Varicose veins on the legs are not just 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 occurrence of varicose veins: from a sedentary lifestyle, physical overload, to hormonal imbalances, 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 become stretched under blood pressure.
The valves in the veins are normally locks, and when blood passes through them, they close and allow the blood to flow back.If the valves malfunction, blood can flow freely downward, resulting in blood stagnation.
In this sense, the veins cannot withstand the pressure, they expand, the valves can no longer close the large lumen... all this causes the initial stage of varicose veins to appear (see photo).
Reasons
Why do varicose veins occur and what are they?The main risk factors for developing the disease are genetic predisposition and gender.Due to the love of high heels, hormonal changes during pregnancy and the use of contraceptives, women suffer from 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, venous valves with congenital defects.This is why varicose veins can be seen in young, healthy and active people (regardless of gender) and even in children.According to scientists, genetic predisposition is the main factor that leads to the appearance of varicose veins in the legs.
- Hormonal changes.Due to the characteristics of a woman's body, 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 category of gender patients consults doctors 2-3 times more often.Female organs do not have enough hormones called estrogens.Instead, so-called corpus luteum hormones predominate.It is believed to have a relaxing effect on muscles.This promotes the expansion of the veins.
- A sedentary, sedentary lifestyle or a job that requires standing for long periods of time contributes to the development of varicose veins.
- Age.Over time, the valves and walls of the veins become thinner, which leads to their function being disrupted.
- 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, adequate treatment of the primary disease is carried out.
What causes dilated veins?
The main risk factors for developing the disease are genetic predisposition and gender.Due to the love of high heels, hormonal changes during pregnancy and the use of contraceptives, women suffer from varicose veins twice as often as men.
The development of the disease is promoted by:
- Obesity
- Prolonged standing or sitting
- Heavy physical activity
- Sedentary lifestyle
- Constipation
- Smoking
Secondary varicose veins occur with leg injuries, heart defects, liver and spleen dysfunction.In this case, first of all, adequate treatment of the primary disease is carried out.
What causes dilated veins?
The development of varicose veins is based on congenital weakness of the venous wall, incompetence of the superficial vein valves and the consequent increase in venous pressure.Special one-way valves prevent blood from returning and stagnating in one place;when they are destroyed, the movement of blood from the tissues back to the heart is stopped.It is worth mentioning that conservative treatment does not change the pressure in the veins.
Internships
There are 3 stages of symptom progression in the development of varicose veins.
- Compensation stage.No complaints.On examination, varicose veins are seen in one or both legs.
- Subcompensation stage.On examination, pronounced varicose veins are visible on the legs.Patients complain of a feeling of fullness, paresthesia (“pins and needles”) in the lower legs, and night cramps.There is slight swelling in the feet, ankles and legs at night.In the morning the swelling disappears.
- Decompensation stage.Dermatitis and eczema are added to the listed symptoms.Patients are bothered by itchy skin.The skin becomes dry, shiny and firmly fused with the subcutaneous tissue.Minor hemorrhages and subsequent hemosiderin deposition 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, moreover, they will progress, leading to all kinds of complications, which 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 later stages, you may notice the appearance of spider veins on the skin, protruding veins and various seals, indicating congestion in the blood vessels.
Varicose veins: symptoms
It is very difficult to diagnose the initial stages of the disease, as in the initial stage there are no spider veins and dilated veins rising above the skin.
Initial symptoms of varicose veins:
- Heavy legs at the end of the day
- Fatigue
- Mild to moderate pain
- Increased venous pattern in 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 only cosmetic defects in the skin cause inconvenience.As a rule, in the early stages, the symptoms of varicose veins disappear completely or significantly decrease with rest and therefore often go unnoticed.
One or more varicose nodules protruding above the skin indicate the progression and neglect of the disease.When standing for a long time, pain occurs in the node area, numbness, tingling, “crawling” and swelling in the legs are felt.At the end of the day, swelling often occurs, which disappears after a night's sleep.Swelling can be judged by loose shoes in the morning, which begin to tighten at night.
Why are varicose veins dangerous?
The most common complications of varicose veins include thrombophlebitis.In addition, increased pressure in the venous section leads to the penetration of red blood cells through the walls of blood vessels into the tissue.As a result, 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 rupture and cause heavy bleeding.
Diagnosis
To diagnose varicose veins of the lower extremities and prescribe appropriate treatment, the specialist will ask the patient to undergo a complete examination, which includes several methods.
- Duplex scanning (vein ultrasound) is the most informative method for diagnosing varicose veins in the legs, allowing you to get an idea of the degree of dilation of the veins, the direction of blood flow in the veins and their patency, as well as detecting the presence of blood clots (thrombi).
- Contrast venography, which is an examination method that allows you to detect dilated veins and determine the degree of blood permeability.
Only a highly qualified phlebologist can diagnose deep vein varicose 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 manifest themselves in changes in the color of the skin on the legs, redness, darkening and bluishness of the skin.
Also characterized by constant swelling of the ankle, especially severe when walking or standing.In the calf region there is pain when walking, pain in the tortuous vein, thickening of the skin and the formation of ulcers of various sizes.
During pregnancy
Pregnancy significantly increases the risk of developing varicose veins in the lower extremities, for the following reasons:
- Hormones circulating in the blood during pregnancy increase the distensibility of the venous wall and contribute to stagnation of venous blood in the legs.
- The increase in intra-abdominal pressure at the end of pregnancy makes it difficult for blood to flow through the leg veins.
- Varicose veins that occur during pregnancy may disappear completely after childbirth or progress further, depending on individual factors (heredity, presence of other contributing factors).
Treatment of varicose veins in the legs
For varicose veins in the legs, treatment may not be a medical necessity 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 get rid of this problem.
- Sclerotherapy.This method of treatment is used independently 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 disappears completely.Sessions are held once a week, requiring 3 to 6 sessions.The method allows you to avoid scars and scars.
- Non-surgical treatment.If varicose veins are in the early stages and do not cause much discomfort, elastic compression stockings may be recommended.They are used during daily activities.They help compress the veins, preventing them from stretching and limiting any discomfort or pain.
- Drug treatment of varicose veins relieves symptoms, reduces swelling and pain, slows down the development process, but is not able to completely stop the disease and restore damaged veins.
- Laser treatment for varicose veins in the legs can be used on the surface of the skin.With the help of a small flash of laser light, a sclerosis process develops in the vein wall and the varicose vein disappears, as if it had been removed.
Physical activity plays an important role in treatment and prevention - brisk walking, gymnastics, swimming and water exercises (excluding sports exercises with a large load on the legs - tennis, weight lifting, jumping).
Conservative treatment of varicose veins is prescribed mainly for people who have clear contraindications to surgical intervention.
Furthermore, this treatment is indicated if the patient has mild varicose veins, which is a purely cosmetic defect.The aim of conservative therapy is also to prevent the progression of this disease.To this end, patients are recommended to bandage the legs affected by varicose veins with an elastic bandage.Furthermore, compression garments are recommended for varicose veins.People who are prone to varicose veins or who already suffer from this disease should regularly place their legs on an elevated surface throughout the day, resting for several minutes.There are also special exercises for the leg and foot, which aim to activate the muscle-venous pump.This is the periodic extension and flexion of the ankle and knee joints.
The patient should be careful not to allow the legs and thighs to be joined by multiple 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 the saphenous veins, promote the body's metabolic processes and blood microcirculation.
But to obtain positive results it is important to wrap the leg correctly.This process should be done in the morning, before getting out of bed.The bandage starts from the toes to the thigh, and slight tension in the bandage should be felt.During the wrapping process, be sure to grip the heel and ankle joint.With each turn of the limb, the dressing must cover half of the previous turn.You should only purchase certified elastic bandages and compression stockings.
Treatment of varicose veins also involves wearing comfortable shoes, which should have low heels and hard soles.You should not stand for a long time, allow physical stress or remain in environments with high temperature and humidity for a long time.It is advisable to keep your legs elevated while sleeping.
Patients should limit fluid and salt intake and try to get rid of overweight.To treat varicose veins, it is necessary to periodically take diuretics, medications that improve the tone of the veins.Additionally, if indicated, the patient may be prescribed medications that stimulate microcirculation in tissues.Treatment for varicose veins may also include the use of nonsteroidal anti-inflammatory drugs.
If the patient presents an uncomplicated form of the disease, physiotherapeutic exercises are indicated.Swimming, other water treatments, footbaths with warm water, to which a 5-10% sodium chloride solution is added, are very useful.
Often, local therapy methods are used in the treatment of varicose veins.But this treatment must be used in combination with other medicinal methods.Local remedies 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 normalize the tone of the vein walls and can correct lymphatic drainage and microcirculation disorders.Some local preparations contain several different active ingredients.
If a secondary infection occurs during the varicose vein process, it is advisable to use external agents with antibiotics or antiseptics.
It has been used for treatment since ancient times hirudotherapy with varicose veins.The use of leeches that secrete hirudin allows the blood to thin and promote reabsorption blood clots, getting rid of spider veins and varicose veins.Additionally, hirudotherapy for varicose veins can reduce leg pain and overcome swelling.However, it is important to use hirudotherapy in the early 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 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 dilated branches, sclerotherapy may be used.This operation involves injecting a sclerosing solution into the vein to seal the vein walls.After this, repeated injections are made into other sections of the vein, achieving complete obliteration of the vein.
Combined surgical therapy is also used for varicose veins, in which large trunks of altered veins are removed and sclerotherapy of small branches is performed.After surgery, it is recommended that patients continue using an elastic bandage for 8 to 12 weeks.
Conservative treatment
Anyone looking for an effective and miraculous cure for varicose veins will be immediately disappointed: even the most modern and expensive medicines cannot completely eliminate varicose veins.They help to 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 at the initial stage of the disease, after which it is carried out to prevent the development of varicose veins.The main 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 medications 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 the regular use of compression stockings: stockings, knee socks, tights.They improve blood microcirculation and prevent the formation of 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
To improve vascular tone, venotonic tablets for varicose veins - phlebotonics - are used.These medications are analogues and contain a purified flavonoid fraction composed of 90% diosmin.One tablet is taken twice a day, the course of treatment is selected 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 large 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) must be poured with 500 grams of alcohol and then left to infuse for 14 days, shaking the bottle every day.Apply the tincture through the mesh and take a tablespoon with water three times a day before meals.After receiving treatment for a week, take a two-week break.Then the treatment can be restarted.
- An infusion of dried nettle is used for varicose veins.Crushed dry leaves of the plant are placed in a thermos with 1/2 liter of boiling water, left for 30-40 minutes, filtered and taken 1/3 cup 3 times a day, 1 hour after meals.
- Tomato compress.Chopped tomato, placed on a bandage, gauze and applied to the sore spot.For convenience, you can tie it with an elastic band or other bandage.Keep this compress on the vein for 2 hours, then change it for a new one and so on 3 times.The convenience of this compress is that it can be repeated every day.
- Walnut oil tincture: chop green walnuts, pour into a glass container, pour olive oil and leave for 40 days in a sunny place.Lubricate the painful areas 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 therapy with special gymnastics - Mikulin's exercises allow you to feel a significant improvement.
Complications of varicose veins in the legs
Often, as a complication of varicose veins,acute thrombophlebitis of superficial veins.Sometimes, as a result of damage, varicose veins rupture and bleed.When blood leaks from a burst nodule, very significant blood loss is possible.
Furthermore, due to increased pressure in the venous system, arterial blood flow decreases.Because of this, you can develophypoxiaand beyondoxygen starvation.As a result of the development of this condition, tissue cells may die, which is a dangerous process for the body.Due to severe 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 leg tissues and the appearance of pigmentation and darkening of the skin.
The subcutaneous fat layer gradually becomes denser anddermatitis,venous trophic ulcers.In very rare cases, these ulcers degenerate into malignant formations.
If the disease persists for a long period, the person may later 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 have suffered from varicose veins, or due to your occupation you are forced to stand for a long time, you need to 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 slow the progress of existing varicose veins.
Prevention measures:
- Avoid excessive exposure to sunlight and hot baths.Ideally, bathhouses and saunas should not be visited.
- Avoid wearing tight shoes, tight socks and tight clothing.
- The ideal heel height is no more than 6 cm.
- Avoid weight gain.Try to eat a diet rich in fiber, vegetables and fruits.
- Avoid excessively intense physical activity and heavy lifting.
- Do special exercises for your legs, including lifting them (“bicycle”, “scissors”).
- Do 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 their prevalence, varicose veins are quite difficult to treat.When the first alarming symptoms appear, do not delay the visit to the vascular surgeon, as the sooner the disease is detected, the greater the chances of avoiding surgery.
Forecast
Varicose veins in the legs are a disease that can be treated for years;Even after surgical removal, 80% of them reappear.
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) makes it possible to stop the development of the disease.You will have to adhere to a strict prevention framework throughout your life.
In the later stages (with the appearance of severe deformities, nodules, swelling and signs of lack of oxygen in the tissues), the prognosis is determined by the presence of concomitant diseases (diabetes, obesity) and the patient's willingness to follow the doctor's recommendations (undergoing examination, taking medication, losing weight).
In diabetes mellitus, complications from varicose veins (thrombophlebitis, trophic ulcers) develop in 89%.
Varicose veins are considered a non-life-threatening disease, but their complications can greatly worsen quality of life and prognosis.In deep vein thrombosis, about 50% of patients die from thromboembolism within 3 months.