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, resulting in impaired blood flow and blood stagnation. The function of the venous valves is compromised, causing blood to backflow and stagnate. The walls of the veins expand, thin and burst. Over time, blood clots form that can block a vessel and lead to a stroke or heart attack. Women are more often at risk of varicose veins, but men can experience them too. The age of the disease is from 20 years and above, sometimes during adolescence varicose veins may occur. Varicose veins are often caused by a sedentary lifestyle and professional characteristics, but the disease can also originate from other factors.
Causes of varicose veins
Veins in the body are essential for blood circulation and the transport of nutrients from tissues to the heart. In the area of the lower extremities, this network occurs in the form of deep or superficial veins, connected to each other by an emergency blood drainage system. Basically, most of the load falls on the deep veins, since they are larger and stronger. Superficial veins do about 15% of the work.
The heart is needed to pump and move blood through the veins, and some of the blood moves through the veins against gravity due to the work of surrounding muscles during walking and other movements. When the muscles are relaxed, the person moves little or stands, the blood returns downwards under the influence of gravity. But thanks to special valves it is kept in place.
If the valves fail to perform their function, the veins begin to dilate and become inflamed and cannot hold blood. Because of this, stagnation of blood circulation occurs, the veins expand and rise above the skin.
Blood circulation is impaired and varicose veins occur. The causes of varicose veins can be:
- absence, defect or damage to venous valves - the reverse flow of blood in the legs is interrupted, blood stagnates in the veins and they become stretched;
- constant stay in an upright position: very often hairdressers, teachers, sellers and others who cost a lot suffer from varicose veins;
- overweight and obesity: high weight puts pressure on the lower limbs, resulting in dilation of the veins and the appearance of varicose veins;
- intestinal diseases, constipation: create intra-abdominal pressure, which leads to varicose veins;
- flat feet;
- pregnancy: the uterus with the fetus creates additional pressure on the legs, causing varicose veins;
- weight lifting: excessive physical activity causes dilation of the veins and stretching of the walls of the blood vessels;
- 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 significantly.
Symptoms
In the initial stage, the veins located under the skin expand. If you immediately restore venous circulation, no other complaints will arise.
If the disease progresses, the following symptoms appear
- rapid fatigability;
- feeling of heaviness in the lower limbs;
- cramps in the calf muscles (more often appear in the evening and at night);
- There is a sensation of tingling and numbness in the legs.
With the further development of this disease, trophic disorders begin, which are 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 forms;
- 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 incurable.
In the chronic form of varicose veins, symptoms manifest themselves in the form of swelling of the lower extremities during prolonged standing. After a night's rest, the swelling usually disappears completely.
Varicose veins on the legs of men
Varicose veins in the legs of men occur in 32% of cases. Most often, the disease is observed at the age of 45 and older. Male varicose veins occur for the same reasons as female ones, due to heavy load on the lower extremities. It is less common, since this is due to the peculiarities of the structure of the male body. However, due to smoking and severe stress, varicose veins in men are observed already in middle age.
The development of varicose veins in men on the legs is associated with the loss of elasticity and tone of the vascular wall for several reasons:
- professional characteristics: inactive work, staying in the same position for a long time, standing work, weight lifting;
- excess weight;
- fatty and unhealthy foods that negatively affect the walls of blood vessels;
- liver diseases: hepatitis and cirrhosis;
- metabolic diseases, diabetes;
- active sports, bodybuilding, heavy physical activity;
- hypertension;
- hereditary factor;
- smoking and alcohol.
The disease can last several years. At first, a man may experience pain and swelling in the legs in the evening or after a long stay in a standing position. In the later stages, varicose veins in men on the legs cause hair loss and burning in painful areas, itching in venous nodes. Due to poor skin nutrition, trophic ulcers occur that itch and hurt. It becomes more difficult for the patient to walk, so the mobility of the limbs disappears. There is a loss of sensation and numbness in the legs.
Leg ulcers due to varicose veins
Ulcers on the legs are the most dangerous consequence of varicose veins. They are located on the internal surface of the lower third of the leg, in the supramalleolar region. Before their 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 irregular, flat, the secretions are scanty, serous or purulent. Trophic ulcers are difficult to heal and can increase in size. They become more painful when they trap fibers. Over time, the hardening of the subcutaneous tissue increases.
Trophic ulcers manifest themselves 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. An ulcer on the leg with varicose veins itches and itches, causing aching pain. It can be dangerous due to blood poisoning and limb amputation. How to treat an ulcer with varicose veins should be decided by a phlebologist after a comprehensive diagnosis of the veins.
Symptoms of varicose veins on 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 noted, the pain is practically not bothersome.
- Phase 2: feeling of heaviness, fullness, pain, cramps during sleep.
- Phase 3 – formation of edema, feeling of fullness, thickening of the skin and subcutaneous tissue, formation of dark spots.
- Stage 4 – appearance of trophic ulcers, burning and itching, severe pain, protruding veins, changes in gait, difficulty walking.
The most common symptoms of varicose veins on 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 with prolonged standing and disappears when lying down;
- burning and itching sensation in the legs in the evening;
- severe fatigue with light loads and short walks.
Another important symptom of varicose veins is that the veins become less noticeable when a person lies down or raises their legs and become larger when standing up, especially during prolonged standing.
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 working day. Bloating can occur in people who spend a lot of time on their feet and in those who are overweight. Comfortable shoes begin to tighten in the evening and become narrow. When you stay in the same position for a long time, your legs swell or swell immediately. You can check for leg swelling yourself. To do this, you need to measure the circumference of the shins with a tape measure: the narrowest part of the shin - the point above the ankles and the widest part - the calf muscle. It is necessary to measure 2 times a day: in the evening before going to bed and immediately after waking up. If within a few days the calf circumference 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 that itch and itch unpleasantly.
Complications
Varicose veins are a serious disease, as they can cause a number of consequences: eczema, skin ulcers, severe venous hemorrhages due to injuries of the lower extremities, thrombophlebitis.
Thrombophlebitis is especially dangerous because blood clots form in the vessels and can rupture at any time. Blockage of the pulmonary artery is fatal.
Varicose veins of the lower extremities can lead to 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 in the portal venous system increases.
With varicose veins in the legs it becomes difficult to walk and in the later stages the person becomes disabled.
Treatment of varicose veins on 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 dilated veins are glued, sealed and removed. The most common methods are:
Sclerosis
A procedure in which doctors glue small vessels together to remove "stars. "A special substance is injected into the vein to glue the walls of the vein together. After some time, this vein forms a cord and resolves. Sclerotherapy is a painless method and is carried out without anesthesia within 15 minutes.
Phlebectomy
If varicose veins require radical treatment, surgical intervention is used. Varicose vein surgery involves the removal of the veins. To do this, a procedure called phlebectomy is performed: this is a surgical operation in which the saphenous veins are removed. This helps prevent stress on the deeper venous layers.
Endovascular laser coagulation
The next method of vein removal is endovascular laser coagulation. A modern treatment method, the essence of which is the effect of the thermal energy of laser radiation. The laser hits 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 blood flow. The procedure is performed using local anesthesia and without hospitalization. An ultra-thin laser light guide is inserted into a vein through a skin puncture. The procedure gives good results and is popular due to the possibility of outpatient treatment and rapid rehabilitation.
Conservative treatment
In some cases, conservative treatment is used with drugs prescribed by the attending physician. 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.
Drugs for the treatment of varicose veins are divided into several groups:
- phlebotonics
- anticoagulants
- anti-edema remedies
- disaggregating
- during trophic changes
- antioxidants
- non-steroidal analgesics;
- fibrinolytics
The patient should bandage 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. blood.
Treatment of varicose veins in men involves the use of special compression garments, performing regular exercises, maintaining a correct diet and avoiding alcohol and smoking.
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 give up 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 compromise patency.
In the initial stages of the development of varicose veins and during treatment, it is necessary to regularly perform a set of therapeutic exercises. Exercises should be performed wearing compression clothing at a calm pace until you feel tired. In this case, jumping, running, dancing, classical dance, aerobics and step are excluded, as they increase the load on the veins of the legs. You cannot do strength training or lift barbells or dumbbells. Lifting weights exceeding 3-5 kg is excluded. Exercises in the pool, exercise bike with back support and cycling will be extremely useful. You can walk normally on a treadmill. The best thing is to walk outdoors alternating fast and slow pace.
After vein treatment and surgery, precautions must be taken. Wear suitable shoes, excluding those with high heels, the platform must not be higher than 4 cm. To improve blood circulation it is necessary to constantly wear class 1 or 2 compression clothing, depending on the stage of development of varicose veins on the legs. It is better to wear it during the cold season because it is more comfortable and convenient. It is advisable to give preference to high socks and tights, since knee socks pinch the leg at the knee.
Treatment of varicose veins with laser
For varicose veins, endovenous laser coagulation may be prescribed: laser surgery and echo sclerotherapy. Some patients are shown surgical removal of dilated veins under local anesthesia through pinpoint punctures of the skin surface - miniphlebectomy. Microsclerotherapy can be used to remove varicose veins and intradermal veins.
Laser energy is absorbed by the hemoglobin of red blood cells and within a second is converted into heat (95-100 degrees), which leads to the boiling of plasma and blood elements, causing a thermal burn of the endothelium, the walls of the veins. At the site of laser exposure, a dense blood clot is created, so the veins dissolve and become invisible. If the pots are large and arranged in several layers, the procedure must be repeated after a month.
Treatment of varicose veins with laser refers to surgical methods that are comparable to the method of treating the disease without surgery due to its low invasiveness, the absence of general anesthesia and strictly local exposure of the laser only to the wall of the varicose veins. .
Laser surgery is performed using a duplex ultrasound scanner. The doctor inserts a thin light guide through a skin puncture into the lumen of the vein. The radiation of a certain wavelength of the laser, which is partially absorbed by the wall of the dilated vein, seals the diseased veins. The clinics use a new generation laser that selectively targets the walls of the veins without damaging the surrounding tissue.
The advantages of laser treatment of varicose veins are numerous:
- outpatient treatment – the patient does not require hospitalization and can return home immediately after the procedure;
- local anesthesia is used: general anesthesia or spinal anesthesia is not required;
- short duration of the procedure: laser treatment is performed in 60-90 minutes, after which the patient can return home;
- long-lasting cosmetic effect - after removing varicose veins with laser, no traces remain on the skin; sometimes a dark stripe 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 wears 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 in the area where the large varicose veins are located. Immediately after the treatment procedure, the patient should walk at least 4-5 kilometers. The walk must be brisk and fast so that the blood begins to circulate well and the veins develop. After laser surgery, in the first few days you need to walk for an hour every day.
After laser treatment of varicose veins, it is necessary to regularly 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 art. Gymnastics should be performed every day at a moderate pace, with rest breaks. Its goal is to reduce blood stagnation in the veins, but not to swell the legs, so you should not overwork. After class, you need to lie down with your legs raised at an angle of 90 degrees for several minutes.
Radiofrequency coagulation
Another way to remove 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 the blood flow, when using this method, the vein is, as it were, soldered 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 carrying out the procedure for any concomitant pathologies. This technique does not have a systemic effect on the patient's body.
Since the most difficult consequence of chronic venous insufficiency is trophic ulcers, their treatment is carried out comprehensively, including the method of intravenous laser coagulation, scleropathy and miniphlebectomy. Local treatment is often carried out, 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 drugs:
- Phlebotonics are drugs that act positively on the venous wall and have a tonic effect. They are available in different forms (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 limbs when walking. Wearing specialized underwear made of compression hosiery and bandages made of special bandages will help significantly alleviate the course of the disease and prevent the further spread of complications.
How to treat varicose veins on the legs at home
Varicose veins require physical activity, but it should be gentle, so strength exercises, weight lifting 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 from work, you can do a simple exercise for varicose veins. Stand on your toes 20 times, lifting your heels off the floor. This exercise will help get rid of varicose veins, as it acts like a pump and improves vascular tone. At the end of the day, try keeping your feet elevated or on a pillow. It will be useful to perform the "bicycle" exercise or exercise on an exercise bike with back support.
You need to exercise gently, excluding running, jumping, lifting barbells and dumbbells, strength exercises, squats and deadlifts in the gym. The most effective and healthy sports would be swimming, swimming, walking and cycling. Swimming trains the blood vessels in the legs, while being gentle on the lower limbs, unlike running and strength exercises. It helps eliminate swelling, heaviness in the legs, increases vascular tone and eliminates aesthetic defects.
Every day you need to perform a set of therapeutic exercises for the legs to eliminate swelling, improve blood circulation and strengthen the vascular wall. The exercises should be performed until the legs feel tired. After the gymnastics complex, you need to rest and lie down with your feet on a pillow or on the armrests of the sofa. It is useful to complete the exercises with a contrast shower or foot bath.
It is important to adhere to proper nutrition. It is necessary to exclude salty, spicy and spicy foods, smoked foods, fatty, fried, starchy and sweet foods, as they destroy the walls of blood vessels and retain fluid in the body. It is forbidden 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 acidic fruits, nuts, seeds, herbs, vegetables. As for drinks, it is better to give preference to fruit drinks, jellies, herbal teas and herbal teas. Sugar should be replaced with honey.
It is useful to consume juice days 2 times a week, after consulting your doctor to check if you have stomach diseases.
Prevention of varicose veins
Since varicose veins are often caused by blood pooling in the extremities, at home rest your legs on 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 slightly raise your legs.
Prevention of varicose veins involves weight loss, as excess weight creates additional stress on the legs. Women should not carry weights greater than 3 kilograms in one hand. You have to give up tight clothes and shoes, tight socks and stockings. The heel should not exceed 4 cm, as it creates an obstacle to normal blood circulation. Compression knitwear trains and fixes the veins well, improves their tone. Underwear should be purchased in a pharmacy or specialized store.
Sedentary work requires regular warming up and stretching, and it helps to get up and walk around. If possible, place a low bench under your feet, this will improve blood flow. Walk more often, do regular exercise, swim and climb stairs. This will prevent the development of varicose veins and improve muscle tone.
To avoid varicose veins, you need to follow preventive measures. You should try to minimize hot baths, saunas and steam rooms, as well as prolonged exposure to the sun. This will help reduce venous tone, which leads to blood stagnation in the legs.
To prevent varicose veins in the legs, avoid wearing tight clothing such as socks or stockings with tight elastic, 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 higher than 4 cm, high-heeled shoes can be worn for festive events.