Varicose veins in the legs are not only a cosmetic problem that causes concerns about one's attractiveness, but are a dangerous condition that require adequate treatment and compliance with preventive measures.
Varicose veins develop for many reasons: from a sedentary lifestyle and physical overload, to hormonal imbalances, congenital fragility of blood vessel walls and pregnancy.What happens during varicose veins?Varicose veins in the lower limbs lose their normal elasticity and are stretched under the action of blood pressure.
The valves in veins are usually locked, and when blood passes through them, they close and allow blood to flow back.If the valve fails, blood is pumped freely downward, causing blood to stagnate.
In this regard, the veins are unable to cope with the pressure, they dilate, the valves are no longer able to close the large lumen... All this triggers the appearance of the initial stages of varicose veins (see picture).
reason
Why do varicose veins occur?What are they?The main risk factors for developing the disease are genetic predisposition and gender.Women are twice as likely as men to become victims of varicose veins due to their affinity for high heels, hormonal changes during pregnancy and the use of contraceptives.
The development of the disease is promoted by:
- genetics.What is inherited is not the disease itself, but the genetically determined structure of the veins: weak connective tissue in vein walls, congenitally defective vein valves.This is why varicose veins can be observed in young, healthy and active people (regardless of gender) and even children.Scientists believe that genetic factors are the main cause of varicose veins in the legs.
- Hormonal changes.Due to the characteristics of the female body, periods of hormonal imbalance can cause blood stagnation.The most dangerous times for them are adolescence, pregnancy and the postpartum period.The timing of menopause is also dangerous.Patients in this gender category consult their doctors 2-3 times more frequently.The female organs don't have enough of the hormone called estrogen.Instead, the so-called progesterone dominates.It is believed to have a relaxing effect on muscles.This promotes dilation of the veins.
- Sitting for long periods of time, a sedentary lifestyle, or a job that requires standing for long periods of time can lead to the development of varicose veins.
- age.Over time, vein valves and walls become thinner, causing disruption in their function.
- obesity.Being overweight can cause increased pressure in the veins of the legs.
Secondary varicose veins occur with leg injuries, heart defects, liver and spleen dysfunction.In this case, appropriate treatment of the underlying disease begins.
What causes venous dilatation?
The main risk factors for developing the disease are genetic predisposition and gender.Women are twice as likely as men to become victims of varicose veins due to their affinity for high heels, hormonal changes during pregnancy and the use of contraceptives.
The development of the disease is promoted by:
- obesity
- Remaining standing or sitting for long periods of time
- strenuous physical activity
- sedentary lifestyle
- constipate
- smoking
Secondary varicose veins occur with leg injuries, heart defects, liver and spleen dysfunction.In this case, appropriate treatment of the underlying disease begins.
What causes venous dilatation?
Varicose veins occur due to congenital weakness of the vein walls, insufficiency of the superficial vein valves, and the resulting increase in venous pressure.Special one-way valves prevent blood from flowing backwards and from becoming stagnant in one place; when they are damaged, the movement of blood from the tissues back to the heart is disrupted.Of note, conservative treatment does not affect venous pressure.
stage
The symptoms of varicose veins develop in 3 stages.
- compensation stage.No complaints.On examination, varicose veins are observed on one or both legs.
- Subcompensatory stage.Upon examination, obvious varicose veins were visible in the legs.The patient complains of a feeling of fullness, abnormal sensation ("pins and needles") in the lower legs, and nighttime cramps.Mild swelling of feet, ankles, and legs at night.The swelling is gone in the morning.
- decompensation stage.Dermatitis and eczema were also added to the list of symptoms.The patient is troubled by itchy skin.The skin becomes dry, shiny, and tightly integrated with the subcutaneous tissue.Mild bleeding and subsequent hemosiderin deposition can lead to hyperpigmentation.
Varicose veins themselves are not considered a very serious disease, but if they have developed, they will never go away on their own and may even develop, leading to various complications, which is the greatest danger.
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The first signs that varicose veins are starting to appear:
- Rapid fatigue of the legs;
- Swelling of lower limbs;
- A feeling of heaviness in the legs.
In later stages, people will notice the appearance of spider veins, protruding veins, and various seals on the skin, indicating engorged blood vessels.
Varicose veins: symptoms
Diagnosing the early stages of the disease is quite difficult because in the initial stages there are no spider veins and dilated veins rise above the skin.
Early symptoms of varicose veins:
- Legs feel heavy at the end of the day
- fatigue
- mild to moderate pain
- Increased vein pattern on skin
Usually, until the first spider veins appear or veins are discovered in previously invisible places, patients do not feel other symptoms of the disease, only cosmetic imperfections in the skin cause inconvenience.Often, in the early stages, the symptoms of varicose veins disappear completely or are significantly reduced with rest, so they are often ignored.
One or more varicose nodules protruding above the skin indicate disease progression and neglect.When you stand for a long time, you may experience soreness, numbness, tingling, "crawling" and leg swelling in your joints.Swelling often occurs at the end of the day and disappears after a night's sleep.You can tell if there is swelling by whether your shoes are loose in the morning and begin to press in the evening.
Why are varicose veins dangerous?
The most common complications of varicose veins include thrombophlebitis.Additionally, increased pressure in the venous segment causes red blood cells to pass through the vessel wall and enter the tissue.As a result, skin pigmentation, thickening, and tissue hypoxia occur, leading to the development of trophic ulcers.Even minor damage to the skin in the lymph node area can cause it to rupture and cause severe bleeding.
diagnosis
In order to diagnose varicose veins in the lower extremities and provide appropriate treatment, a specialist will ask the patient to undergo a comprehensive examination, which includes a variety of methods.
- Dual scan (venous ultrasound) is the most informative method for diagnosing varicose veins in the legs. It can tell how dilated the veins are, the direction of blood flow in the veins and their patency, and detect the presence of blood clots (blood clots).
- Contrast venography, a test that allows you to detect dilated veins and see how smoothly they hold blood.
Only a highly qualified phlebologist can diagnose deep varicose veins.
result
The course of varicose veins is complex, with thrombosis and venous inflammation, trophic ulcers, and dermatoses.These complications manifest as changes in the skin color of the legs, redness, darkening, and bluish discoloration of the skin.
Another characteristic is persistent swelling of the ankle, especially when walking or standing.In the calf area, there is pain when walking, pain along the tortuous veins, thickening of the skin, and ulcers of varying sizes forming on it.
during pregnancy
Pregnancy significantly increases the risk of varicose veins in the lower extremities for the following reasons:
- Hormones circulating in the blood during pregnancy increase the distensibility of vein walls and cause venous blood stagnation in the legs.
- Intra-abdominal pressure increases in late pregnancy, making it difficult for blood to flow through the leg veins.
- Varicose veins that develop during pregnancy may disappear completely after delivery, or may worsen, depending on individual factors (genetics, presence of other influencing factors).
Treatment of varicose veins in legs
For varicose veins in the legs, treatment may not be necessary unless symptoms are problematic.
However, some people may want to have varicose veins treated for cosmetic reasons because they are unhappy with their appearance.
Let's look at the main methods that can help solve this problem.
- Sclerotherapy.This treatment can be used alone or in combination with conservative surgery.Its essence is that a sealed special drug is injected into a vein using a fine needle or syringe, after which the vein disappears completely.Meetings are held weekly and 3 to 6 meetings are required.This method allows you to avoid scars and scars.
- Non-surgical treatment.If varicose veins are in their early stages and do not cause much discomfort, elastic compression stockings are recommended.They are worn during daily activities.They help compress the veins, preventing them from stretching and limiting any discomfort or pain.
- Medical treatments for varicose veins can relieve symptoms, reduce swelling and pain, and slow the progression, but they cannot completely stop the disease and restore damaged veins.
- Laser treatment for varicose veins in the legs can be applied to the surface of the skin.With the help of a small flash of the laser, a hardening process occurs in the walls of the veins, and the varicose veins disappear as if they had been removed.
Physical activity plays an important role in treatment and prevention - brisk walking, gymnastics, swimming and aquatic exercises (excluding sports that place heavy loads on the legs - tennis, weightlifting, jumping).
Conservative treatment of varicose veins is primarily reserved for patients with clear contraindications to surgical intervention.
Additionally, this type of treatment is required if the patient has minor varicose veins (a purely cosmetic defect).The goal of conservative treatment is also to prevent further progression of the disease.For this reason, patients are advised to wrap the leg affected by varicose veins with an elastic bandage.Additionally, compression knitwear is suitable for varicose veins.People who are prone to varicose veins or who already have the condition should place their legs on an elevated surface periodically throughout the day and rest this way for several minutes.There are also special exercises for the calves and feet designed to activate the muscle venous pumps.This is the cyclic extension and flexion of the ankle and knee joints.
Patients should be careful not to allow their legs and thighs to be pulled together by various toiletries, as this can severely impede the flow of venous blood.
The use of elastic compression can activate the blood flow of deep veins, prevent swelling, reduce the blood volume of saphenous veins, and promote the body's metabolic process and blood microcirculation.
But in order to achieve positive results, it is important to bandage your legs correctly.This process must be completed before getting up in the morning.Apply the bandage from the toes to the thigh, and you should feel a slight tension in the bandage.During the bandaging process, be sure to hold the heel and ankle joint.Each time it is wrapped around the limb, the bandage should cover half of the previous circle.You should only buy certified elastic bandages and compression stockings.
Varicose vein treatment also includes wearing comfortable shoes, which should have low heels and stiff soles.It is not advisable to stand for a long time, bear physical pressure, or stay in a room with high temperature and humidity for a long time.It is recommended to keep your legs in a higher position while sleeping.
Patients should limit fluid and salt intake and try to avoidoverweight.To treat varicose veins, diuretics, drugs that improve the tone of the veins, need to be taken regularly.In addition, if necessary, patients can be prescribed drugs that stimulate tissue microcirculation.Treatment for varicose veins may also include taking nonsteroidal anti-inflammatory drugs.
If the patient's condition is uncomplicated, physical therapy exercises are required.Very useful for swimming, other water treatments, foot soaks in warm water (with a 5-10% sodium chloride solution).
Typically, topical treatments are used to treat varicose veins.But this treatment must be combined with other pharmaceutical methods.Topical medications to treat varicose veins come in the form of gels, ointments, and creams.Most of these drugs containheparinor intravenous active ingredients.Varicose vein ointment helps normalize the tone of the vein walls and corrects disorders of lymphatic drainage and microcirculation.Some local preparations contain several different active ingredients.
If a secondary infection occurs during the course of varicose veins, then it is recommended to use topical medicationsantibioticorpreservative.
Used for treatment since ancient timesLeech therapyHave varicose veins.Using leeches that secrete hirudin can thin the blood and improve absorption.blood clot, get rid of spider veins and varicose veins.Additionally, hydrotherapy for varicose veins can reduce leg pain and overcome swelling.However, it is important to use leech therapy in the early stages of varicose veins.This treatment should not be used on people with:hemophilia,anemia,hypotension,Pregnant women.
However, the ultimate treatment for varicose veins is surgery.Its purpose is to eliminate venous reflux.This surgery is not recommended if the patient has disease of the lungs, cardiovascular system, kidneys, or liver.Pregnant women and people with purulent diseases should not undergo this surgery.Modern technology makes it possible to perform such surgeries using endoscopic techniques.
If a person only has small branch dilation, sclerotherapy may be used.The procedure involves injecting a sclerosing solution into the vein to seal the vein wall.Thereafter, repeated injections are made into other parts of the vein to achieve complete occlusion of the vein.
For varicose veins, combined surgical treatment is also used, in which the large main trunk of the altered vein is removed and sclerotherapy is performed on the small branches.After surgery, patients are advised to continue wearing the elastic bandage for 8-12 weeks.
Conservative treatment
Those who are looking for an effective and miraculous treatment for varicose veins will be immediately disappointed: even the most modern and expensive drugs cannot completely eliminate varicose veins.They can help relieve pain, swelling, and even improve the condition of the vein wall, but they won't lead to complete recovery.
In addition, conservative treatment will only have a significant effect in the initial stages of the disease, after which it is carried out to prevent the further development of varicose veins.Taking a leading role in the treatment of this disease are herbal medicines based on natural plant substances.However, we should not forget that most intravenous drugs can cause photosensitivity.When taking them, bare skin should not be exposed to sunlight.
In addition to the use of medications, relaxation measures and special exercises for the legs, doctors strongly recommend the regular wearing of compression stockings: stockings, knee-high socks, tights.They improve blood microcirculation and prevent the formation of edema.Choosing the correct size and level of compression stockings is important, both for prevention and treatment.
Treatment with tablets and ointments
To improve the tone of blood vessels, venotonic tablets for varicose veins - phlebotonics are used.These drugs are analogues containing purified flavonoids, 90% of which are diosmin.They are taken one pill twice a day and the course of treatment is individually chosen.
With the help of horse chestnut preparations, you can reduce capillary permeability, reduce blood viscosity and increase venous tone
How to treat varicose veins with folk remedies
There are a number of folk remedies for treating varicose veins in the legs, both externally and internally.The following are the most common:
- Horse chestnut flowers (50g) need to be poured into 500g of alcohol and then brewed for 14 days, shaking the bottle every day.Pass the tincture through a sieve and mix it with a tablespoon of water, 3 times daily before meals.After one week of treatment, take two weeks off.Treatment can then be started again.
- An infusion of dried nettles can be used to treat varicose veins.Pour the dried and crushed plant leaves into a thermos bottle filled with 1/2 liter of boiling water, leave for 30-40 minutes, filter and take 1/3 cup, 3 times a day, 1 hour after meals.
- Tomato Compress.Chop the tomato, place it on a bandage, gauze, and apply it to the sore area.For convenience, you can tie it tightly with an elastic bandage or other bandage.Leave this compress on the vein for 2 hours, then replace it with a new one, and so on, a total of 3 times.The convenience of this compression is that it can be repeated every day.
- Walnut oil tincture: Chop unripe nuts, pour into a glass container, pour olive oil and leave in a sunny place for 40 days.Lubricate the painful area with the prepared tincture.As with using Kalanchoe, the treatment process is lengthy.
In addition to folk remedies, many patients with varicose veins also use special gymnastics - Mikulin exercises, which can make you feel obvious improvements.
Complications of varicose veins in the legs
Many times, as a complication of varicose veins, it occursacute superficial vein thrombophlebitis.Sometimes, due to injury, varicose veins can burst and bleed.When blood leaks from ruptured lymph nodes, significant blood loss can result.
Additionally, arterial blood flow slows down due to increased pressure in the venous system.Because of this, it may develophypoxiaand abovehypoxia.As this condition develops, tissue cells may die, which is a dangerous process for the body.As the blood in the veins becomes severely stagnant, toxins accumulate in the tissues.
Complications of the disease also include blood clots that block blood vessels, compromised nutrition of leg tissue, and pigmentation and darkening of the skin.
The subcutaneous fat layer gradually becomes denser,dermatitis,venous trophic ulcer.In rare cases, such ulcers can degenerate into malignant structures.
If the disease persists for a long time, the person may subsequently developchronic venous insufficiency.
But the most dangerous complication of varicose veins ispulmonary embolism.The disease can be fatal.
Precautions
If you are in a high-risk group, have a loved one with varicose veins, or have to stand for long periods of time due to your occupation, you will need to pay special attention to the condition of your legs to avoid missing the first "bell."
Basic preventive measures can help prevent the disease from occurring and slow the progression of existing varicose veins.
Precautions:
- Avoid overexposure to the sun 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 should not exceed 6 cm.
- Avoid weight gain.Try to eat a diet rich in fiber, vegetables and fruits.
- Avoid excessively strenuous physical activity and heavy lifting.
- Special exercises for the legs, including leg lifts ("bicycle", "scissors").
- If the veins are not swollen, you can perform self-massage.
- At the end of the day, washing your feet with cold water; contrasting with a shower also has a positive effect.
Although varicose veins are common, they can be difficult to treat.Do not put off seeing a vascular surgeon at the first alarming symptoms, because the earlier the disease is detected, the greater the chance of avoiding surgery.
forecast
Varicose veins in the legs are a condition that can be treated for many years.Even after surgical removal, 80% of tumors will reappear.
The prognosis depends on the stage at which treatment is started.A series of preventive measures in the early stages (IV treatments for varicose veins twice a year and a healthy lifestyle) can allow you to prevent further progression of the disease.You must adhere to a strict prevention framework throughout your life.
In the later stages (with signs of severe deformation, nodules, swelling and tissue hypoxia), the prognosis depends on the presence of concomitant diseases (diabetes, obesity) and the patient's willingness to follow the doctor's recommendations (examinations, taking medications, losing weight).
Complications of varicose veins (thrombophlebitis, trophic ulcers) occur in 89% of patients with diabetes.
Varicose veins are considered a non-life-threatening condition, but its complications can significantly worsen quality of life and prognosis.When deep vein thrombosis occurs, about 50% of patients die from thromboembolism within 3 months.