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, which leads to blood flow disorders and blood stagnation. The function of the venous valves is disturbed, due to which the blood flows back and stagnates. The walls of the veins expand, become thin and burst. Over time, blood clots form that can block a vessel and lead to a stroke or heart attack. Women are most often exposed to the risk of varicose veins, but men can also experience it. 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 professional characteristics, but the disease can also start from other factors.
Causes of varicose veins
Veins in the body are necessary for blood circulation and the transport of nutrients from tissues to the heart. In the area of the lower extremities, this network is represented in the form of deep or superficial veins, which are interconnected by a system of emergency blood discharge. Basically, most of the load falls on the deep veins, because they are bigger and stronger. Superficial veins do about 15% of the work.
The heart is needed to pump and move blood through the veins, and some blood moves through the veins against gravity due to the work of the surrounding muscles during walking and other movements. When the muscles are relaxed, the person moves a little or stands, the blood returns downwards under the influence of gravity. But thanks to special valves it stays in place.
If the valves do not cope with their function, the veins begin to expand and become inflamed, they cannot hold blood. For this reason, blood circulation stagnates, veins expand and rise above the skin.
Blood circulation is disturbed and varicose veins appear. The causes of varicose veins can be:
- absence, defect or damage of venous valves - reverse blood flow to the legs is disturbed, blood stagnates in the veins and they stretch;
- constant stay in a vertical position - hairdressers, teachers, salespeople and others who cost a lot often suffer from varicose veins;
- overweight and obesity - heavy weight puts pressure on the lower limbs, due to which the veins expand and varicose veins appear;
- 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, which causes varicose veins;
- weight lifting - excessive physical activity causes veins to expand and blood vessel walls to stretch;
- Professional sports - running, jumping, tennis - cause varicose veins due to constant stress on the lower extremities.
Varicose veins on the legs can be caused by previous injuries and surgeries on the lower extremities. In old age, almost everyone suffers from varicose veins, because the valves weaken and work poorly. They become inelastic and stretch a lot.
Symptoms
In the initial stage, the veins under the skin expand. If you immediately establish venous circulation, other complaints will not appear.
If the disease progresses, the following symptoms appear
- fast fatigue;
- feeling of heaviness in the lower extremities;
- leg muscle spasms (most often occur 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;
- hyperpigmentation of the skin occurs in places;
- skin atrophy;
- dermatitis is a disease characterized by inflammation of the skin;
- in the later stages of the disease, a trophic ulcer may develop, which is practically incurable.
In the chronic form of varicose veins, the symptoms are manifested in the form of swelling of the lower extremities when standing for a long time. After a night's rest, the swelling usually disappears completely.
Varicose veins on men's legs
Varicose veins on the legs of men occur in 32% of cases. Most often, the disease occurs at the age of 45 and older. Varicose veins in men occur for the same reasons as in women - due to the heavy load on the lower limbs. This is less common, because it is due to the special structure of the male body. However, due to smoking and severe stress, varicose veins in men are noticed 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, longer stay in one position, work in a standing position, weight lifting;
- excess weight;
- fatty and unhealthy food that negatively affects the walls of blood vessels;
- liver diseases: hepatitis and cirrhosis;
- metabolic diseases, diabetes;
- active sports, bodybuilding, heavy physical activity;
- arterial hypertension;
- hereditary factor;
- smoking and alcohol.
The disease can last for several years. Initially, a man may feel pain and swelling in his legs in the evening or after a long stay in an upright position. In the later stages, varicose veins in men on the legs cause hair loss and burning in painful places, itching in the venous nodes. Due to poor nutrition of the skin, trophic ulcers occur that itch and hurt. It becomes more difficult for the patient to walk, then the mobility of the limbs disappears. There is a loss of feeling 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 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, usually flat, the bottom is smooth, the edges are uneven, flat, the discharge is scanty, serous or purulent. Trophic ulcers are difficult to heal and can enlarge. They become more painful when they trap fibers. Over time, the induration of the subcutaneous tissue increases.
Trophic ulcers appear with characteristic symptoms, it is difficult to miss them. At the site of the future ulcer, the skin becomes thick, reddish and swollen, and increased pigmentation may occur. A leg ulcer with varicose veins itches and itches, causing 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
Manifestation of symptoms of varicose veins of the legs depends on the degree of development of the disease:
- Stage 1 – some cosmetic defects are noticeable, the pain is practically not bothersome.
- Stage 2 - feeling of heaviness, fullness, pain, cramps during sleep.
- Stage 3 – formation of edema, feeling of fullness, thickening of the skin and subcutaneous tissue, formation of dark spots.
- Phase 4 - appearance of trophic ulcers, burning and itching, severe pain, protruding veins, change in gait, difficulty walking.
The most common symptoms of varicose veins in 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 increases when standing for a long time and disappears when lying down;
- feeling of burning and itching in the legs in the evening;
- severe fatigue with light loads and short walking.
Another prominent symptom of varicose veins is that the veins become less noticeable when a person lies down or raise their legs and become larger when they stand up, especially during prolonged standing.
Varicose veins in the legs cause swelling of the soft tissues in the feet, ankles and lower legs. It is most often noticeable in the evening after a working day. Swelling can occur in people who spend a lot of time standing and those who are overweight. Comfortable shoes start to tighten in the evening and become tight. When you stay in one position for a long time, your legs immediately swell or swell. You can check for leg swelling yourself. To do this, you need to measure the circumference of the lower legs with a measuring tape: the narrowest part of the lower leg - the place above the ankles and the widest part - the calf muscle. Measure 2 times a day: in the evening before going to bed and immediately after waking up. If within a few days the circumference of the leaf varies by more than 1 cm, then there is a reason to check your 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 may swell. With the development of varicose veins, trophic ulcers may appear that itch and itch unpleasantly.
Complications
Varicose veins are a serious disease, because they can cause a number of consequences: eczema, skin ulcers, severe venous bleeding from lower limb injuries, thrombophlebitis.
Thrombophlebitis is especially dangerous, because blood clots form in the vessels and can break off at any time. Pulmonary artery blockage is fatal.
Dilated veins of the lower extremities can lead to diseases such as
- hemorrhoids – a disease characterized by dilated rectal veins;
- varicocele – dilated veins of the spermatic cord;
- Portal hypertension is a syndrome in which the pressure in the portal vein system increases.
With varicose veins on 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 the treatment of varicose veins on the legs depends on the stage of the disease and the symptoms. There are many procedures to tape, close and remove varicose veins. The most common methods are:
Sclerosis
A procedure in which doctors glue small vessels together to eliminate "stars". A special substance is injected into the vein to make the vein walls stick together. After some time, this vein forms a cord and gives way. Sclerotherapy is a painless method and takes place without anesthesia within 15 minutes.
Phlebectomy
If varicose veins require radical treatment, then surgical intervention is used. Varicose vein surgery involves removing the veins. To achieve 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.
Endovasal laser coagulation
The next method of vein removal is endovasal laser coagulation. A modern treatment method, the essence of which is the effect of thermal energy of laser radiation. The laser affects only the areas of the vein wall, without affecting the tissues and nerve endings located nearby. Under the influence of radiation, the vein closes and is cut off from the blood stream. 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 quick rehabilitation.
Conservative treatment
In some cases, conservative treatment with drugs prescribed by your doctor is used. It is suitable for those patients who are contraindicated for surgery, with insufficiency of deep vein valves, with varicose veins in the initial stage, who have only an aesthetic defect, and who refuse to undergo surgery.
Medicines for the treatment of varicose veins are divided into several groups:
- phlebotonics
- anticoagulants
- anti-edema drugs
- disaggregatants
- during trophic changes
- antioxidants
- non-steroidal analgesics;
- fibrinolytics
The patient needs to wrap the lower extremities with an elastic bandage or wear elastic socks, occasionally raise the legs above the level of the heart, and perform preventive exercises for the foot and lower leg in order to improve blood circulation in the legs and eliminate venous stagnation. blood.
Treatment of varicose veins in men includes wearing special compression garments, performing regular exercises, maintaining a proper diet, and avoiding alcohol and smoking.
Treatment for 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 vitamins P, C, E, proteins and microelements in the diet to strengthen the vascular wall. It is forbidden to smoke and drink alcohol, because they stretch the walls of the blood vessels and impair their patency.
In the initial stages of the development of varicose veins and during treatment, it is necessary to regularly perform a complex of therapeutic exercises. Exercises should be done in a compression garment at a leisurely pace until you feel tired. In this case, jumping, running, dancing, ballet, aerobics and tap are excluded, because they increase the load on the veins on the legs. You cannot do strength training or lift weights or dumbbells. Lifting of more than 3-5 kg is excluded. Exercise in the pool, stationary bike with back support and cycling will be extremely beneficial. You can walk normally on the treadmill. It is best to walk outdoors with alternating fast and slow pace.
After vein treatment and surgery, precautions should be taken. Wear the right shoes, high-heeled shoes are excluded, the platform should not be higher than 4 cm. To improve blood circulation, you must constantly wear a class 1 or 2 compression suit, depending on the stage of development of varicose veins on the legs. It is best to wear it in the cold season, because it is more comfortable and comfortable. It is advisable to give preference to high socks and stockings, because knee socks will squeeze your leg in the knee.
Laser treatment of varicose veins
Endovenous laser coagulation - laser surgery and echo sclerotherapy can be prescribed for varicose veins. Some patients are shown surgical removal of varicose veins under local anesthesia through precise 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 within one second it turns 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. A thick blood clot forms at the point of exposure to the laser, and then the veins dissolve and become invisible. If the vessels are large and are located in several layers, the procedure must be repeated after a month.
Treatment of varicose veins with laser refers to surgical methods, which due to low invasiveness, absence of general anesthesia and strict local laser exposure only to the wall of varicose veins, are comparable to the method of treating the disease without surgery. .
Laser surgery is performed using an ultrasound duplex scanner. The doctor inserts a thin light guide through a skin puncture into the lumen of the vein. Radiation of a certain laser wavelength, which is partially absorbed by the wall of the varicose vein, closes the diseased veins. Clinics use a new generation laser that selectively affects the vein walls without damaging the surrounding tissue.
There are several advantages of laser treatment of varicose veins:
- outpatient treatment - the patient does not need hospitalization and can go home immediately after the procedure;
- local anesthesia is used - no general anesthesia or spinal anesthesia is required;
- short duration of the procedure - laser treatment is performed in 60-90 minutes, after which the patient can go home;
- permanent cosmetic effect - after laser removal of varicose veins, no marks remain on the skin, sometimes a dark strip 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 level of pressure for a long time. Special latex pads or cotton rolls are placed on the area where there are large varicose veins. Immediately after the treatment, the patient must walk at least 4-5 kilometers. Walking should be fast and brisk so that the blood begins to circulate well and the veins develop. After laser surgery, you must walk for an hour every day for the first few days.
After laser treatment of varicose veins, it is necessary to undergo regular vascular diagnostics. Therapeutic gymnastics, walking, swimming, cycling are shown. It is worth giving up running, jumping, strength training in the gym, lifting weights, dancing and any kind of martial arts. Gymnastics should be performed every day at a moderate pace, with rest breaks. Its goal is to reduce the stagnation of blood in the veins, but not to pump up the legs, so you should not strain yourself too much. After class, you must lie with your legs raised at an angle of 90 degrees for a few 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, welded under radiation. Gradually, the vein recedes 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 performing procedures for any accompanying pathologies. This technique has no systemic effect on the patient's body.
Since the most serious consequence of chronic venous insufficiency are trophic ulcers, their treatment is carried out comprehensively, including the method of endovenous laser coagulation, scleropathy and miniphlebectomy. Local treatment is often performed, which consists of surgically cleaning the ulcer and grafting skin to the affected areas of the body. For this complication, the specialist prescribes the following drugs:
- phlebotonics are drugs that have a positive effect on the venous 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 relieve heaviness, swelling and pain in the lower extremities when walking. Wearing specialized underwear made of compression knitwear 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, lifting weights in the gym, running, jumping and dancing are excluded. The most effective method is regular walking, which improves muscle work and blood circulation in the vessels. During a break at work, you can do a simple exercise for varicose veins. Raise yourself 20 times on your toes, lifting your heels off the floor. This exercise will help you get rid of varicose veins, because it acts like a pump and improves the tone of blood vessels. At the end of the day, try to keep your feet elevated or on a pillow. It will be useful to perform a "bicycle" exercise or an exercise on an exercise bike with a back support.
You need to exercise in a gentle way, excluding running, jumping, lifting weights and dumbbells, strength training, squats and deadlifts in the gym. The most effective health-enhancing sports would be swimming, swimming, walking and cycling. Swimming trains the blood vessels of the legs, while being gentle on the lower limbs, unlike running and strength training. It helps to remove swelling, heaviness in the legs, increases vascular tone and removes cosmetic defects.
It is necessary to perform a set of therapeutic exercises for the legs every day in order to remove swelling, improve blood circulation and strengthen the vascular wall. Exercises should be performed until your legs feel tired. After the gymnastic complex, you need to rest and lie with your feet on a pillow or sofa armrests. It is useful to finish the exercises with a contrast shower or foot bath.
It is important to follow a proper diet. It is necessary to exclude salty, hot and spicy foods, smoked, fatty, fried, floury and sweet foods, because they destroy the walls of blood vessels and retain fluid in the body. It is forbidden to drink alcohol and smoke in order 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, sour berries and fruits, nuts, seeds, herbs, vegetables. As for drinks, it is better to give preference to fruit drinks, jelly, green and herbal tea. Sugar should be replaced with honey.
It is useful to take juice days 2 times a week, after consulting your doctor to see if you have stomach ailments.
Prevention of varicose veins
Since varicose veins are most often caused by blood stagnation in the extremities, put your legs at home 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, put a pillow or a folded blanket under your feet to raise your legs a little.
Varicose vein prevention includes losing weight, as excess weight creates additional stress on the legs. Women should not carry weights heavier than 3 kilograms in one hand. You must give up tight clothes and shoes, tight socks and stockings. The heel must not be higher than 4 cm. They create an obstacle to normal blood circulation. Compression knitwear trains and fixes veins well, improves their tone. Underwear should be purchased at a pharmacy or specialized store.
Sitting work requires regular warming up, stretching, and it is useful to get up and walk. If possible, place a low bench under your feet, this will improve blood flow. 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 sun exposure. This will help reduce venous tone, which leads to stagnation of blood in the legs.
To prevent varicose veins in your legs, avoid wearing tight-fitting items such as stockings or tights with tight elastic bands, 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 exceed 4 cm. Heeled shoes can be worn for formal events.