Varicose veins on the legs are not only a cosmetic problem that causes people to worry about their attractiveness, but also a dangerous disease that requires adequate treatment and compliance with 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?With 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 out.If the valves malfunction, blood can be freely delivered downwards, resulting in blood stagnation.
In this regard, the veins cannot cope with the pressure, they expand, the valves are no longer able to close the large lumen... all this provokes the occurrence of the initial stage of varicose veins (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 become victims of 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, congenital defective vein valves.That is why varicose veins can be observed in young, healthy and active (regardless of gender) people and even in children.According to scientists, genetic predisposition is the main factor leading to varicose veins in the legs.
- Hormonal changes.Due to the characteristics of the body in women, periods of hormonal imbalances become causes of blood stagnation.For them, the most dangerous periods are puberty, pregnancy, and the time after childbirth.The time when menopause occurs is also dangerous.This gender category of patients consults doctors 2-3 times more often.The female organs do not have enough hormones called estrogens.Instead, the so-called corpus luteum hormones predominate.It is believed that it has a relaxing effect on the muscles.This promotes the expansion of veins.
- A sedentary, sedentary lifestyle, or work 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 disruption of their function.
- Obesity.Excess weight leads to increased stress on the veins of the legs.
Secondary varicose veins occur with leg injuries, heart defects, dysfunction of the liver and spleen.In this case, first of all, appropriate treatment of the primary disease is carried out.
What causes veins to dilate?
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 become victims of varicose veins twice as often as men.
The development of the disease is promoted by:
- Obesity
- Prolonged stay in a standing or sitting position
- Heavy physical activity
- Sedentary lifestyle
- Constipation
- Smoking
Secondary varicose veins occur with leg injuries, heart defects, dysfunction of the liver and spleen.In this case, first of all, appropriate treatment of the primary disease is carried out.
What causes veins to dilate?
The development of varicose veins is based on congenital weakness of the venous wall, incompetence of the valves of the superficial veins, and a resulting increase in venous pressure.Special one-way valves prevent the blood from flowing back and prevent it from stagnating in one place; when they are destroyed, the movement of blood from the tissues back to the heart is disrupted.It is worth noting that conservative treatment does not affect the pressure in the veins.
Stages
There are 3 stages of progression of symptoms in the development of varicose veins.
- Compensation stage.No complaints.On examination, varicose veins are observed on one or both legs.
- Subcompensation stage.Upon 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 of the feet, ankles and legs in the evenings.In the morning the swelling disappears.
- Stage of decompensation.Dermatitis and eczema are added to the listed symptoms.Patients are bothered by itchy skin.The skin becomes dry, shiny, tightly fused with the subcutaneous tissue.Minor hemorrhages and subsequent deposition of hemosiderin cause hyperpigmentation.
Varicose veins in themselves are not considered a very serious disease, but if they have already developed, they will never go away on their own, and even moreover, they will progress, leading to all sorts of complications, which pose the greatest danger.
Signs
The first signs indicating the onset of the development of varicose veins:
- rapid fatigue of the legs;
- swelling of the lower extremities;
- feeling of heaviness in the legs.
At later stages, one can note the appearance of spider veins on the skin, protruding veins and various seals, indicating congestion in the blood vessels.
Varicose veins: symptoms
It is quite difficult to diagnose the early stages of the disease, since at the initial stage there are no spider veins and dilated veins rising above the skin.
Early varicose veins symptoms:
- Heavy legs at the end of the day
- Fatigue
- Mild to moderate pain
- Increased venous pattern on 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 on the skin cause inconvenience.As a rule, in the early stages, the symptoms of varicose veins completely disappear or significantly decrease with rest, and therefore often go unnoticed.
One or more varicose nodes protruding above the skin indicate the progression and neglect of the disease.When standing for a long time, aching pain occurs in the area of the nodes, numbness, tingling, “crawling”, and swelling in the legs are felt.By 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 press in the evening.
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.Because of this, 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 node, it can rupture and cause severe bleeding.
Diagnostics
In order to diagnose varicose veins of the lower extremities and prescribe appropriate treatment, the specialist will ask the patient to undergo a comprehensive examination, which includes various methods.
- Duplex scanning (ultrasound of veins) is the most informative method for diagnosing varicose veins of the legs, making it possible to get an idea of the degree of dilation of the veins, the direction of blood flow through the veins and their patency, as well as detect the presence of blood clots (thrombi).
- Contrast venography, which is an examination method that allows you to detect dilated veins and learn about the degree of their patency for blood.
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 disorders.These complications manifest themselves in changes in skin color on the legs, redness, darkening, and blueness of the skin.
Also characterized by constant swelling of the ankle, especially severe when walking or standing.In the calf area, there is pain when walking, pain along the tortuous vein, thickening of the skin and the formation of ulcers of various sizes on it.
During pregnancy
Pregnancy significantly increases the risk of developing varicose veins of the lower extremities, due to 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.
- Increased intra-abdominal pressure in late pregnancy makes it difficult for blood to flow through the veins of the legs.
- Varicose veins that occur during pregnancy may disappear completely after childbirth, or progress further, depending on individual factors (heredity, the presence of other contributing factors).
Treatment of varicose veins on 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 treatment method is used both independently and in combination with conservative procedures.Its essence is that a special drug that seals it is injected into the vein with a thin needle or syringe, and subsequently the vein completely disappears.Sessions are held once a week, 3 to 6 such sessions are required.The method allows you to avoid scars and scars.
- Non-surgical treatment.If varicose veins are in the early stages and if they do not cause too much discomfort, elastic compression stockings may be recommended.They are worn during daily activities.They help compress the veins, keeping 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 stop the disease completely and restore damaged veins.
- Laser treatment for varicose veins on 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 a major role in treatment and prevention - brisk walking, gymnastics, swimming and exercises in water (excluding sports exercises with a large load on the legs - tennis, weightlifting, jumping).
Conservative treatment of varicose veins is mainly prescribed to those people who have clear contraindications to surgical intervention.
Also, such treatment is indicated if the patient has slight varicose veins, which is purely a cosmetic defect.The goal of conservative therapy is also to prevent further progression of this disease.For this purpose, patients are recommended to bandage legs affected by varicose veins with an elastic bandage.In addition, compression knitwear is indicated for varicose veins.People who have a tendency to varicose veins or already suffer from this disease should regularly place their legs on an elevated surface throughout the day, resting in this way for several minutes.There are also special exercises for the lower leg and foot, aimed at activating the muscular-venous pump.This is periodic extension and flexion of the ankle and knee joints.
The patient should be careful not to allow the legs and thighs to be pulled together by various toilet items, as this can significantly impede the flow of venous blood.
Using elastic compression, you can activate blood flow in the deep veins, prevent swelling, reduce the amount of blood in the saphenous veins, promote the body's metabolic processes and blood microcirculation.
But in order to achieve positive results, it is important to bandage the leg correctly.This process must be done in the morning, before getting out of bed.Bandaging begins from the toes to the thigh, and a slight tension of the bandage should be felt.During the bandaging process, be sure to grab the heel and ankle joint.With each turn around the limb, the bandage should cover half the previous turn.You should only buy 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 stay in rooms with high temperature and humidity for a long time.It is advisable to keep your legs in an elevated position while sleeping.
Patients should limit fluid and salt intake and try to get rid of excess weight.To treat varicose veins, it is periodically necessary to take diuretics, drugs that improve the tone of the veins.In addition, if indicated, the patient may be prescribed medications that stimulate microcirculation in tissues.Treatment for varicose veins may also include taking non-steroidal anti-inflammatory drugs.
If the patient has an uncomplicated form of the disease, physical therapy exercises are indicated.Swimming, other water treatments, foot baths with warm water, to which a 5-10% sodium chloride solution is added, are very useful.
Very often, local therapy methods are used in the treatment of varicose veins.But such 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 drugs contain heparin or venoactive components.Ointments for varicose veins help normalize the tone of the vein walls and can correct disorders of lymphatic drainage and microcirculation.Some local preparations contain several different active ingredients.
If during the process of varicose veins a secondary infection occurs, then it is advisable to use external agents with antibiotics or antiseptics.
Has been used for treatment since ancient times hirudotherapy with varicose veins.The use of leeches that secrete hirudin allows blood to thin and promotes resorption blood clots, getting rid of spider veins and varicose veins.In addition, hirudotherapy for varicose veins can reduce pain in the legs and overcome swelling.However, it is important to use hirudotherapy in the earliest 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 carried out 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 make it possible to use endoscopic techniques for such an operation.
If a person has only small branches dilated, sclerotherapy can 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.
For varicose veins, combined surgical therapy is also used, in which large trunks of the altered veins are removed and sclerotherapy of small branches is performed.After surgery, patients are recommended to continue wearing an elastic bandage for 8-12 weeks.
Conservative treatment
Those who are looking for an effective and miraculous cure for varicose veins will immediately be disappointed: even the most modern and expensive drugs cannot completely eliminate varicose veins.They help 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 further development of varicose veins.The leading role in the treatment of this disease belongs to herbal medicines, which are based on natural plant substances.However, we should not forget that most venotonic drugs 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 regularly wearing 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 are used - phlebotonics.These drugs are analogues and contain a purified flavonoid fraction consisting of 90% diosmin.They are taken one tablet twice a day, the course of treatment is selected individually.
You can reduce capillary permeability, reduce blood viscosity and increase the tone of veins with the help of preparations based on horse chestnut
How to treat varicose veins with folk remedies
There are a huge 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) need to be poured with 500 grams of alcohol, then allowed to brew for 14 days, shaking the bottle every day.Pass the tincture through the mesh and take a tablespoon with water three times a day before meals.Once you have been treated for a week, take a break for two weeks.Then treatment can be started again.
- An infusion of dried nettle is used for varicose veins.Dry crushed leaves of the plant are poured into 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.Finely chopped tomato, placed on a bandage, gauze, and applied to the sore spot.For convenience, you can tie it with an elastic or other bandage.Keep this compress on the vein for 2 hours, then change it to a new one, and so on a total of 3 times.The convenience of this compress is that it can be repeated every day.
- Oil tincture of walnuts: chop unripe nuts, pour into a glass container, pour in olive oil and leave for 40 days in a sunny place.Lubricate sore 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 of the legs
Very often, as a complication of varicose veins, it appearsacute thrombophlebitis of the superficial veins.Sometimes, as a result of damage, varicose veins rupture and bleeding.When blood leaks from a node that has burst, very significant blood loss is possible.
In addition, due to increased pressure in the venous system, arterial blood flow slows down.Because of this, it may 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 layer of subcutaneous fat gradually becomes denser, anddermatitis,venous trophic ulcers.In very rare cases, such ulcers degenerate into malignant formations.
If the disease continues over a long period, the person may subsequently 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 suffered from varicose veins, or due to their occupation they are forced to spend a lot of time standing, 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 down the progress of existing varicose veins.
Prevention measures:
- Avoid overexposure to sunlight and hot baths.Ideally, bathhouses and saunas should not be visited at all.
- Avoid wearing tight shoes, tight stockings, and tight-fitting clothing.
- The optimal 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.
- Perform 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 cool water; a contrast shower also has a positive effect.
Despite its prevalence, varicose veins are quite difficult to treat.When the first alarming symptoms appear, do not delay your visit to a vascular surgeon, because 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) allows you to stop the further development of the disease.You will have to adhere to a strict framework of prevention throughout your life.
In the later stages (with the appearance of severe deformation, nodes, swelling and signs of tissue oxygen starvation), the prognosis is determined by the presence of concomitant diseases (diabetes, obesity) and the patient’s willingness to follow the doctor’s recommendations (get examined, take medications, lose weight).
In diabetes mellitus, complications of varicose veins (thrombophlebitis, trophic ulcers) develop in 89%.
Varicose veins are considered a non-life-threatening disease, but its complications can greatly worsen the quality of life and prognosis.With deep vein thrombosis, about 50% of patients die from thromboembolism within 3 months.