers.
Endovasal laser coagulation
The next method of vein removal is endovasal laser coagulation. A modern method of treatment, the essence of which is the effect of thermal energy of laser radiation. The laser affects only areas of the venous wall, without affecting the tissues and nerve endings that are nearby. Under the influence of radiation, the vein closes and is excluded from the bloodstream. The procedure is performed with local anesthesia and without hospitalization. An ultra-thin laser light guide is inserted into a vein through a puncture in the skin. The procedure gives good results and is popular due to the possibility of outpatient treatment and quick rehabilitation.
Conservative treatment
In some cases, conservative treatment is used with medications prescribed by your treating doctor. It is suitable for those patients who are contraindicated for surgery, with insufficiency of deep venous valves, with varicose veins in the initial stage, who have only a cosmetic defect and who refuse to undergo surgery.
Medicines for the treatment of varicose veins are divided into several groups:
- phlebotonics
- anticoagulants
- remedies against edema
- disaggregants
- during trophic changes
- antioxidants
- non-steroidal analgesics;
- fibrinolytics
The patient should bind the lower extremities with an elastic bandage or wear elastic stockings, periodically raise the legs above the level of the heart, and perform preventive exercises for the foot and lower leg to improve blood circulation in the legs and eliminate venous stagnation of blood.
Treatment of varicose veins in men involves wearing special compression garments, performing regular exercises, maintaining proper nutrition, and avoiding alcohol and smoking.
The treatment of varicose veins in the legs involves following a diet to lose excess weight and reduce swelling and tension in the legs. It is necessary to abandon salt and sugar and reduce fluid intake. It is necessary to include foods with vitamin P, C, E, proteins and microelements in the diet to strengthen the vascular wall. Smoking and drinking alcohol are prohibited, as they stretch the walls of blood vessels and alter permeability.
In the initial stages of the development of varicose veins and during treatment, it is necessary to regularly perform a series of therapeutic exercises. Exercises should be performed in compression garments at a leisurely pace until you feel tired. In this case, jumping, running, dancing, ballet, aerobics and step are excluded, since they increase the load on the leg veins. You cannot do strength training or lift weights or dumbbells. Lifting weights of more than 3-5 kg is excluded. Exercises in the pool, a stationary bike with a backrest and cycling will be very useful. You can do a normal walk on a treadmill. It is best to walk outdoors alternating fast and slow paces.
After venous treatment and surgery, precautions should be taken. Use appropriate footwear, high-heeled shoes are excluded, the platform should not measure more than 4 cm, to improve blood circulation, class 1 or 2 compression garments should be constantly used, depending on the stage of development of the varicose veins in the legs. . It is best to wear it during the cold season as it is more comfortable and convenient. It is recommended to give preference to high stockings and tights, since knee-high socks will pinch the leg at the knee.
Laser varicose vein treatment.
For varicose veins, endovenous laser coagulation can be prescribed: laser surgery and echo sclerotherapy. Some patients are shown surgical removal of dilated veins under local anesthesia using point punctures of the skin surface - miniphlebectomy. Microsclerotherapy can be used to remove spider veins and intradermal veins.
The laser energy is absorbed by the hemoglobin of red blood cells and in one second it is converted into heat (95-100 degrees), which causes the boiling of plasma and blood elements, causing a thermal burn of the endothelium, the walls of the veins. A dense blood clot is created at the site of laser exposure, then the veins dissolve and become invisible. If the vessels are large and located in several layers, the procedure must be repeated after a month.
Laser treatment of varicose veins refers to surgical methods that are comparable to the non-surgical method of treating the disease due to its low invasiveness, the absence of general anesthesia and strictly local exposure of the laser only to the wall of the veins. varicose veins.
Laser surgery is performed using an ultrasonic duplex scanner. The doctor inserts a thin light guide through a puncture in the skin into the lumen of the vein. Radiation of a certain laser wavelength, which is partially absorbed by the dilated vein wall, seals the diseased veins. The clinics use a new generation laser that selectively affects the walls of the veins without damaging the surrounding tissue.
There are several advantages of laser treatment for varicose veins:
- outpatient treatment - the patient does not require hospitalization and can go home immediately after the procedure;
- local anesthesia is used; no general anesthesia or spinal anesthesia is required;
- short duration of the procedure: laser treatment is performed in 60 to 90 minutes, after which the patient can go home;
- Long-lasting cosmetic effect: after removing varicose veins with a laser, no traces remain on the skin, sometimes a dark strip of skin may appear, which disappears after 2-3 months.
After laser surgery for varicose veins, it is necessary to ensure compression of the treated varicose veins.
To do this, the patient uses compression stockings. They are thin, elastic and maintain the required degree of pressure for a long time. Special latex pads or cotton rolls are placed on the area where large varicose veins are located. Immediately after the treatment procedure, the patient should walk at least 4 to 5 kilometers. The walk should be fast and energetic so that the blood begins to circulate well and the veins develop. After laser surgery, the first few days you should walk for an hour every day.
After laser treatment of varicose veins, it is necessary to periodically undergo vascular diagnostics. Therapeutic gymnastics, walking, swimming, cycling are shown. It is worth giving up running, jumping, strength exercises in the gym, weight lifting, dancing and any type of martial arts. Gymnastics should be done every day at a moderate pace, with breaks. Its goal is to reduce blood stagnation in the veins, but not to inflate the legs, so you should not work too hard. After classes, you should lie down with your legs raised at a 90-degree angle for several minutes.
Radiofrequency coagulation
Another way to eliminate varicose veins is radiofrequency coagulation. The essence of the method is that the vascular walls of the veins are exposed to radiofrequency radiation. Since the main goal is to stop blood flow, when using this method, the vein is welded, so to speak, under radiation. Gradually, the vein resolves and disappears completely within six months to a year. The advantage of this method is the complete absence of surgical intervention, as well as the possibility of performing the procedure in case of concomitant pathologies. This technique does not have a systemic effect on the patient's body.
Since the most serious consequence of chronic venous insufficiency is trophic ulcers, their treatment is carried out comprehensively, including the method of endovenous laser coagulation, scleropathy and miniphlebectomy. Local treatment is often performed, which consists of surgical cleaning of the ulcer and skin grafting to the affected areas of the body. For this complication, the specialist prescribes the following medications:
- Phlebotonics are drugs that have a positive effect on the venous wall and have a tonic effect. They come in different presentations (ointments, gels, tablets);
- antihistamines: to block histamine receptors;
- Antibiotics: to stop and control the inflammatory process in the body.
Compression therapy is used to eliminate heaviness, swelling and pain in the lower extremities when walking. The use of specialized underwear made of compression knitwear and bandages made from special bandages will help to significantly alleviate the course of the disease and prevent further spread of complications.
How to treat varicose veins in the legs at home.
Varicose veins require physical activity, but it should be gentle, so strength exercises, lifting weights in the gym, running, jumping and dancing are excluded. The most effective method is regular walking, which improves muscle function and blood circulation in the vessels. During a break at work, you can do a simple exercise for varicose veins. Stand on tiptoe 20 times, lifting your heels off the floor. This exercise will help eliminate varicose veins, as it acts as a pump and improves vascular tone. At the end of the day, try to keep your feet elevated or on a pillow. It will be useful to perform the "bicycle" exercise or exercise on a stationary bike with back support.
You should exercise gently, excluding running, jumping, lifting weights and dumbbells, strength exercises, squats and deadlifts in the gym. The most effective and health-improving sports would be swimming, swimming, walking and cycling. Swimming trains the blood vessels in the legs and at the same time is gentle on the lower extremities, unlike running and strength exercises. It helps eliminate swelling, heaviness in the legs, increases vascular tone and eliminates aesthetic defects.
Every day it is necessary to perform a series of therapeutic leg exercises to eliminate swelling, improve blood circulation and strengthen the vascular wall. The exercises should be done until your legs feel tired. After the gymnastics complex, you should rest and lie down with your feet on a pillow or the armrests of the sofa. It is useful to complete the exercises with a contrast shower or footbath.
It is important to follow proper nutrition. It is necessary to exclude salty, spicy and spicy foods, smoked, fatty, fried, floury and sweet foods, as they destroy the walls of blood vessels and retain fluid in the body. It is prohibited to drink alcohol and smoke to avoid the formation of blood clots in the vessels. The diet should be rich in foods with vitamins C, B, E, proteins, microelements: citrus fruits, berries and sour fruits, nuts, seeds, herbs, vegetables. As for drinks, it is better to give preference to fruit drinks, jellies, green and herbal teas. Sugar should be replaced with honey.
It is helpful to drink juice a day 2 times a week, after checking with your doctor to see if you have any stomach illnesses.
Prevention of varicose veins
Since varicose veins are usually caused by stagnation of blood in the extremities, at home, place your legs over the back of the sofa or on a low table or chair. This relieves fatigue and tension in the legs. Before going to bed, place a pillow or folded blanket under your feet to elevate your legs a little.
Prevention of varicose veins includes weight loss, since excess weight creates additional stress on the legs. Women should not carry weights weighing more than 3 kilograms in one hand. It is necessary to abandon tight clothing and shoes, tight tights and socks. The heel should not exceed 4 cm, as they create an obstacle to normal blood circulation. Compression knitwear trains and repairs veins well, improves their tone. Underwear should be purchased at a pharmacy or specialized store.
Sedentary work requires regular warm-ups and stretches and it is helpful to get up and walk around. If possible, place a low bench under your feet, this will improve blood flow. Walk more often, exercise regularly, swim, and climb stairs. This will prevent the development of varicose veins and improve muscle tone.
To avoid varicose veins it is necessary to follow preventive measures. Try to minimize hot baths, saunas and steam baths, as well as prolonged sun exposure. This will help reduce venous tone, which causes blood stagnation in the legs.
To prevent varicose veins in your legs, avoid wearing tight clothing such as socks or stockings with tight elastic bands, as they put too much pressure on the veins and can cause poor circulation and dilation. High heels are excluded, everyday shoes should not be taller than 4 cm. Shoes with heels can be worn for festive events.