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 imbalance, 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 closed, and when blood passes through them, they close and allow the blood to flow back out.If the valves do not function properly, blood can freely flow downwards, leading to 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 provokes 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 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 fall victim to varicose veins twice as often as men.
The development of the disease is promoted by:
- Heredity.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 venous valves.That is why varicose veins can be observed in young, healthy and active (regardless of gender) people 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 body in women, periods of hormonal imbalance become causes of blood stagnation.For them, the most dangerous periods are puberty, pregnancy and the period after childbirth.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 muscle relaxing effect.This promotes dilation of the veins.
- A sedentary, sedentary lifestyle or work that requires prolonged standing contributes to the development of varicose veins.
- Age.Over time, the valves and walls of the veins become thinner, which leads to a violation 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, appropriate treatment of the underlying 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 fall victim to varicose veins twice as often as men.
The development of the disease is promoted by:
- obesity
- Prolonged standing or sitting
- Heavy physical activity
- A sedentary lifestyle
- constipation
- Smoking
Secondary varicose veins occur with leg injuries, heart defects, liver and spleen dysfunction.In this case, first of all, appropriate treatment of the underlying 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 backflow of blood and prevent it from stagnating in one place;when they are destroyed, the flow of blood from the tissues back to the heart is impaired.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 stage.No complaints.On examination, varicose veins of one or both legs are observed.
- Stage of subcompensation.On examination, pronounced varicose veins are visible on the legs.Patients complain of a feeling of fullness, paresthesia ("tingling") in the lower legs and night 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 worried about itchy skin.The skin becomes dry, shiny, tightly merged with the subcutaneous tissue.Small hemorrhages and the subsequent 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 on their own and will even progress, which will lead to all kinds of complications that pose the greatest danger.
Signs
The first signs indicating the beginning of the development of varicose veins:
- rapid leg fatigue;
- swelling of the lower limbs;
- feeling of heaviness in the legs.
In the later stages, the appearance of cobwebs on the skin, bulging veins and various seals can be noticed, indicating congestion in the blood vessels.
Varicose veins: symptoms
It is quite difficult to diagnose the early stages of the disease, because in the initial stage there are no spider veins and varicose veins rising above the skin.
Early symptoms of varicose veins:
- Heavy legs at the end of the day
- Fatigue
- Mild to moderate pain
- Increased venous pattern of the skin
Often, before the first spider veins appear or veins are found 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 inconvenience.As a rule, in the early stages, the symptoms of varicose veins completely disappear or significantly decrease with rest, and therefore often remain unnoticed.
One or more varicose nodes protruding above the skin indicate progression and neglect of the disease.With prolonged standing, pain appears in the area of the nodes, numbness, tingling, "creeping" and swelling of the legs are felt.By 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 include thrombophlebitis.In addition, the increased pressure in the venous section leads to the penetration of red blood cells through the walls of the blood vessels into the tissue.Therefore, 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 nodule, it can burst and cause heavy 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, which includes various methods.
- Duplex scanning (ultrasound of the veins) is the most informative method for diagnosing varicose veins of the legs, which allows you 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 a research method that allows you to find varicose veins and learn about the degree of their permeability for blood.
Only a highly qualified phlebologist can diagnose varicose veins of the deep veins.
Consequences
The complicated course of varicose veins is accompanied by the formation of thrombosis and inflammation of the veins, trophic ulcers and skin diseases.These complications are expressed in changes in the color of the skin of the legs, redness, darkening and bruising of the skin.
It is also characterized by constant swelling of the ankle, especially when walking or standing.In the area of the calf there is pain when walking, pain along the arched 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, due to the following reasons:
- Hormones circulating in the blood during pregnancy increase the extensibility of the venous wall and contribute to the stagnation of venous blood in the legs.
- Increased intra-abdominal pressure at the end of pregnancy makes it difficult for blood circulation through the leg veins.
- Varicose veins that appear during pregnancy may disappear completely after birth 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 medically necessary unless the symptoms are problematic.
However, some people may want 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 you get rid of this problem.
- Sclerotherapy.This method of treatment is used both alone 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 subsequently the vein completely disappears.Sessions are held once a week, from 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 if they do not cause much discomfort, elastic compression stockings may be recommended.They are worn for everyday activities.They help to compress the veins, preventing them from stretching and limiting 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 of varicose veins of the legs can be used on the surface of the skin.With the help of a small flash of laser light, a process of sclerosis develops in the venous wall and the varicose vein disappears as if it had been removed.
A major role in treatment and prevention is played by physical activity - brisk walking, gymnastics, swimming and water exercises (with the exception of sports with a heavy load on the legs - tennis, weight lifting, jumping).
Conservative treatment of varicose veins is prescribed mainly to those people who have clear contraindications for surgical intervention.
Also, such treatment is indicated if the patient has mild varicose veins, which is a purely 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, compression hosiery is indicated for varicose veins.People who are prone 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 musculo-venous pump.This is periodic extension and flexion of the ankle and knee joints.
The patient should be careful not to tighten the legs and thighs by various toilet items, as this can significantly impede the outflow of venous blood.
With the help of elastic compression, you can activate the blood flow in the 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 correctly.This procedure should be done in the morning before getting out of bed.Bandaging starts from the toes to the thigh, and a slight tension of the bandage should be felt.During the bandage process, do not forget to grasp the heel and ankle joint.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 firm soles.You should not stand for a long time, allow physical stress, stand 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 overweight.For the treatment of varicose veins, it is necessary to periodically take diuretics, drugs that improve the tone of the veins.In addition, if there are indications, the patient can be prescribed drugs that stimulate microcirculation in the tissues.Treatment of varicose veins may also include the use of 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 should 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 drugs 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, then it is advisable to use external means with antibiotics or antiseptics.
It has been used for treatment since ancient times hirudotherapy with varicose veins.The use of leeches, which secrete hirudin, allows blood dilution and promotes resorption blood clots, 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 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, as well as people suffering from purulent diseases.Modern technologies allow the use of endoscopic techniques for such an operation.
If a person only has small enlarged branches, sclerotherapy can be used.This surgery involves injecting a sclerosing solution into the vein to seal the vein walls.Repeated injections are then made in other areas of the vein, achieving complete obliteration of the vein.
For varicose veins, combined surgical therapy is also used, in which large trunks of the changed veins are removed and sclerotherapy is performed on small branches.After surgery, patients are advised 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 eliminate varicose veins.They help relieve pain, swelling and even improve the condition of the venous 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 the further development of varicose veins.The leading role in the treatment of this disease belongs to herbal medicines, which are based on natural plant substances.However, we must not forget that most venotonic drugs cause photosensitivity;when taking them, exposure of open skin to sunlight should not be allowed.
In addition to the use of drugs, relaxation measures and special exercises for the legs, doctors strongly recommend regular wearing of compression stockings: socks, knee socks, pantyhose.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 course of treatment is selected individually.
You can reduce the permeability of 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 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, then left to brew 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 you have been treated for a week, take a break for two weeks.After that, treatment can start again.
- An infusion of dried nettle is used for varicose veins.Dry crushed leaves of the plant are poured into a thermos with 1/2 l of boiling water, left for 30-40 minutes, strained 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 a sore spot.For convenience, you can tie it with an elastic or another bandage.Keep this compress on the vein for 2 hours, then replace it with a new one, and so 3 times in total.The convenience of this compress is that it can be repeated every day.
- Oil tincture of walnuts: unripe nuts are cut, poured into a glass container, poured with olive oil and left for 40 days in a sunny place.Lubricate the sore spots with the prepared tincture.The course of treatment is long, as with the use of Kalanchoe.
In addition to folk remedies, many patients with varicose veins supplement the therapy with special gymnastics - Mikulin's exercises allow you to feel a significant improvement.
Complications of varicose veins of the legs
Very often it appears as a complication of varicose veinsacute thrombophlebitis of superficial veins.Sometimes, as a result of damage, varicose veins rupture and bleed.When blood leaks from a knot that has ruptured, very significant blood loss is possible.
In addition, due to increased pressure in the venous system, arterial blood flow slows down.Therefore, 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 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 layer of subcutaneous fat gradually becomes denser anddermatitis,venous trophic ulcers.In very rare cases, such ulcers degenerate into malignant formations.
If the disease lasts for a long 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 relatives suffered from varicose veins, or because of their profession they are forced to spend a lot of time standing, 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 delay the development 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 height of the current is no more than 6 cm.
- Avoid gaining weight.Try to eat a diet rich in fiber, vegetables and fruits.
- Avoid excessively intense physical activity and heavy lifting.
- Do 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 with lukewarm 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 surgery.
Forecast
Varicose veins of the legs is a disease that takes years to treat;even after surgical removal, 80% of them recur.
The prognosis depends on the stage at which 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 deformation, nodules, 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 (examine, take medication, lose weight).
In diabetes, complications of varicose veins (thrombophlebitis, trophic ulcers) develop in 89%.
Varicose veins are considered a life-threatening disease, but its complications can significantly impair quality of life and prognosis.In deep vein thrombosis, about 50% of patients die of thromboembolism within 3 months.