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 adherence to preventive measures.
There are many reasons for the appearance of varicose veins: from a sedentary lifestyle, physical overload, to hormonal imbalance, congenital weakness of the vascular walls and pregnancy.What happens during varicose veins?In varicose veins of the lower extremities, they lose their normal elasticity and stretch under blood pressure.
The valves in the veins are usually locked and when blood passes through them, they close and allow the blood to flow back.If the valves don't work, blood can freely flow downwards, resulting in blood stagnation.
In this regard, the veins cannot cope with the pressure, they expand, the valves can no longer close the large lumen... all this causes the appearance of the initial stage of varicose veins (see picture).
Reasons
Why do varicose veins occur 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 are twice as likely to be victims of varicose veins as men.
Disease development is encouraged by:
- Heredity.What is not inherited is not the disease itself, but the genetically determined structure of the veins: weak connective tissue of the vein walls, congenitally defective venous valves.This is why varicose veins can be seen in young, healthy and active (regardless of gender) people, and even in children.According to scientists, genetic predisposition is the main factor that leads to varicose veins on the legs.
- Hormonal changes.Due to the characteristics of the organism in women, periods of hormonal imbalance become causes of blood stagnation.The most dangerous periods for them are puberty, pregnancy and the time after childbirth.The time when menopause occurs is also dangerous.This gender category of patients turns to 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 encourages dilation of the veins.
- A sedentary, sedentary lifestyle or work that requires prolonged standing contributes to the development of varicose veins.
- Old age.Over time, the valves and walls of the veins become thinner, which leads to disruption of their function.
- Obesity.Excess weight leads to increased stress on leg veins.
Secondary varicose veins occur in 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 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 are twice as likely to be victims of varicose veins as men.
Disease development is encouraged by:
- Obesity
- Prolonged stay in a standing or sitting position
- Heavy physical activity
- Sedentary lifestyle
- Prison
- Smoking
Secondary varicose veins occur in 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 varicose veins?
The development of varicose veins is based on congenital weakness of the venous wall, incompetence of the valves of the superficial veins and the resulting increase in venous pressure.Special one-way valves prevent blood from returning and prevent it from stagnating in one place;when they are destroyed, the movement of blood from the tissues back to the heart is disturbed.It is worth noting that conservative treatment does not affect the pressure in the veins.
Phases
There are 3 stages of symptom progression in the development of varicose veins.
- Compensation phase.No complaints.During the examination, varicose veins are observed on one or both legs.
- Subcompensation phase.On examination, pronounced dilated veins on the legs are visible.Patients complain of a feeling of fullness, paresthesia ("pins and needles") in the lower legs and night cramps.In the evening, slight swelling of the feet, ankles and legs occurs.In the morning, the swelling disappears.
- Decompensation phase.Dermatitis and eczema are added to the above symptoms.Patients suffer from itchy skin.The skin becomes dry, shiny, firmly fused with the subcutaneous tissue.Smaller hemorrhages and later deposition of hemosiderin cause hyperpigmentation.
Varicose veins in themselves are not considered a very serious disease, but if they have already developed, they will never disappear by themselves, and moreover, they will progress, which leads to various complications that pose the greatest danger.
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, protruding veins and various seals can be observed, which indicates the congestion of blood vessels.
Varicose veins: symptoms
It is quite difficult to diagnose the early stage of the disease, because in the initial stage there are no spider veins and varicose 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 vein pattern on 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 discomfort is caused only by cosmetic defects on the skin.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 nodes protruding above the skin indicate progression and neglect of the disease.When standing for a long time, aching pain occurs in the area of the joints, numbness, tingling, "crawling", and swelling in the legs are felt.By the end of the day, swelling often occurs, which disappears after a night's sleep.The island can be judged by the loose shoes in the morning, which start 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 part leads to the penetration of red blood cells through the walls of blood vessels into the tissue.Because of 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 knot, it can burst and cause heavy bleeding.
Diagnostics
In order 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 (ultrasound of veins) is the most informative method for diagnosing varicose veins of the legs, which allows one to get an idea of the degree of vein enlargement, 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 find out about the degree of their permeability for blood.
Only a highly qualified phlebologist can diagnose varicose veins of deep veins.
Consequences
Complicated course of varicose veins is accompanied by thrombosis and inflammation of 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 swelling of the ankle, especially when walking or standing.In the area of the lower leg, there is pain when walking, pain along the tortuous vein, thickening of the skin and formation of ulcers of various sizes on 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 elasticity of the venous wall and contribute to the stagnation of venous blood in the legs.
- Increased intra-abdominal pressure in late pregnancy hinders blood flow through leg veins.
- Varicose veins that occur during pregnancy can completely disappear after childbirth, or progress further, depending on individual factors (heredity, the presence of other contributing factors).
Treatment of varicose veins on the legs
For varicose veins in the legs, treatment may not be medically necessary unless the symptoms are troublesome.
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 you get rid of this problem.
- Sclerotherapy.This method of treatment is used independently and in combination with conservative interventions.Its essence is that a special drug is injected into the vein, which closes it with a thin needle or syringe, and after that the vein disappears completely.Sessions are held once a week, 3 to 6 such sessions are required.The method allows you to avoid scars and scars.
- Non-surgical treatment.If varicose veins are at an early stage and do not cause too much discomfort, elastic compression stockings may be recommended.They are worn during everyday activities.They help compress the veins, preventing them from stretching and limiting any discomfort or pain.
- Treatment of varicose veins with drugs 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 of varicose veins on the legs can be used on the surface of the skin.With the help of a small flash of laser light, the process of sclerosis occurs in the vein wall and the varicose vein disappears, as if it had been removed.
A big role in treatment and prevention is played by physical activity - brisk walking, gymnastics, swimming and water exercises (excluding sports exercises with a heavy load on the legs - tennis, weight lifting, jumping).
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 slightly enlarged veins, which is a purely cosmetic defect.The goal of conservative therapy is to prevent further progression of this disease.For this purpose, patients are recommended to wrap their legs affected by varicose veins with an elastic bandage.In addition, compression knitwear is indicated for varicose veins.People who are prone to varicose veins or already suffer from this disease should regularly put their feet on an elevated surface during the day, resting in this way for a few minutes.There are also special exercises for the lower leg and foot, which aim to activate the muscular-venous pump.This is periodic extension and flexion of the ankle and knee joints.
The patient should be careful not to allow the legs and thighs to come together with various toilet items, as this can significantly impede the flow of venous blood.
Using elastic compression, you can activate blood flow in deep veins, prevent swelling, reduce the amount of blood in saphenous veins, stimulate metabolic processes in the body and blood microcirculation.
But in order to achieve positive results, it is important to bandage the leg properly.This procedure must be done in the morning, before getting out of bed.The bandage starts from the toes to the thigh and you should feel a slight tension of the bandage.During the wrapping process, be sure to grasp the heel and ankle.With each turn around the limb, the bandage should cover half of the previous turn.You should only buy certified elastic bandages and compression stockings.
Treatment of varicose veins also includes wearing comfortable shoes, which should have low heels and hard soles.You should not stand for a long time, allow physical stress, or stay for a long time in rooms with high temperature and humidity.It is recommended to keep your legs elevated while sleeping.
Patients should limit fluid and salt intake and try to get rid of them excess weight.For the treatment of varicose veins, it is occasionally necessary to take diuretics, drugs that improve the tone of the veins.In addition, if indicated, the patient can be prescribed drugs that stimulate microcirculation in the tissues.Treatment of 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 5-10% sodium chloride solution is added, are very useful.
Local therapy methods are very often used in the treatment of varicose veins.But such treatment must be used in combination with other medical methods.Topical drugs for varicose veins are produced in the form of gels, ointments and creams.Most of these medicines contain heparin or venoactive components.Ointments for varicose veins help to 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 occurs during the process of varicose veins, it is advisable to use external means with antibiotics or antiseptics.
It has been used for healing since ancient times hirudotherapy with varicose veins.The use of leeches that secrete hirudin allows blood to be diluted and promotes resorption blood clots, dealing with 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 accompanying 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 allow the use of endoscopic techniques for such an operation.
If a person has only small branches enlarged, sclerotherapy can be used.This operation involves injecting a sclerosing solution into the vein to seal the vein walls.After that, injections are repeated in other parts of the vein, which achieves complete obliteration of the vein.
In the case of varicose veins, combined surgical therapy is used, 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 immediately be disappointed: even the most modern and expensive drugs cannot completely remove varicose veins.They help relieve pain, swelling and even improve the condition of the vein wall, but complete recovery does not occur.
In addition, conservative treatment brings a noticeable effect only in the initial stage of the disease, after which it is carried out to prevent further development of varicose veins.Herbal medicines, which are based on natural plant substances, play a leading role in the treatment of this disease.However, we should not forget that most venotonics cause photosensitivity;when taking them, 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 regular wearing of compression stockings: socks, knee socks, tights.They improve blood microcirculation and prevent edema.It is very important to choose the correct size of elastic stockings and the degree of compression, which can be both preventive and therapeutic.
Treatment with tablets and ointments
Venotonic tablets for varicose veins - phlebotonics - are used to improve vascular tone.These drugs are analogues and contain a purified flavonoid fraction consisting of 90% diosmin.One tablet is taken twice a day, the course of treatment is chosen individually.
You can reduce capillary permeability, reduce blood viscosity and increase vein tone with the help of preparations based on horse chestnut
How to treat varicose veins with folk remedies
There are a huge number of methods for treating varicose veins on the legs with folk remedies, both for external and internal use.Below are the most common:
- Horse chestnut flowers (50 grams) should be poured with 500 grams of alcohol, and then left to brew for 14 days, shaking the bottle every day.Pass the tincture through a mesh and take a tablespoon of water three times a day before meals.After you have been on therapy for a week, take a two-week break.Then the treatment can be restarted.
- An infusion of dried nettle is used for varicose veins.Dry crushed leaves of the plant are poured into a thermos with 1/2 liter of boiling water, left for 30-40 minutes, strained and taken 1/3 cup 3 times a day 1 hour after meals.
- Tomato compress.Finely chopped tomatoes, put on a bandage, gauze and apply to the painful area.For convenience, you can tie it with an elastic or other bandage.Keep this dressing on the vein for 2 hours, then change it to a new one, and so 3 times in total.The convenience of this wrap is that it can be repeated every day.
- Oil tincture of walnuts: chop unripe walnuts, pour into a glass container, cover with olive oil and leave for 40 days in a sunny place.Apply the prepared tincture to sore spots.The course of treatment is long, as with the use of Kalanchoe.
In addition to folk remedies, many patients with varicose veins supplement therapy with special gymnastics - Mikulin's exercises allow you to feel a significant improvement.
Complications of varicose veins of the legs
It often occurs as a complication of varicose veinsacute thrombophlebitis of superficial veins.Sometimes, as a result of damage, varicose veins burst and bleed.When blood oozes from a ruptured node, very significant blood loss is possible.
In addition, due to increased pressure in the venous system, arterial blood flow slows down.This is why 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 strong stagnation of blood in the veins, toxins accumulate in the tissues.
Complications of this disease are blockage of blood vessels by a blood clot, disturbed nutrition of the leg tissues, appearance of pigmentation and darkening of the skin.
The layer of subcutaneous fat gradually becomes denser, idermatitis,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 suffered from varicose veins or because of their occupation they are forced to spend a lot of time standing, you need to pay special attention to the condition of your legs so that you don't miss the first "bells".
Basic preventive measures help prevent the onset of disease and slow down the progression of existing varicose veins.
Prevention 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 higher than 6 cm.
- Avoid gaining weight.Try to eat a diet rich in fiber, vegetables and fruits.
- Avoid overly intense physical activity and heavy lifting.
- Perform special exercises for the legs, including lifting them ("bicycle", "scissors").
- Do a 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 a visit to a vascular surgeon, because the sooner the disease is detected, the greater the chances of avoiding surgery.
Forecast
Varicose veins on the legs are a disease that can be treated for years;even after surgical removal, 80% of them recur.
The prognosis depends on the stage at which the treatment is started.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 need to adhere to a strict prevention framework throughout your life.
In the later stages (with the appearance of severe deformations, knots, swelling and signs of oxygen starvation in the tissue), the prognosis is determined by the presence of concomitant diseases (diabetes, obesity) and the patient's willingness to comply with the doctor's recommendations (check up, 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.