Varicose veins on the legs are not only a cosmetic problem that makes people worry about their attractiveness, but also a dangerous disease that requires adequate treatment and compliance with preventive measures.
There are many reasons for the appearance of varicose veins: from a sedentary lifestyle, physical overload, to hormonal imbalances, congenital weakness of the vascular walls and pregnancy.What happens during varicose veins?With varicose veins of the lower extremities, they lose their normal elasticity and stretch under blood pressure.
The valves in the veins are normally locked, and when blood passes through them, they close and allow the blood to flow back out.If the valves are malfunctioning, blood can flow freely downwards, resulting in blood stagnation.
In this regard, the veins cannot withstand the pressure, they expand, the valves are no longer able to close the large lumen... all this provokes the appearance of the initial stage of varicose veins (see photo).
reason
Why do varicose veins appear and what are they?The main risk factors for the development of the disease are genetic predisposition and gender.Due to the love of high heels, hormonal changes during pregnancy and the use of contraceptives, women become victims of varicose veins twice as often as men.
The development of the disease is triggered by:
- Inheritance.What is inherited is not the disease itself, but the genetically determined structure of the veins: weak connective tissue of the venous walls, congenitally defective vein valves.This is why varicose veins can be seen in young, healthy and active people (regardless of gender) and even in children.According to scientists, genetic predisposition is the main factor leading to varicose veins in the legs.
- Hormonal changes.Due to the characteristics of the female body, periods of hormonal imbalance cause blood stagnation.For them, the most dangerous periods are puberty, pregnancy and postpartum.The time when menopause occurs is also dangerous.This gender category of patients consults with doctors 2-3 times more often.Female organs do not have enough hormones called estrogens.Instead, the so-called corpus luteum hormones predominate.It is believed to have a relaxing effect on the muscles.This promotes dilation of the veins.
- A sedentary, sedentary lifestyle or work that requires long standing contributes to the development of varicose veins.
- Age.Over time, the valves and walls of the veins become thinner, which leads to the breakdown of their function.
- Obesity.Excess weight leads to increased stress on the leg veins.
Secondary varicose veins occur with leg injuries, heart defects, liver and spleen dysfunction.In this case, first of all, proper treatment of the primary disease is carried out.
What causes varicose veins?
The main risk factors for the development of the disease are genetic predisposition and gender.Due to the love of high heels, hormonal changes during pregnancy and the use of contraceptives, women become victims of varicose veins twice as often as men.
The development of the disease is triggered by:
- Obesity
- Prolonged standing or sitting
- Heavy physical activity
- Sedentary lifestyle
- Constipation
- Smoking
Secondary varicose veins occur with leg injuries, heart defects, liver and spleen dysfunction.In this case, first of all, proper treatment of the primary disease is carried out.
What causes varicose veins?
The development of varicose veins is based on the congenital weakness of the venous wall, the incompetence of the valves of the superficial veins and a resulting increase in venous pressure.Special one-way valves prevent blood from flowing back and prevent it from getting stuck in one place;when they are destroyed, the movement of blood from the tissues back to the heart is interrupted.It is worth noting that conservative treatment does not affect the pressure in the veins.
stages
There are 3 stages of symptom progression in the development of varicose veins.
- Compensation phase.There are no complaints.On examination, varicose veins are seen in one or both legs.
- Undercompensation phase.After examination, pronounced varicose veins are visible on the legs.Patients complain of a feeling of fullness, paresthesia ("pins and needles") in the lower part of the legs and cramps at night.There is slight swelling of the legs, ankles and feet in the evening.In the morning the swelling disappears.
- Decompensation phase.Dermatitis and eczema are added to the listed symptoms.Patients are bothered by itching of the skin.The skin becomes dry, shiny, tightly fused with the subcutaneous tissue.Small hemorrhages and subsequent hemosiderin deposition cause hyperpigmentation.
Varicose veins in themselves are not considered a very serious disease, but if they have already developed, they will never go away on their own and, moreover, they will progress, leading to all kinds of complications, which pose the greatest risk.
The signs
The first signs that indicate the beginning of the development of varicose veins:
- rapid leg fatigue;
- swelling of the lower extremities;
- feeling of heaviness in the legs.
In the later stages, the appearance of spider veins on the skin, elongated veins and various seals can be observed, indicating congestion in the blood vessels.
Varicose veins: symptoms
It is quite difficult to diagnose the early stages of the disease, since in the initial stage there are no spider veins and dilated veins that rise above the skin.
Early symptoms of varicose veins:
- Heavy legs at the end of the day
- Fatigue
- Mild to moderate pain
- Increased venous pattern in the skin
Often, before the first spider veins appear or veins are discovered in places where they were not visible before, the patient does not feel other symptoms of the disease, and only cosmetic defects on the skin cause discomfort.As a rule, in the early stages, the symptoms of varicose veins disappear completely or are significantly reduced with rest, and therefore often go unnoticed.
One or more varicose veins that protrude above the skin indicate the progression and neglect of the disease.When standing for a long time, pain appears in the joint area, numbness, tingling, "creeping" and swelling are felt in the legs.At the end of the day, swelling often occurs, which disappears after a night's sleep.Swelling can be judged by loose shoes in the morning, which begin to press in the evening.
Why are varicose veins dangerous?
The most common complications of varicose veins include thrombophlebitis.In addition, the increased pressure in the venous section leads to the penetration of red blood cells through the walls of blood vessels into the tissues.Due to this, skin pigmentation, thickening and tissue hypoxia are observed, which contributes to the appearance of trophic ulcers.Even with minor damage to the skin in the area of the joint, it can tear and cause heavy bleeding.
Diagnosing
To diagnose varicose veins of the lower extremities and prescribe the appropriate treatment, the specialist will ask the patient to undergo a comprehensive examination, which includes various methods.
- Duplex scanning (sonography of veins) is the most informative method for diagnosing varicose veins of the legs, making it possible to get an idea of the degree of expansion of the veins, the direction of blood flow through the veins and their patency, as well as to detect the presence of blood clots (thrombi).
- Contrast venography, which is an examination method that allows you to detect dilated veins and learn about the degree of their permeability for blood.
Only a highly qualified phlebologist can diagnose varicose veins.
The consequences
The complicated course of varicose veins is associated with the formation of thrombosis and inflammation of the veins, trophic ulcers and skin disorders.These complications are manifested in changes in the color of the skin on the legs, redness, darkening and blueness of the skin.
It is also characterized by constant ankle swelling, especially severe when walking or standing.In the area of the calf there is pain when walking, pain along the tortuous vein, thickening of the skin and the formation of ulcers of various sizes in it.
During pregnancy
Pregnancy significantly increases the risk of developing varicose veins of the lower extremities, for the following reasons:
- Hormones circulating in the blood during pregnancy increase the stretch of the venous wall and contribute to venous blood stagnation in the legs.
- Increased intra-abdominal pressure in late pregnancy makes it difficult for blood to flow through the leg veins.
- Varicose veins that appear during pregnancy can disappear completely after birth, or progress further, depending on individual factors (heredity, the presence of other contributing factors).
Treatment of varicose veins in the legs
For varicose veins in the legs, treatment may not be a medical necessity unless symptoms are problematic.
However, some people may want to be treated for varicose veins for cosmetic reasons because they are not happy with their appearance.
Let's look at the main methods that will help to get rid of this problem.
- Sclerotherapy.This treatment method is used both independently and in combination with conservative procedures.Its essence is that a special drug that closes it is injected into the vein with a thin needle or syringe, and then the vein disappears completely.Sessions are held once a week, 3 to 6 such sessions are required.The method allows you to avoid wounds and scars.
- Non-surgical treatment.If the varicose veins are in the early stages and do not cause much discomfort, elastic compression stockings may be recommended.They are worn during daily activities.They help compress the veins, keeping them from stretching and limiting any discomfort or pain.
- Medicinal treatment of varicose veins relieves symptoms, reduces swelling and pain, slows down the development process, but is unable to completely stop the disease and restore damaged veins.
- Laser treatment for varicose veins in the legs can be used on the surface of the skin.With the help of a small flash of laser light, a sclerosis process develops in the vein wall and the varicose vein disappears, as if it had been removed.
Physical activity plays a major role in treatment and prevention - brisk walking, gymnastics, swimming and water exercises (excluding sports exercises with a heavy load on the legs - tennis, weightlifting, dancing).
Conservative treatment of varicose veins is mainly prescribed to those people who have clear contraindications for surgical intervention.
Also, such treatment is indicated if the patient has mild varicose veins, which is simply a cosmetic defect.The goal of conservative therapy is also to prevent further progression of this disease.For this purpose, patients are recommended to bandage the legs affected by varicose veins with an elastic bandage.In addition, knitted compression garments are indicated for varicose veins.People who have a tendency to varicose veins or already suffer from this disease should regularly place their feet on an elevated surface throughout the day, resting in this way for a few minutes.There are also special exercises for the lower leg and foot, aimed at activating the muscular-venous pump.This is periodic extension and flexion of the ankle and knee.
The patient should be careful not to allow the legs and thighs to be pulled by various toilet items, as this can significantly impede venous blood flow.
Using elastic compression, you can activate the blood flow in the deep veins, prevent swelling, reduce the amount of blood in the saphenous veins, stimulate the body's metabolic processes and blood microcirculation.
But to achieve positive results, it is important to bandage the leg correctly.This process should be done in the morning, before you get out of bed.The bandage starts from the toes to the thigh and a slight tension of the bandage should be felt.During the taping process, be sure to grasp the heel and ankle.With each rotation around the limb, the bandage should cover half of the previous turn.You should only purchase certified elastic bandages and compression stockings.
Treatment of varicose veins also includes wearing comfortable shoes, which should have low heels and strong soles.You should not stand for a long time, allow physical stress or stay in rooms with high temperature and humidity for a long time.It is recommended to keep your legs in an elevated position while sleeping.
Patients should limit fluid and salt intake and try to get rid of it excess weight.For the treatment of varicose veins, it is necessary to periodically take diuretics, drugs that improve the tone of the veins.In addition, if indicated, the patient may be prescribed medications that stimulate tissue microcirculation.Treatment for varicose veins may also include taking non-steroidal anti-inflammatory drugs.
If the patient has an uncomplicated form of the disease, physical therapy exercises are indicated.Swimming, other water treatments, foot baths with warm water to which a 5-10% solution of sodium chloride is added are very helpful.
Very often, local therapy methods are used in the treatment of varicose veins.But such treatment should be used in combination with other medicinal methods.Local remedies for varicose veins are produced in the form of gels, ointments and creams.Most of these drugs contain heparin or venoactive components.Ointments for varicose veins help normalize the tone of the vein walls and can correct disorders of lymphatic drainage and microcirculation.Some topical preparations contain several different active ingredients.
If a secondary infection appears during the process of varicose veins, then the use of external agents with antibiotics OR antiseptics.
It has been used for treatment since ancient times Hirudotherapy with varicose veins.The use of leeches that secrete hirudin allows the blood to be diluted and promotes resorption blood clotting, getting rid of spider veins and varicose veins.In addition, hirudotherapy for varicose veins can reduce leg pain and overcome swelling.However, it is important to use hirudotherapy in the earliest stages of varicose veins.This treatment should not be used in people with hemophilia, anemia, hypotension, pregnant women.
However, the radical method of treating varicose veins is surgery.It is performed to eliminate venous reflux.This operation is not performed if the patient has concomitant diseases of the lungs, cardiovascular system, kidneys or liver.This operation should not be performed on pregnant women, as well as on people suffering from purulent diseases.Modern technologies make it possible to use endoscopic techniques for such an operation.
If a person only has small enlarged branches, sclerotherapy can be used.This operation involves injecting a sclerosing solution into the vein to close the vein walls.After that, repeated injections are made in other sections of the vein, achieving the complete disappearance of the vein.
Combined surgical therapy is also used for varicose veins, in which the large trunks of the changed veins are removed and sclerotherapy of small branches is performed.After surgery, patients are recommended to continue wearing an elastic bandage for 8-12 weeks.
Conservative treatment
Those looking for an effective and miraculous cure for varicose veins will be immediately disappointed: even the most modern and expensive drugs cannot completely eliminate varicose veins.They help relieve pain, swelling and even improve the condition of the venous wall, but complete recovery does not occur.
Moreover, conservative treatment brings a noticeable effect only in the initial stage of the disease, after which it is carried out to prevent the further development of varicose veins.Herbal medicines, which are based on natural plant substances, play the main role in the treatment of this disease.However, we must not forget that most venotonic drugs cause photosensitivity;during their reception, exposure of exposed skin to sunlight should not be allowed.
In addition to the use of medications, relaxation measures and special exercises for the legs, doctors strongly recommend regularly wearing compression stockings: socks, knee socks, tights.They improve blood microcirculation and prevent the formation of edema.It is very important to choose the right size of elastic stockings and the degree of compression, which can be both preventive and therapeutic.
Treatment with tablets and ointments
To improve vascular tone, venotonic tablets for varicose veins - phlebotonics are used.These drugs are analogues and contain a purified flavonoid fraction consisting of 90% diosmin.They are taken one tablet twice a day, the course of treatment is selected individually.
You can reduce the permeability of the capillaries, reduce the viscosity of the blood and increase the tone of the veins with the help of preparations based on horse chestnut
How to treat varicose veins with folk remedies
There are a large number of methods for the treatment of varicose veins in the legs with folk remedies, both for external use and for internal use.Below are the most common:
- Horse chestnut flowers (50 grams) should be poured with 500 grams of alcohol, then left to mature for 14 days, shaking the bottle every day.Pass the tincture through a mesh and take a tablespoon with water three times a day before meals.After you have been treated for a week, take a break for two weeks.Then the treatment can be started again.
- An infusion of dried nettle is used for varicose veins.Crushed dry leaves of the plant are placed in a thermos with 1/2 liter of boiling water, left for 30-40 minutes, filtered and taken 1/3 cup 3 times a day 1 hour after meals.
- Compress with tomatoes.Finely chopped tomato, placed on a bandage, gauze and applied to the injured area.For convenience, you can tie it with an elastic or other bandage.Keep this compress in the vein for 2 hours, then change to a new one and so on 3 times in total.The convenience of this compress is that it can be repeated every day.
- Tincture of walnut oil: chop unripe walnuts, pour into a glass container, pour olive oil and leave for 40 days in a sunny place.Lubricate the injured areas with the prepared solution.The course of treatment is long, as with the use of Kalanchoe.
In addition to folk remedies, many patients with varicose veins complement the therapy with special gymnastics - Mikulin's exercises allow you to feel a noticeable improvement.
Complications of varicose veins of the legs
Very often, as a complication of varicose veins, it appearsacute thrombophlebitis of superficial veins.Sometimes, as a result of damage, varicose veins rupture and bleed.When blood flows from a ruptured joint, very significant blood loss is possible.
In addition, due to increased pressure in the venous system, arterial blood flow slows down.Because of this, it can develophypoxiaand beyondoxygen starvation.As a result of the development of this condition, tissue cells can die, which is a dangerous process for the body.Due to severe stagnation of blood in the veins, toxins accumulate in the tissues.
Complications of this disease also include the blockage of blood vessels by a blood clot, damaged nutrition of the tissues of the legs and the appearance of pigmentation and darkening of the skin.
The layer of subcutaneous fat gradually becomes denser anddermatitis,venous trophic ulcers.In very rare cases, such ulcers degenerate into malignant formations.
If the disease continues for a long period, the person may develop laterchronic venous insufficiency.
But the most dangerous complication of varicose veins ispulmonary embolism.This disease can be fatal.
Preventive measures
If you belong to a risk group, your relatives have suffered from varicose veins, or because of their profession they are forced to spend a lot of time on their feet, you should pay special attention to the condition of your legs in order not to lose the first "bells".
Basic preventive measures help prevent the occurrence of the disease and also slow down the progression of existing varicose veins.
Preventive measures:
- Avoid excessive exposure to sunlight and hot baths.Ideally, baths and saunas should not be visited at all.
- Avoid wearing tight shoes, tight socks and tight clothing.
- The optimal heel height is no more than 6 cm.
- Avoid gaining weight.Try to eat a diet rich in fiber, vegetables and fruits.
- Avoid too intense physical activity and lifting weights.
- Perform special exercises for your legs, including lifting them ("bicycle", "scissors").
- Do self-massage if there are no swollen veins.
- At the end of the day, wash your feet in cold water;A contrast shower also has a positive effect.
Despite its prevalence, varicose veins are quite difficult to treat.When the first alarming symptoms appear, do not delay the visit to the vascular surgeon, because the sooner the disease is detected, the greater the chances of avoiding surgery.
PREDICTION
Varicose veins in the legs are a disease that can be treated for years;even after surgical removal, 80% of them reappear.
The prognosis depends on the stage at which treatment begins.A set of preventive measures in the early stages (treatment of varicose veins with venotonics twice a year and a healthy lifestyle) allows you to stop the further development of the disease.You will have to adhere to a strict prevention framework throughout your life.
In the later stages (with the appearance of severe deformities, joints, swelling and signs of tissue oxygen starvation), the prognosis is determined by the presence of concomitant diseases (diabetes, obesity) and the patient's willingness to follow the doctor's recommendations (to be examined, take medication, lose weight).
In diabetes mellitus, complications of varicose veins (thrombophlebitis, trophic ulcers) develop in 89%.
Varicose veins are considered a non-life-threatening disease, but its complications can greatly worsen the quality of life and prognosis.With deep vein thrombosis, about 50% of patients die of thromboembolism within 3 months.