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 damage to blood flow and blood stagnation. The function of the venous valves is impaired, causing blood to flow backward and stagnate. The walls of the veins expand, become thin and burst. Over time, blood clots form, which can block a vessel and lead to a stroke or heart attack. Women are more often at risk of varicose veins, but men can also experience it. The age of the disease is from 20 years and older, sometimes varicose veins can appear in adolescence. Varicose veins are most often caused by a sedentary lifestyle and occupational characteristics, but the disease can also be caused by other factors.
Causes of varicose veins
Veins in the body are essential for blood circulation and the transport of nutrients from the tissues to the heart. In the area of the lower extremities, this network is presented in the form of deep or superficial veins, which are connected to each other by an emergency blood discharge system. Basically, most of the load falls on the deep veins, as 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 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 is kept 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 impaired and varicose veins appear. The causes of varicose veins can be:
- absence, defect or damage of venous valves - the reverse flow of blood in the leg is interrupted, blood stagnates in the veins and they stretch;
- constant standing in a vertical position - more often hairdressers, teachers, sellers and others who cost a lot suffer from varicose veins;
- overweight and obesity - heavy weight puts pressure on the lower limbs, as a result of 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;
- lifting weights - excessive physical activity causes dilation of veins and stretching of blood vessel walls;
- Professional sports - running, dancing, tennis - cause varicose veins due to constant stress on the lower extremities.
Varicose veins in the legs can be caused by injuries and previous surgeries on the lower extremities. In old age, almost everyone suffers from varicose veins, as the valves weaken and work poorly. They become inelastic and stretch too much.
Symptoms
In the initial stage, the veins located under the skin expand. If you establish venous circulation immediately, then other complaints will not appear.
If the disease progresses, the following symptoms appear
- rapid fatigue;
- feeling of heaviness in the lower extremities;
- calf muscle cramps (most often appear in the evening and at night);
- There is a 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
- the thickening of the vein walls is formed;
- skin hyperpigmentation 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 untreatable.
In the chronic form of varicose veins, symptoms appear in the form of swelling of the lower extremities during prolonged standing. After a night's rest, the swelling usually disappears completely.
Varicose veins in 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. Varicose veins in men occur for the same reasons as in women - due to the heavy load on the lower limbs. 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 already observed in middle age.
The development of varicose veins in men's legs is associated with the loss of elasticity and tone of the vascular wall for several reasons:
- occupational characteristics - inactive work, standing in one position for a long time, standing work, lifting weights;
- 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;
- arterial hypertension;
- hereditary factor;
- smoking and alcohol.
The disease 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 a vertical position. In the later stages, varicose veins in men on the legs cause hair loss and burning in the painful areas, itching in the veins. Due to poor nutrition of the skin, trophic ulcers appear 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 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 surface of the lower third of the leg, in the supramalleolar region. Before their appearance, dermatitis appears, which is accompanied by eczema and severe itching. The ulcer can be single or multiple, most often 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 grow in size. They become more painful when they block the fibers. Over time, the hardening of the subcutaneous tissue increases.
Trophic ulcers appear with characteristic symptoms; they are hard to miss. At the site of the future ulcer, the skin becomes dense, red and swollen, and there may be increased pigmentation. A leg ulcer with varicose veins itches and itches, causing excruciating 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 in the legs
The appearance 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 practically does not bother.
- Stage 2 - a feeling of heaviness, satiety, pain, cramps during sleep.
- Stage 3 - the formation of edema, the feeling of fullness, thickening of the skin and subcutaneous tissue, the formation of dark spots.
- Stage 4 - the appearance of trophic ulcers, burning and itching, severe pain, elongated veins, changes in gait, difficulty in 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, intensifying with prolonged standing and disappearing 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 visible when a person lies down or raise their legs and become larger when standing, especially during prolonged standing.
Varicose veins in the legs cause swelling of the soft tissues in the legs, ankles and lower legs. It is most often observed in the evening after a working day. Swelling can occur in people who spend a lot of time on their feet and those who are overweight. Comfortable shoes begin to squeeze in the evening and become tight. When you stand in one position for a long time, your feet swell or swell immediately. You can control the swelling of your feet yourself. To do this, you need to measure the circumference of your legs with a measuring tape: the narrowest part of the leg - the place above the ankles, and the widest part - the calf muscle. You should measure 2 times a day: in the evening before going to bed and immediately after waking up. If in a few days the circumference of the calf 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 the poor nutrition of the tissues of the lower extremities, trophic ulcers appear on the skin of the legs and feet. First, the skin begins to thicken and spots appear in the form of dark spots. 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 uncomfortably.
Complications
Varicose veins are a serious disease, as they can cause a number of consequences: eczema, skin ulcers, severe venous bleeding from injuries to the lower extremities, thrombophlebitis.
Thrombophlebitis is particularly dangerous, as blood clots form in vessels and can break off 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 the pressure in the portal vein 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 in the legs
The nature of treatment for varicose veins in the legs depends on the stage of the disease and the symptoms. There are many procedures by which varicose veins are attached, closed and removed. 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 glue the vein walls together. After some time, this vein forms a cord and dissolves. Sclerotherapy is a painless method and is performed 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 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.
Endovasal laser coagulation
Another 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 venous wall, without affecting the tissues and nerve endings that are nearby. Under the influence of radiation, the vein is closed and excluded from the blood circulation. The procedure is performed with 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 known for 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 those patients who are contraindicated for surgery, with insufficiency of deep vein valves, with varicose veins in the initial stage, who have only a cosmetic defect and who refuse to undergo surgery.
Medicines for the treatment of varicose veins are divided into several groups:
- phlebotonics
- anticoagulants
- anti-edema remedies
- decomposers
- during trophic changes
- antioxidants
- nonsteroidal analgesic;
- 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 leg and lower leg to improve blood circulation in the legs and eliminate venous stagnationof blood.
Treatment of varicose veins in men includes wearing special compression garments, exercising regularly, 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 in your diet foods with vitamin P, C, E, protein and trace elements to strengthen the vascular walls. Smoking and drinking alcohol are prohibited, as they stretch the walls of blood vessels and damage the 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 compression garments at a leisurely pace until you feel tired. In this case, dancing, running, dancing, ballet, gymnastics and stepping are excluded, as they increase the load on the veins in the legs. You cannot do strength training or lift barbells or dumbbells. Lifting weights more than 3-5 kg is excluded. Exercise in the pool, an exercise bike with back support and cycling will be extremely beneficial. You can do normal walking on a treadmill. Walking outside at alternating fast and slow paces is best.
After vein treatment and surgery, precautions should be taken. Wear appropriate shoes, high heels are excluded, the platform should not be higher than 4 cm. To improve blood circulation, you should constantly wear compression garments of class 1 or 2, depending on the stage of development of varicose veins in the legs. . It is good to wear it during the cold season as it is more comfortable and cozy. It is recommended to give preference to high socks and tights, as knee socks will tighten your leg at the knee.
Laser treatment of varicose veins
For varicose veins, endovenous laser coagulation - laser surgery and echo sclerotherapy can be prescribed. Some patients are shown surgical removal of enlarged veins under local anesthesia through precise punctures of the skin surface - miniphlebectomy. Microsclerotherapy can be used to remove spider veins and intradermal veins.
The laser energy is absorbed by the hemoglobin of the red blood cells and within a second it turns into heat (95-100 degrees), which leads to the boiling of plasma and blood elements, causing thermal burns of the endothelium - the walls of the veins. A dense blood clot is created at the laser exposure site, then the veins dissolve and become invisible. If the dishes are large and placed in several layers, the procedure should be repeated after a month.
Treatment of varicose veins with laser refers to surgical methods, which are comparable to the method of treating the disease without surgery due to low invasiveness, lack of general anesthesia and strictly local exposure of the laser only to the 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, which is partially absorbed by the wall of the dilated 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 for varicose veins:
- outpatient treatment - the patient does not require hospitalization and can go home immediately after the procedure;
- local anesthesia is used - general anesthesia or spinal anesthesia is not required;
- the short duration of the procedure - the laser treatment is performed in 60-90 minutes, after which the patient can go home;
- lasting cosmetic effect - after the removal of varicose veins with a laser, no traces 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. In the area where large varicose veins are located, special latex pads or cotton rolls are placed. Immediately after the treatment procedure, the patient should 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 should walk for an hour every day for the first few days.
After laser treatment of varicose veins, it is necessary to regularly undergo vascular diagnostics. Therapeutic gymnastics, walking, swimming, cycling are indicated. It is worth giving up running, dancing, strength exercises 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 purpose is to reduce blood stagnation in the veins, but not to pump the legs, so you should not overwork. After classes, you should lie down 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 to expose the vascular walls of the veins to radiofrequency radiation. Since the main goal is to stop the flow of blood, when this method is used, the vein, so to speak, sticks under the radiation. Gradually, the vein resolves and disappears completely within six months to a year. The advantage of this method is the complete lack of surgical intervention, as well as the possibility of performing the procedure for any accompanying pathology. 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 endovenous laser coagulation, scleropathy and miniphlebectomy. Local treatment is often performed, 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 venous wall and have a tonic effect. They come in different forms (ointment, gel, 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 while walking. Wearing specialized underwear made of compression knitwear and bandages made of special bandages will help to significantly soften the course of the disease and prevent the further spread of complications.
How to treat varicose veins in 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 function and blood circulation in blood vessels. During a break at work, you can do a simple exercise for varicose veins. Stand up on your toes 20 times, lifting your heels off the floor. This exercise will help remove varicose veins, as it acts as a pump and improves vascular tone. At the end of the day, try to keep your feet up or on a pillow. It will be useful to perform the "bicycle" exercise or the exercise on an exercise bike with back support.
You should exercise gently, excluding running, jumping, lifting weights and barbells, strength exercises, squats and lifting in the gym. The most effective and health-improving 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 eliminate swelling, heaviness in the legs, increases vascular tone and eliminates cosmetic defects.
Every day it is necessary to perform a series of therapeutic exercises for the legs to eliminate swelling, improve blood circulation and strengthen the vascular wall. Exercises should be performed until your legs feel tired. After the gymnastics complex, you need to rest and lie down with your feet on a pillow or sofa support. It is useful to finish the exercises with a contrast shower or foot bath.
It is important to stick to the right food. 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 fluids in the body. It is forbidden to drink alcohol and smoke to avoid the formation of blood clots in the blood vessels. The diet should be rich in foods with vitamins C, B, E, proteins, microelements: citrus fruits, berries and sour 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 have juice days 2 times a week, after consulting your doctor to see if you have any 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, place a pillow or a folded blanket under your legs to elevate your legs a bit.
Varicose vein prevention involves losing weight, as excess weight puts extra stress on the legs. Women should not hold weights that weigh more than 3 kilograms in one hand. You should give up tight clothes and shoes, tight socks and stockings. The heel should not exceed 4 cm. They create an obstacle for normal blood circulation. Compression knitwear trains and regulates veins well, improves their tone. Underwear should be purchased at a pharmacy or specialty store.
Sitting work requires regular warm-ups, stretching, and it's helpful to get up and walk around. If possible, place a low stool 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, 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 blood stagnation in the legs.
To prevent varicose veins in your legs, avoid wearing tight 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 should not be higher than 4 cm. Heeled shoes can be worn for festive events.