Varicose veins (varicose veins of the lower limbs)– this is damage to the walls of the veins of the lower extremities, weakening of the venous valves, leading to impaired blood flow and stagnation of blood. The functioning of the venous valves is impaired, which leads to reflux and stagnation of blood. The walls of the veins expand, thin and burst. Over time, blood clots form, which can block a vessel and lead to a stroke or heart attack. Women are most often at risk of varicose veins, but men can also suffer from them. The age of the disease is 20 years and older, sometimes varicose veins can occur in adolescence. Varicose veins are most often caused by a sedentary lifestyle and work characteristics, but the disease can also arise from other factors.
Causes of varicose veins
The body's veins are essential for blood circulation and transporting nutrients from tissues to the heart. In the lower limbs, this network takes the form of deep or superficial veins, linked together by an emergency blood evacuation system. Basically, most of the load falls on the deep veins, because they are larger and stronger. The superficial veins do about 15% of the work.
The heart is needed to pump and circulate blood through the veins, and some 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 upright, the blood returns downward under the influence of gravity. But thanks to special valves, it is held in place.
If the valves do not perform their function, the veins begin to dilate and become inflamed; they can no longer hold blood. Due to this, blood circulation stagnates, veins expand and rise above the skin.
Blood circulation is impaired and varicose veins appear. The causes of varicose veins can be:
- absence, defect or damage to the venous valves - the reverse blood flow in the legs is disrupted, blood stagnates in the veins and they stretch;
- constantly stay in an upright position - most often hairdressers, teachers, sellers and other expensive people suffer from varicose veins;
- overweight and obesity - high weight puts pressure on the lower limbs, which leads to dilation of veins and the appearance of varicose veins;
- intestinal diseases, constipation - create intra-abdominal pressure which leads to varicose veins;
- flat foot;
- pregnancy - the uterus and fetus create additional pressure on the legs, which causes varicose veins;
- lifting weights - excessive physical activity causes dilation of veins and stretching of blood vessel walls;
- 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 to the lower extremities. In old age, almost everyone suffers from varicose veins, as the valves weaken and function poorly. They become inelastic and stretch considerably.
Symptoms
In the initial stage, the veins located under the skin expand. If you immediately establish venous circulation, no further complaints will arise.
If the disease progresses, the following symptoms appear
- rapid fatigability;
- feeling of heaviness in the lower limbs;
- calf muscle cramps (most often appearing in the evening and at night);
- There is a feeling of tingling and numbness in the legs.
With the further development of this disease, trophic disorders begin, which are most often concentrated in the area of the inner surface of the lower leg.
Symptoms of trophic disorders
- thickening of the vein walls is formed;
- skin hyperpigmentation appears in places;
- skin atrophy;
- dermatitis is a disease characterized by inflammation of the skin;
- in later stages of the disease, a trophic ulcer can progress, practically incurable.
In the chronic form of varicose veins, symptoms appear as swelling of the lower limbs during prolonged standing. After a night's rest, the swelling usually disappears completely.
Varicose veins on men's legs
Varicose veins in men's legs 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 a strong load on the lower extremities. It is less common, as 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 a loss of elasticity and tone of the vascular wall for several reasons:
- professional characteristics - inactive work, staying in one position for a long time, standing work, lifting weights;
- overweight;
- fatty and unhealthy foods that negatively affect the walls of blood vessels;
- liver diseases: hepatitis and cirrhosis;
- metabolic diseases, diabetes;
- active sports, bodybuilding, intense physical activity;
- high blood pressure;
- hereditary factor;
- smoking and alcohol.
The illness can last for several years. At first, a man may experience pain and swelling in the legs in the evening or after a long stay in an upright position. In later stages, varicose veins in men on the legs cause hair loss and burning in painful areas, as well as itching in venous nodes. Due to poor nutrition of the skin, trophic ulcers arise, causing itching and pain. It becomes more difficult for the patient to walk, then the mobility of the limbs disappears. There is loss of sensation and numbness in the legs.
Leg ulcers due to varicose veins
Leg ulcers are the most dangerous consequence of varicose veins. They are located on the inner side of the lower third of the leg, in the supramalleolar region. Before their appearance, dermatitis occurs, accompanied by eczema and severe itching. Ulcers can be single or multiple, most often flat, the bottom is smooth, the edges are uneven, flat, the discharge is rare, serous or purulent. Trophic ulcers are difficult to heal and can grow larger. They become more painful when they trap the fibers. Over time, induration of the subcutaneous tissue increases.
Trophic ulcers appear with characteristic symptoms; it's hard to ignore them. 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 itch and itch, causing painful pain. May be dangerous due to blood poisoning and limb amputation. How to treat an ulcer accompanied by 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 visible, the pain is practically not bothersome.
- Stage 2 - a feeling of heaviness, fullness, pain, cramping during sleep.
- Stage 3 – formation of edema, feeling of fullness, thickening of the skin and subcutaneous tissue, formation of brown 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:
- heaviness and fatigue in the legs, cramps in the calf muscles during sleep and after waking up;
- dull, arching pain in the calves, intensifying on prolonged standing and disappearing on lying down;
- burning and itching in the legs in the evening;
- severe fatigue with light loads and short walking.
Another important symptom of varicose veins is that the veins become less visible when a person lies down or raises their legs and become larger when they stand up again, especially during prolonged standing.
Varicose veins in the legs cause swelling of the soft tissues of the feet, ankles, and lower legs. Most often this is visible in the evening after a day of work. Swelling may occur in people who spend a lot of time on their feet and in those who are overweight. Comfortable shoes start to feel tight in the evening and become tight. When you stay in the same position for a long time, your legs immediately swell or swell. You can check leg swelling yourself. To do this, you need to measure the circumference of your shins with a tape measure: the narrowest part of the shin - the place above the ankles and the widest part - the calf muscle. You need to measure 2 times a day: in the evening before going to bed and immediately after waking up. If in a few days the calf circumference changes by more than 1 cm, then there is a reason to check your 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, which itch and itch unpleasantly.
Complications
Varicose veins are a serious disease, because they can lead to many consequences: eczema, skin ulcers, severe venous bleeding due to injuries to the lower extremities, thrombophlebitis.
Thrombophlebitis is particularly dangerous, because blood clots form in the vessels and can break off at any time. Pulmonary artery blockage is fatal.
Varicose veins of the lower limbs 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 vein system increases.
With varicose veins in the legs, it becomes difficult to walk, and later the person becomes disabled.
Treatment of varicose veins on the legs
The nature of the treatment for varicose veins of the legs depends on the stage of the disease and the symptoms. There are many procedures for taping, sealing, and removing enlarged veins. 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 a while, this vein forms a cord and resolves. Sclerotherapy is a painless method and takes place without anesthesia in 15 minutes.
Phlebectomy
If varicose veins require radical treatment, then surgical intervention is used. Varicose vein surgery involves removing 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 deeper venous layers.
Endovasal laser coagulation
The next method of vein ablation is endovasal laser coagulation. A modern treatment method, the essence of which is the effect of thermal energy of laser radiation. The laser only affects areas of the vein wall, without affecting nearby tissues and nerve endings. Under the influence of radiation, the vein closes and is excluded from blood circulation. The procedure is performed under 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 medications prescribed by your attending physician. It is suitable for patients who are contraindicated for surgery, have insufficiency of deep venous valves, have varicose veins in the initial stage, have only a cosmetic defect and refuse to undergo surgery.
Medicines for the treatment of varicose veins are divided into several groups:
- phlebotonic
- anti coagulants
- anti-edema remedies
- disaggregators
- during trophic changes
- antioxidants
- nonsteroidal 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 inlegs and eliminate venous stagnation of blood.
Treatment of varicose veins in men involves wearing special compression garments, performing regular exercises, maintaining a good diet, and avoiding alcohol and tobacco.
Treatment for varicose veins in the legs involves dieting to lose weight and reduce swelling and tension in the legs. It is necessary to abandon salt and sugar and reduce fluid intake. It is necessary to include foods containing vitamins P, C, E, proteins and microelements in your diet to strengthen the vascular wall. Smoking and drinking alcohol is prohibited, as they stretch the walls of blood vessels and impair permeability.
At the early stages of the development of varicose veins and during treatment, it is necessary to regularly perform a complex of therapeutic exercises. Exercises should be performed in compression clothing at a calm pace until you feel tired. In this case, jumping, running, dancing, ballet, aerobics and step are excluded, as they increase the load on the veins of the legs. You cannot do weight training or lift dumbbells or barbells. Lifting weights of more than 3 to 5 kg is excluded. Pool exercises, an exercise bike with back support, and cycling will be extremely helpful. You can walk normally on a treadmill. It is best to walk outside, alternating between fast and slow paces.
After vein treatment and surgery, precautions should be taken. Wear suitable shoes, high-heeled shoes are excluded, the platform must not exceed 4 cm. To improve blood circulation, you should constantly wear class 1 or 2 compression clothing, depending on the stage of development of varicose veins on the legs. . It is best to wear it in the cold season, as it is more comfortable and practical. It is recommended to favor high stockings and tights, as high socks will pinch your leg at the knee.
Laser varicose vein treatment
For varicose veins, endovenous laser coagulation can be prescribed - laser surgery and echosclerotherapy. Some patients undergo surgical removal of enlarged veins under local anesthesia through point punctures of the skin surface - miniphlebectomy. Microsclerotherapy can be used to remove spider veins and intradermal veins.
Laser energy is absorbed by the hemoglobin of red blood cells and is converted within a second into heat (95-100 degrees), which leads to boiling of plasma and blood elements, causing thermal burn of the endothelium- the walls of the veins. A dense blood clot forms at the laser exposure site, then the veins dissolve and become invisible. If the vessels are large and distributed in several layers, the procedure should be repeated after a month.
Laser treatment of varicose veins refers to surgical methods comparable to the method of treating the disease without surgery due to its low invasiveness, lack of general anesthesia and strictly local exposure of the laser only tothe wall of 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. Radiation of a certain laser wavelength, partially absorbed by the wall of the dilated vein, seals diseased veins. The clinics use a new generation laser that selectively affects the walls of the veins without damaging the surrounding tissues.
Laser treatment of varicose veins has several advantages:
- outpatient treatment – the patient does not need to be hospitalized and can return home immediately after the procedure;
- local anesthesia is used – general anesthesia or spinal anesthesia is not necessary;
- short duration of the procedure - laser treatment is carried out in 60-90 minutes, after which the patient can go home;
- long-lasting cosmetic effect - after removing varicose veins with a laser, no traces remain on the skin, sometimes a dark strip of skin may appear and disappear 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 large varicose veins are located. Immediately after the treatment procedure, the patient should walk at least 4-5 kilometers. Walking should be brisk and brisk so that the blood begins to circulate well and the veins develop. After laser surgery, for the first few days you should walk for an hour every day.
After laser treatment of varicose veins, it is necessary to carry out regular vascular diagnosis. Therapeutic gymnastics, walking, swimming, cycling are presented. It is worth giving up running, jumping, bodybuilding exercises in the gym, weightlifting, dancing and any types of martial arts. Gymnastics should be done every day at a moderate pace, with 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 a 90-degree angle for several minutes.
Radiofrequency coagulation
Another way to eliminate 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 blood flow, when using this method, the vein is, as it were, welded 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 possible concomitant pathologies. This technique does not have a systemic effect on the patient's body.
Since trophic ulcers are the most difficult consequence of chronic venous insufficiency, their treatment is carried out comprehensively, including the method of laser endovenous 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 medications:
- phlebotonics are drugs that have a positive effect on the vein wall and have a tonic effect. They come 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 extremities when walking. Wearing specialized underwear made from compression knitwear and bandages made from special bandages will help significantly alleviate the course of the disease and prevent the spread of complications.
How to treat varicose veins on the legs at home
Varicose veins require physical activity, but it should be gentle, therefore strength exercises, strength training 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 at work, you can do a simple exercise against varicose veins. Stand up on your tiptoes 20 times, lifting your heels off the floor. This exercise will help get rid of varicose veins, as it acts as a pump and improves vascular tone. At the end of the day, try to keep your feet elevated or on a pillow. It will be useful to perform the "cycling" exercise or the exercise on an exercise bike with back support.
You should exercise in a gentle way, excluding running, jumping, lifting dumbbells and dumbbells, strength exercises, squats and deadlifts in the gym. The most effective and beneficial sports for health 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 it is necessary to perform a set of therapeutic exercises for the legs in order to eliminate swelling, improve blood circulation and strengthen the vascular wall. Exercises should be performed until your legs are tired. After the gymnastic complex, you need to rest and lie down with your feet on a pillow or the armrests of the sofa. It is useful to supplement the exercises with a contrast shower or foot bath.
It is important to adhere to good nutrition. It is necessary to exclude salty, hot and spicy foods, smoked foods, fatty, fried, floury and sweet foods, as they destroy the walls of blood vessels and retain fluid in the body. It is prohibited to drink alcohol and smoke to avoid the formation of blood clots in the vessels. The diet should be rich in foods containing vitamins C, B, E, proteins, microelements: citrus fruits, sour berries and fruits, nuts, seeds, herbs, vegetables. As for drinks, it is better to give preference to fruit drinks, jelly, green and herbal teas. Sugar should be replaced with honey.
It is useful to consume juice 2 times a week, after consulting your doctor whether you suffer from stomach diseases.
Varicose vein prevention
Since varicose veins are most often caused by stagnation of blood in the extremities, throw your legs at home on the back of the sofa or on a coffee 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 elevate your legs a little.
Prevention of varicose veins includes weight loss, as excess weight creates additional stress on the legs. Women should not carry weight exceeding 3 kilograms in one hand. You should give up tight clothes and shoes, tight stockings and socks. The heel should not exceed 4 cm, they create an obstacle to normal blood circulation. Compression knitwear trains and fixes the veins well, improves their tone. Underwear should be purchased at a pharmacy or specialty store.
Sedentary work requires regular warm-ups, stretching, and it helps to get up and walk around. If possible, place a low bench under your feet, this will improve blood circulation. Walk more often, exercise regularly, swim and climb stairs. This will prevent the development of varicose veins and improve muscle tone.
To avoid varicose veins, it is necessary 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 stagnation of blood in the legs.
To prevent varicose veins in the legs, avoid wearing tight items such as socks or stockings with tight elastics, as they put too much pressure on the veins and can lead to poor circulation and dilation. High heels are excluded, everyday shoes must not be higher than 4 cm. Heeled shoes can be worn for festive events.