Varicose veins on the legs are not only an aesthetic problem that causes people to worry about their attractiveness, but also a dangerous disease that requires adequate treatment and compliance with preventive measures.
The reasons for the appearance of varicose veins are numerous: from a sedentary lifestyle, to physical overload, hormonal imbalances, congenital weakness of the vascular walls and pregnancy.What happens with 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 closed and when blood passes through them, they close and allow the blood to flow backwards.When the valves malfunction, blood can flow freely downward, leading to blood stagnation.
In this regard, the veins cannot withstand the pressure, they dilate, the valves are no longer able to close the large lumen... all this causes the appearance of the initial stage of varicose veins (see photo).
Reasons
Why do varicose veins appear and what are they?The main risk factors for developing the disease are genetic predisposition and gender.Due to the love of high heels, hormonal changes during pregnancy and the use of contraceptives, women experience varicose veins twice as often as men.
The development of the disease is favored by:
- Heredity.What is inherited is not the disease itself, but the genetically determined structure of the veins: weak connective tissue of the vein walls, congenital 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 the appearance of varicose veins in the legs.
- Hormonal changes.Due to the characteristics of the body in women, periods of hormonal imbalances become causes of blood stagnation.For them, the most dangerous periods are puberty, pregnancy and the period following childbirth.The timing of menopause is also dangerous.This gender category of patients consults doctors 2-3 times more often.Female organs do not contain enough hormones called estrogen.Instead, so-called corpus luteum hormones predominate.It is believed to have a relaxing effect on the muscles.This promotes the expansion of the veins.
- A sedentary lifestyle or a job that requires standing for long periods contributes to the development of varicose veins.
- Age.Over time, the valves and vein walls become thinner, leading to a disruption in their function.
- Obesity.Excess weight leads to increased load on the leg veins.
Secondary varicose veins occur during leg injuries, heart defects, liver and spleen dysfunction.In this case, first of all, appropriate treatment of the primary disease is carried out.
What causes veins to dilate?
The main risk factors for developing the disease are genetic predisposition and gender.Due to the love of high heels, hormonal changes during pregnancy and the use of contraceptives, women experience varicose veins twice as often as men.
The development of the disease is favored by:
- Obesity
- Prolonged stay in a standing or sitting position
- Intense physical activity
- Sedentary lifestyle
- Constipation
- Smoking
Secondary varicose veins occur during leg injuries, heart defects, liver and spleen dysfunction.In this case, first of all, appropriate treatment of the primary disease is carried out.
What causes veins to dilate?
The development of varicose veins is based on congenital weakness of the vein wall, incompetence of the valves of the superficial veins and a resulting increase in venous pressure.Special non-return valves prevent blood from flowing backwards and prevent it from stagnating in one place;when they are destroyed, the movement of blood from the tissues to the heart is disrupted.It should be noted that conservative treatment does not affect the pressure in the veins.
Steps
There are 3 stages of symptom progression in the development of varicose veins.
- Compensation stage.No complaints.On examination, varicose veins are observed on one or both legs.
- Undercompensation stage.On examination, pronounced varicose veins are visible on the legs.Patients complain of a feeling of fullness, paresthesias (“tingling”) in the lower legs and nighttime cramps.There is slight swelling of the feet, ankles and legs in the evening.In the morning, the swelling disappears.
- Decompensation stage.Dermatitis and eczema are added to the listed symptoms.Patients are bothered by itchy skin.The skin becomes dry, shiny, tightly fused with the subcutaneous tissue.Minor hemorrhages and subsequent hemosiderin deposition cause hyperpigmentation.
Varicose veins themselves are not considered a very serious disease, but if they have already developed, they will never disappear on their own and, moreover, they will progress, leading to all sorts of complications that pose the greatest danger.
Signs
The first signs indicating the beginning of the development of varicose veins:
- rapid fatigue of the legs;
- swelling of the lower limbs;
- feeling of heaviness in the legs.
In later stages, the appearance of spider veins on the skin, protruding veins and various seals can be noted, indicating congestion of blood vessels.
Varicose veins: symptoms
It is quite difficult to diagnose the early stages of the disease, since at the initial stage there are no spider veins or enlarged veins rising above the skin.
Early symptoms of varicose veins:
- Heavy legs at the end of the day
- Fatigue
- Mild to moderate pain
- Increased vein pattern on the skin
Often, before the appearance of the first spider veins or the discovery of veins in places where they were not visible before, the patient does not experience any other symptoms of the disease and only cosmetic defects in the skin cause inconvenience.As a rule, in the early stages, the symptoms of varicose veins disappear completely or significantly diminish with rest and therefore often go unnoticed.
One or more varicose nodes protruding above the skin indicate the progression and neglect of the disease.With prolonged standing, aching pain occurs in the nodes, numbness, tingling, “crawling” and swelling of the legs are felt.At the end of the day, swelling often appears, 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 are thrombophlebitis.In addition, increased pressure in the venous section causes red blood cells to penetrate through the walls of blood vessels into the tissues.As a result, skin pigmentation, thickening and tissue hypoxia are observed, which contribute to the appearance of trophic ulcers.Even with minor damage to the skin at the knot, it can rupture and cause serious bleeding.
Diagnosis
In order to diagnose varicose veins of the lower extremities and prescribe appropriate treatment, the specialist will ask the patient to undergo a comprehensive examination including various methods.
- Duplex ultrasound (ultrasound of the veins) is the most informative method for diagnosing varicose veins of the legs, allowing you to get an idea of the degree of dilation of the veins, the direction of blood flow in the veins and their patency, as well as detect the presence of blood clots (thrombus).
- Contrast venography, which is an examination method that allows you to detect dilated veins and know their degree of permeability to blood.
Only a highly qualified phlebologist can diagnose deep vein varicose veins.
Consequences
The complicated course of varicose veins is accompanied by the formation of thromboses and inflammation of the veins, trophic ulcers and skin disorders.These complications are manifested by changes in skin color on the legs, redness, darkening and bluing of the skin.
Also characterized by constant swelling of the ankle, especially severe when walking or standing.In the calf area there is pain when walking, pain along the tortuous vein, thickening of the skin and the formation of ulcers of various sizes.
During pregnancy
Pregnancy significantly increases the risk of developing varicose veins of the lower limbs, for the following reasons:
- Hormones circulating in the blood during pregnancy increase the distensibility of the vein wall and contribute to the stagnation of venous blood in the legs.
- The increase in intra-abdominal pressure at the end of pregnancy makes it difficult for blood to circulate in the leg veins.
- Varicose veins that occur during pregnancy may disappear completely after delivery or progress further, depending on individual factors (heredity, presence of other contributing factors).
Treatment of varicose veins on the legs
For varicose veins in the legs, treatment may not be a medical necessity unless the symptoms are problematic.
However, some people may wish to be treated for varicose veins for cosmetic reasons because they are unhappy with their appearance.
Let's look at the main methods that will help solve this problem.
- Sclerotherapy.This method of treatment is used both independently and in combination with conservative procedures.Its essence is that a special medicine that seals it is injected into the vein with a thin needle or syringe, and then the vein completely disappears.Sessions take place once a week, 3 to 6 sessions are necessary.The method helps to avoid scarring and scarring.
- Non-surgical treatment.If the varicose veins are in their early stages and are not causing too much discomfort, elastic compression stockings may be recommended.They are worn during daily activities.They allow the veins to be compressed, thus preventing them from stretching and limiting any discomfort or pain.
- Drug treatment of varicose veins relieves symptoms, reduces swelling and pain, slows down the development process, but fails to completely stop the disease and restore damaged veins.
- Laser treatment for leg varicose veins 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 significant load on the legs - tennis, weightlifting, jumping).
Conservative treatment of varicose veins is mainly prescribed to people with clear contraindications to surgical intervention.
In addition, such treatment is indicated if the patient has slight varicose veins, which are a purely cosmetic defect.The goal of conservative treatment is also to prevent the progression of this disease.To this end, patients are recommended to bandage the legs affected by varicose veins with an elastic bandage.In addition, compression knits are indicated for varicose veins.People who are prone to or already suffering from varicose veins should regularly place their legs on an elevated surface throughout the day, resting for several minutes.There are also special exercises for the lower leg and foot, aimed at activating the musculovenous pump.It involves periodic extension and flexion of the ankle and knee joints.
The patient should ensure that their legs and thighs are not brought together by various toiletries, as this could significantly hamper the circulation of venous blood.
Thanks to elastic compression, you can activate blood flow in deep veins, prevent swelling, reduce the amount of blood in the saphenous veins, promote the body's metabolic processes and blood microcirculation.
But to achieve positive results, it is important to bandage the leg well.This process should be done in the morning, before getting out of bed.The bandage starts from the toes to the thigh, and a slight tension of the bandage should be felt.During the bandaging process, be sure to grip the heel and ankle joint.At each turn of the limb, the bandage should cover half of the previous turn.You should only purchase certified elastic bandages and support stockings.
Treatment of varicose veins also involves wearing comfortable shoes with low heels and hard 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 advisable to keep your legs in an elevated position while sleeping.
Patients should limit their fluid and salt intake and try to get rid of them. excess weight.To treat varicose veins, it is periodically necessary to take diuretics, drugs that improve the tone of the veins.Additionally, if indicated, the patient may be prescribed drugs that stimulate microcirculation in the tissues.Treatment for varicose veins may also include taking nonsteroidal anti-inflammatory drugs.
If the patient has a simple form of the disease, physiotherapy exercises are indicated.Swimming, other water treatments, foot baths in warm water, to which 5-10% sodium chloride solution is added, are very useful.
Very often, local therapeutic methods are used in the treatment of varicose veins.But this 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 medications contain heparin or venoactive components.Ointments against varicose veins help to normalize the tone of the vein walls and can correct lymphatic drainage and microcirculation disorders.Some local preparations contain several different active ingredients.
If in the process of varicose veins a secondary infection occurs, then it is advisable to use external agents with antibiotics Or antiseptics.
Has been used for treatment since ancient times hirudotherapy with varicose veins.The use of leeches secreting hirudin helps thin the blood and promotes resorption blood clots, eliminating spider veins and varicose veins.Additionally, hirudotherapy for varicose veins can reduce leg pain and overcome swelling.However, it is important to use hirudotherapy in the early stages of varicose veins.This treatment should not be used in people with haemophilia, anemia, hypotension, pregnant women.
However, the radical method of treating varicose veins is surgery.It is carried out to eliminate venovenous 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, nor 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, dilated branches, sclerotherapy may be used.This operation consists of injecting a sclerosing solution into the vein to seal the vein walls.After this, repeated injections are given into other sections of the vein, thus completely obliterating the vein.
For varicose veins, combined surgical therapy is also used, in which large trunks of altered veins are removed and sclerotherapy of small branches is carried out.After surgery, patients are recommended to continue wearing an elastic bandage for 8 to 12 weeks.
Conservative treatment
Those looking for an effective and miraculous remedy for varicose veins will immediately be 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 vein wall, but complete recovery does not occur.
Moreover, conservative treatment brings a noticeable effect only at the initial stage of the disease, after which it is carried out to prevent the further development of varicose veins.The main role in the treatment of this disease belongs to herbal medicines, based on natural plant substances.However, it should be remembered that most venotonic drugs cause photosensitivity;when taking them, exposure of exposed skin to the sun 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: stockings, knee-highs, 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 are used - phlebotonics.These drugs are analogues and contain a purified flavonoid fraction consisting of 90% diosmin.They are taken one tablet twice a day, the duration of treatment is selected individually.
You can reduce capillary permeability, reduce blood viscosity and increase vein tone with the help of horse chestnut preparations.
How to treat varicose veins with folk remedies
There are a large number of methods for treating varicose veins of the legs with folk remedies, both for external and internal use.Here are the most common:
- Horse chestnut flowers (50 grams) should be poured with 500 grams of alcohol, then left to infuse for 14 days, shaking the bottle every day.Pass the tincture through the mesh and take one tablespoon with water three times a day before meals.After a week of treatment, take a two-week break.The treatment can then be resumed.
- An infusion of dried nettle is used for varicose veins.Crushed dry leaves of the plant are poured into 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.
- Tomato compress.Finely chopped tomato, placed on a bandage, gauze and applied to the sore spot.For convenience, you can tie it with an elastic band or other bandage.Keep this compress on the vein for 2 hours, then replace it with a new one, and so on 3 times in total.The advantage of this compress is that it can be repeated every day.
- Walnut oil tincture: chop unripe walnuts, pour into a glass container, pour in olive oil and leave for 40 days in a sunny place.Lubricate sore areas with the prepared tincture.The duration of treatment is long, as with the use of Kalanchoe.
In addition to folk remedies, many patients suffering from varicose veins supplement their treatment with special gymnastics.Mikulin's exercises allow you to feel significant 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 escapes from a burst lymph node, very significant blood loss is possible.
In addition, due to increased pressure in the venous system, arterial blood flow slows down.For this reason it can develophypoxiaand beyondlack of oxygen.Due to the development of this disease, tissue cells may die, which is a dangerous process for the body.Due to the strong stagnation of blood in the veins, toxins accumulate in the tissues.
Complications of this disease also include blockage of blood vessels by a blood clot, impaired nutrition of the tissues of the legs and the appearance of pigmentation and darkening of the skin.
The subcutaneous fat layer gradually becomes denser anddermatitis,venous trophic ulcers.In very rare cases, these ulcers degenerate into malignant formations.
If the illness persists over a long period of time, the person may subsequently developchronic 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 loved ones suffer from varicose veins or, due to 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 so as not to miss the first "bells".
Basic preventive measures help prevent the onset of the disease and also slow down the progression of existing varicose veins.
Prevention measures:
- Avoid overexposure to the sun and hot baths.Ideally, public baths and saunas should not be visited at all.
- Avoid wearing tight shoes, tight stockings and tight clothing.
- The optimal heel height is no more than 6 cm.
- Avoid weight gain.Try to eat a diet rich in fiber, vegetables and fruits.
- Avoid strenuous physical activities and heavy lifting.
- 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 with cool water;a contrast shower also has a positive effect.
Despite their prevalence, varicose veins are quite difficult to treat.When the first alarming symptoms appear, do not delay your visit to a vascular surgeon, because the earlier the disease is detected, the greater the chances of avoiding surgical intervention.
Forecast
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 is started.A set of preventive measures at an early stage (treatment of varicose veins with venotonics twice a year and a healthy lifestyle) makes it possible to stop the further development of the disease.You will have to respect a strict prevention framework throughout your life.
In later stages (with the appearance of severe deformities, lymph nodes, swelling and signs of lack of oxygen in the tissues), the prognosis is determined by the presence of concomitant diseases (diabetes, obesity) and the patient's willingness to follow the doctor's recommendations (get examined, take medications, lose weight).
In diabetes mellitus, complications of varicose veins (thrombophlebitis, trophic ulcers) develop in 89% of cases.
Varicose veins are considered a non-life-threatening disease, but their complications can significantly worsen quality of life and prognosis.In cases of deep vein thrombosis, approximately 50% of patients die from thromboembolism within 3 months.