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, leading to a decrease in blood flow and blood stagnation. The function of the venous valves is impaired, causing blood to flow backwards and stagnate. The walls of the veins expand, become thin, and rupture. Over time, blood clots form, which can block a vessel and cause a stroke or heart attack. Women are more often at risk of developing varicose veins, but men can get it too. The age of the disease is from 20 years old, 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 due to other factors.
Causes of varicose veins
The body's veins are essential for blood circulation and transport of nutrients from tissues to the heart. In the region of the lower extremities, this network takes the form of deep or superficial veins, which are interconnected 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 of the 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 downwards under the influence of gravity. But thanks to special valves it is held in place.
If the valves cannot fulfill their function, the veins begin to expand and become inflamed; they cannot retain the blood. For this reason, blood circulation stagnates, the veins expand and rise above the skin.
Blood circulation is impaired and varicose veins occur. The causes of varicose veins can be:
- absence, defect or damage to venous valves - the reverse flow of blood to the legs is disrupted, blood stagnates in the veins and they stretch;
- constant stay in an upright position - most often hairdressers, teachers, salespeople and others who cost a lot suffer from varicose veins;
- overweight and obesity - heavy weight puts pressure on the lower limbs, resulting in the dilation of veins and the occurrence of varicose veins;
- intestinal diseases, constipation - create intra-abdominal pressure, which leads to the appearance of varicose veins;
- flat foot;
- pregnancy - the uterus with the fetus creates additional pressure on the legs, which causes varicose veins;
- lifting weights - excessive physical activity causes dilation of the veins and stretching of the walls of the blood vessels;
- 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 become weak and function poorly. They become inelastic and stretch a lot.
Symptoms
In the initial phase, the veins located under the skin expand. If you establish venous circulation immediately, no other complaints will arise.
If the disease progresses, the following symptoms appear
- rapid fatigue;
- feeling of heaviness in the lower extremities;
- cramps in the calf muscles (more often appear in the evening and at night);
- There is a tingling sensation and numbness in the legs.
With the development of this disease, trophic disorders begin, which are most often concentrated in the area of the inner surface of the leg.
Symptoms of trophic disorders
- thickening of the vein walls forms;
- skin hyperpigmentation occurs in some places;
- skin atrophy;
- dermatitis is a disease characterized by inflammation of the skin;
- In the later stages of the disease, a trophic ulcer, which is practically intractable, may progress.
In the chronic form of varicose veins, symptoms manifest themselves in the form of swelling of the lower extremities 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 after 45 years of age. Male varicose veins occur for the same reasons as female varicose veins - due to the heavy load on the lower limbs. It is less common, as it 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 on the legs in men is associated with loss of elasticity and tone of the vascular wall for several reasons:
- professional characteristics - inactive work, prolonged stay in the same position, 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;
- arterial hypertension;
- hereditary factor;
- smoking and alcohol.
The illness can last for several years. At first, a man may experience pain and swelling in the legs at night or after a long stay in an upright position. In later stages, varicose veins on the legs in men cause hair loss and burning in painful areas, itching in vein nodules. Due to poor nutrition of the skin, trophic ulcers that itch and hurt occur. It becomes more difficult for the patient to walk, so 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 surface of the lower third of the leg, in the supramalleolar region. Before its 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 secretion is scanty, serous or purulent. Trophic ulcers are difficult to heal and can increase in size. They become more painful when they trap the fibers. Over time, the hardening of the subcutaneous tissue increases.
Trophic ulcers occur with characteristic symptoms; are difficult to ignore. At the site of the future ulcer, the skin becomes dense, red and swollen, and increased pigmentation may occur. A leg ulcer with varicose veins itches and itches, causing severe pain. It can be dangerous due to blood poisoning and limb amputation. The treatment of a varicose ulcer should be decided by a phlebologist after a comprehensive diagnosis of the veins.
Symptoms of varicose veins in the legs
The manifestation of symptoms of varicose veins in the legs depends on the stage 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, sensation of fullness, thickening of the skin and subcutaneous tissue, formation of dark spots.
- Stage 4 – appearance of trophic ulcers, burning and itching, intense pain, bulging veins, changes 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 upon waking;
- dull, arching pain in the calves, intensifying with prolonged standing and disappearing when lying down;
- burning sensation and itching in the legs at night;
- severe fatigue with light loads and short walks.
Another prominent symptom of varicose veins is that the veins become less visible when a person lies down or lifts their legs and increase in size when they stand up, especially during prolonged periods of standing.
Varicose veins in the legs cause swelling of the soft tissues of the feet, ankles, and legs. Most often it is noticeable in the evening, after a working day. Bloating can occur in people who spend a lot of time on their feet and in people who are overweight. Comfortable shoes start to pinch at night and feel tight. When you stay in the same position for a long time, your legs immediately swell or swell. You can check your legs for swelling yourself. To do this, you need to measure the circumference of the 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 sleep and immediately after waking up. If within a few days your calf circumference varies by more than 1 cm, 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 dark freckle-shaped spots appear. The skin becomes dry, bluish in color and swelling may occur. With the development of varicose veins, trophic ulcers may appear, which are unpleasantly itchy and itchy.
Complications
Varicose veins are a serious disease, as they can cause a series of consequences: eczema, skin ulcers, severe venous bleeding due to injuries to the lower extremities, thrombophlebitis.
Thrombophlebitis is especially dangerous because blood clots form in the vessels and can rupture at any time. Pulmonary artery blockage 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 pressure in the portal vein system increases.
With varicose veins in the legs, it becomes difficult to walk and, in 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 symptoms. There are many procedures by which enlarged veins are glued, sealed and removed. The most common methods are:
Sclerosis
Procedure in which doctors glue small vessels to eliminate the "stars". A special substance is injected into the vein to glue the vein walls together. After some time, 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, surgical intervention will be used. Varicose vein surgery involves removing the veins. To do this, a procedure called phlebectomy is performed - it 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. Modern treatment method, the essence of which is the effect of thermal energy from laser radiation. The laser only affects areas of the venous wall, without affecting nearby tissues and nerve endings. Under the influence of radiation, the vein closes and is excluded from the bloodstream. The procedure is performed under local anesthesia and without hospitalization. An ultra-thin laser light guide is inserted into a vein through a puncture in the skin. 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 the attending physician. It is indicated for patients with surgical contraindications, with insufficiency of deep venous valves, with early-stage varicose veins, who only have 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
- disintegrants
- during trophic changes
- antioxidants
- non-steroidal analgesics;
- fibrinolytics
The patient needs to 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 foot and leg exercises to improve blood circulation in the legs and eliminate venous blood stagnation.
Treatment of varicose veins in men involves wearing special compression garments, exercising regularly, maintaining an adequate 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 abandon 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. Smoking and drinking alcohol are prohibited, as they stretch the walls of blood vessels and impair patency.
In the initial stages of the development of varicose veins and during treatment, it is necessary to regularly perform a set of therapeutic exercises. Exercises should be done with 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 leg veins. You cannot do strength training or lift barbells or dumbbells. Lifting weights exceeding 3-5 kg is excluded. Exercises in the pool, exercise bike with back support and cycling will be extremely helpful. You can do normal walking on a treadmill. Walking outdoors at alternating fast and slow paces is best.
After venous treatment and surgery, precautions should be taken. Wear suitable shoes, high-heeled shoes are excluded, the platform should be no more than 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 in the legs. It is better to use it in the cold season, as it is more comfortable and convenient. It is recommended to give preference to high stockings and tights, as knee-high stockings tighten the leg at the knee.
Laser varicose vein treatment
For varicose veins, intravenous laser coagulation can be prescribed - laser surgery and ecosclerotherapy. Some patients have surgical removal of dilated veins under local anesthesia using pinpoint punctures on the surface of the skin - miniphlebectomy. Microsclerotherapy can be used to remove spider veins and intradermal veins.
The laser energy is absorbed by the hemoglobin of red blood cells and within a second is converted 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 dense blood clot is created at the site of laser exposure, so the veins dissolve and become invisible. If the vessels are large and located in several layers, the procedure will have to be repeated after a month.
Treatment of varicose veins with a laser refers to surgical methods comparable to the method of treating the disease without surgery due to its low invasiveness, absence of general anesthesia and strictly local exposure of the laser only to the wall of the varicose veins. .
Laser surgery is performed using a duplex ultrasonic scanner. The doctor inserts a thin light guide through a puncture in the skin into the lumen of the vein. Radiation of a certain laser wavelength, which is partially absorbed by the dilated vein wall, seals the diseased veins. The clinics use a new generation laser that selectively affects the walls of the veins 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 - no general anesthesia or spinal anesthesia is required;
- short duration of the procedure - laser treatment is carried out within 60-90 minutes, after which the patient can go home;
- lasting cosmetic effect - after removing varicose veins with a laser, no traces remain on the skin, sometimes a dark stripe may appear on the skin, disappearing 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 on the area where large varicose veins are located. Immediately after the treatment procedure, the patient must 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 regularly carry out vascular diagnostics. Therapeutic gymnastics, walking, swimming, cycling are shown. It's worth giving up running, jumping, doing strength exercises at the gym, lifting weights, dancing and any type of martial art. Gymnastics should be performed every day at a moderate pace, with rest breaks. Your goal is to reduce blood stagnation in the veins, but not to pump your legs, so you shouldn't work too hard. After classes, you need to lie down with your legs raised at an angle of 90 degrees for several 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 blood flow, when using this method, the vein is, as it were, welded together 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 any concomitant pathologies. 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 laser endovenous coagulation, scleropathy and miniphlebectomy. Local treatment is often carried out, which consists of surgical cleaning of the ulcer and skin grafting on the affected areas of the body. For this complication, the specialist prescribes the following medications:
- Phlebotonics are medicines 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 eliminate heaviness, swelling, and pain in the lower extremities when walking. Wearing specialized underwear made of compression mesh and bandages made of special bandages will help significantly alleviate the course of the disease and prevent the spread of complications.
How to treat varicose veins in the legs at home
Varicose veins require physical activity, but it should be gentle, therefore 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 the vessels. During a break from work, you can do a simple exercise for varicose veins. Stand on your toes 20 times, lifting your heels off the floor. This exercise will help eliminate varicose veins, as it acts like a pump and improves vascular tone. At the end of the day, try to keep your feet elevated or supported on a pillow. It will be useful to perform the "bicycle" exercise or exercise on an exercise bike with back support.
You need to exercise in a gentle manner, excluding running, jumping, lifting barbells and dumbbells, strength exercises, squats and deadlifts in the gym. The most effective and health-improving sports would be swimming, swimming, walking and cycling. Swimming trains the blood vessels in your legs while being gentle on your lower limbs, unlike running and strength exercises. Helps 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 become tired. After the gymnastics complex, you need to rest and lie with your feet on a pillow or sofa arms. It is useful to complete the exercises with a contrast bath or foot bath.
It is important to adhere to proper nutrition. It is necessary to exclude salty, spicy and spicy, smoked, fatty, fried, flour and sweet foods, as they destroy the walls of blood vessels and retain fluid in the body. It is forbidden to drink alcohol and smoke 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 fruits and berries, nuts, seeds, herbs, vegetables. As for drinks, it is better to give preference to fruit juices, jellies, green and herbal teas. Sugar must be replaced with honey.
It is useful to drink juice 2 times a week after consulting your doctor to check if you have any stomach ailments.
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 low table or chair. This relieves fatigue and tension in the legs. Before going to sleep, 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 weights exceeding 3 kg in one hand. You need to give up tight clothes and shoes, tight socks and stockings. The heel should not exceed 4 cm, as it creates an obstacle to normal blood circulation. Compression knitwear trains and fixes the veins well, improving their tone. Underwear must be purchased at a pharmacy or specialized store.
Sedentary work requires regular warm-ups and stretching, and it is helpful to get up and walk around. If possible, place a low bench under your feet to 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 baths, 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 the legs, avoid wearing tight-fitting items, such as stockings or stockings with tight elastic bands, as they put a lot of pressure on the veins and can cause poor circulation and dilation. High heels are excluded, shoes for every day should not exceed 4 cm, shoes with heels can be worn at festive events.