Varicose veins (varicose veins of the lower extremities)– this causes damage to the walls of the veins of the lower limbs, weakening of the venous valves, disruption of blood flow and blood stagnation. The function of the venous valves is disturbed, causing backflow and stagnation of blood. The walls of blood vessels expand, thin and burst. Over time, blood clots form, which can block an artery and cause a stroke or heart attack. Women are most at risk of varicose veins, but men can also experience them. The age of the disease is over 20 years old, sometimes varicose veins can appear during adolescence. Varicose veins are most often caused by a sedentary lifestyle and professional characteristics, but the disease can also be caused by other factors.
Causes of varicose veins
Blood vessels in the body are important for blood circulation and transport of nutrients from the tissues to the heart. In the region of the lower extremities, this network is presented in the form of deep or superficial veins connected to each other by the emergency blood drainage system. Basically, most of the load falls on the deep veins, because they are larger and stronger. Superficial veins do about 15% of the work.
The heart is needed to pump and move blood through the vessels, and during walking and other movements, some of the blood moves through the vessels against gravity due to the work of the surrounding muscles. When the muscles relax, the person moves a little or stands up, and the blood returns to the bottom under the influence of gravity. But it is kept in place thanks to special valves.
If the valves do not cope with their functions, the veins begin to expand and become inflamed, unable to hold the blood. Due to this, stagnation of blood circulation occurs, the vessels expand and rise above the skin.
Blood circulation is disrupted and varicose veins expand. The causes of varicose veins can be:
- absence, defect or damage of venous valves - the reverse flow of blood to the legs is disturbed, blood stagnates in the veins and they stretch;
- constant standing in an upright position - most often hairdressers, teachers, sellers and others who are expensive suffer from varicose veins;
- overweight and obesity - heavy weight puts pressure on the lower extremities, as a result of which veins expand and varicose veins expand;
- intestinal diseases, constipation - creates intra-abdominal pressure that causes varicose veins;
- straight legs;
- pregnancy - the uterus with the fetus creates additional pressure on the legs, which causes varicose veins;
- lifting weights - excessive physical activity leads to the expansion of blood vessels and stretching of the walls of blood vessels;
- Professional sports - running, jumping, tennis - cause varicose veins due to constant stress on the lower extremities.
Varicose veins in the legs can occur as a result of previous injuries and operations in the lower extremities. In old age, almost everyone suffers from varicose veins, because the valves weaken and work poorly. They are inelastic and very stretchy.
Symptoms
In the initial stage, the veins under the skin expand. If you immediately establish venous circulation, then other complaints will not arise.
If the disease progresses, the following symptoms appear
- rapid fatigue;
- a feeling of heaviness in the lower extremities;
- calf muscle cramps (most often appear in the evening and at night);
- There is tingling and numbness in the legs.
With the further development of this disease, trophic disorders begin, mostly concentrated in the area of the inner surface of the lower leg.
Symptoms of trophic disorders
- thickening of vascular walls occurs;
- skin hyperpigmentation occurs in places;
- atrophy of the skin;
- dermatitis is a disease characterized by inflammation of the skin;
- in the later stages of the disease, a practically incurable trophic ulcer may develop.
In the chronic form of varicose veins, the symptoms manifest themselves in the form of swelling of the lower limbs 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 heavy load on the lower extremities. It is less common, because it is related to the characteristics of the structure of the male organ. 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 the loss of elasticity and tone of the vascular wall due to several reasons:
- occupational characteristics - inactive work, staying in one position for a long time, standing, lifting weights;
- overweight;
- fatty and unhealthy foods that have a negative effect on the walls of blood vessels;
- liver diseases: hepatitis and cirrhosis;
- metabolic diseases, diabetes;
- active sports, physical education, heavy physical activity;
- arterial hypertension;
- hereditary factor;
- smoking and alcohol.
The disease can last for several years. At first, 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 on the legs in men cause hair loss and burning in painful places, itching in the veins. Due to poor nutrition of the skin, itchy and painful trophic ulcers occur. It becomes difficult for the patient to walk, then 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 localized on the inner surface of the lower third of the foot, in the supramalleolar region. Their appearance is preceded by dermatitis, which is accompanied by eczema and severe itching. The ulcer can be single or multiple, in most cases it is flat, the bottom is smooth, the edges are uneven, smooth, there is little discharge, serous or purulent. Trophic ulcers are difficult to heal and may increase in size. They are more painful when they catch the fiber. Over time, the induration of the subcutaneous tissue increases.
Trophic ulcers occur with characteristic symptoms, which are difficult to miss. At the site of the future ulcer, the skin becomes dense, red and swollen, pigmentation may increase. An ulcer on a leg with varicose veins itches and itches, causing excruciating pain. It can be dangerous due to blood poisoning and amputation of limbs. How to treat an ulcer with varicose veins should be decided by a phlebologist after a thorough diagnosis of the veins.
Symptoms of varicose veins in the legs
Manifestation of the symptoms of varicose veins of the legs depends on the stage of development of the disease:
- Stage 1 - some cosmetic defects are noticeable, pain is practically not bothersome.
- Stage 2 - a 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.
- Stage 4 - the appearance of trophic ulcers, burning and itching, severe pain, protruding veins, changes in gait, difficulty walking.
The most common symptoms of varicose veins in the legs include:
- heaviness and fatigue in the legs, cramps in the calf muscles during sleep and after waking up;
- dull, arching pain in calves, aggravated by long standing and relieved by lying down;
- burning and itching sensation in the legs in the evening;
- severe fatigue with light loads and short walking.
Another symptom of varicose veins is that when a person lies down or raises their legs, the veins become less noticeable and grow when they stand up, especially after standing for a long time.
Varicose veins in the legs cause swelling of the soft tissues in the legs, ankles and lower legs. It is often noticeable in the evening hours after a working day. Swelling can occur in people who spend a lot of time on their feet and who are overweight. Comfortable shoes start to feel cramped and tight in the evening. When you stay in one position for a long time, your feet immediately swell or swell. You can check the leg swelling yourself. To do this, you need to measure the circumference of your calves with a measuring tape: the narrowest part of the calf - the place above the ankles, and the widest part - the calf muscle. It is necessary to measure twice a day: in the evening before going to bed and immediately after waking up. If the circumference of the calf changes by more than 1 cm in a few days, there is a reason to check your veins and arteries.
If varicose veins are not treated, the disease progresses and new symptoms appear. Trophic ulcers occur on the skin of the legs and feet due to poor nutrition of the tissues of the lower extremities. First, the skin begins to thicken and spots appear in the form of dark freckles. The skin becomes dry, blue, and swelling may occur. With the development of varicose veins, trophic ulcers can appear, which is itching and unpleasant itching.
Complications
Varicose veins are a serious disease, because it can cause a number of consequences: eczema, skin wounds, severe venous bleeding from damage to the lower extremities, thrombophlebitis.
Thrombophlebitis is especially dangerous because blood clots form in the veins and can break at any time. Pulmonary artery occlusion is fatal.
It can cause diseases such as varicose veins of the lower limbs
- 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 venous system increases.
It becomes difficult to walk with varicose veins in the legs, and in the later stages, a person becomes disabled.
Treatment of varicose veins in the legs
The nature of the treatment of varicose veins in the legs depends on the stage of the disease and symptoms. There are many procedures in which enlarged veins are glued, tied, and removed. The most common methods are:
Sclerosis
A procedure in which doctors stitch together small veins to remove "stars". A special substance is injected into the vein to glue the vessel 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. For 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. Modern treatment method, its essence is the effect of thermal energy of laser radiation. The laser affects only the areas of the venous wall without affecting the nearby tissues and nerve endings. Under the influence of radiation, the vessel is closed and removed from the bloodstream. 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 popular due to the possibility of outpatient treatment and rapid rehabilitation.
Conservative treatment
In some cases, conservative treatment is used with drugs prescribed by the attending physician. It is suitable for patients who have contraindications for surgery, have insufficiency of deep vein valves, have varicose veins in the initial stage, have only cosmetic defects and refuse surgery.
Medicines for the treatment of varicose veins are divided into several groups:
- phlebotonics
- anticoagulants
- anti-edema agents
- disaggregation
- during trophic changes
- antioxidants
- non-steroidal analgesics;
- fibrinolytics
The patient should wrap the lower limbs with an elastic bandage or wear elastic stockings, periodically raise the legs above the level of the heart, perform preventive exercises for the legs and lower legs to improve blood circulation in the legs and eliminate venous stagnation. blood
The treatment of varicose veins in men consists of wearing special compression clothes, exercising regularly, maintaining a proper diet, and avoiding alcohol and smoking.
Treatment of varicose veins in the legs consists of losing excess weight and following a diet to reduce swelling and tension in the legs. It is necessary to give up salt and sugar and reduce fluid intake. In order to strengthen the vascular wall, it is necessary to include foods containing vitamins P, C, E, proteins, microelements in your diet. It is forbidden to smoke and drink alcohol, because they stretch the walls of blood vessels and disrupt their permeability.
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 at a leisurely pace in compression garments until fatigue is felt. In this case, jumping, running, dancing, ballet, aerobics and steps are excluded, because they increase the load on the veins in the legs. You can't do strength training, you can't lift barbells or dumbbells. Lifting weights more than 3-5 kg is excluded. Exercises in the pool, exercise bike with back support and cycling will be extremely useful. You can walk normally on the treadmill. It is best to walk briskly and slowly in the open air.
Precautions should be taken after treatment and vascular surgery. Wear proper shoes, high heels are excluded, the platform should not be higher than 4 cm. To improve blood circulation, you should always wear compression garments of class 1 or 2, depending on the stage of development of varicose veins in the legs. . It is better to wear it in the cold season because it is more comfortable and convenient. It is recommended to opt for high socks and tights as knee socks will squeeze your leg from the knee.
Laser treatment of varicose veins
Endovenous laser coagulation can be prescribed for varicose veins - laser surgery and echo sclerotherapy. Some patients are shown surgical removal of dilated 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 red blood cells and turns into heat (95-100 degrees) within a second, which leads to the boiling of plasma and blood elements, causing thermal burning of the endothelium - the walls of the vessels. A dense blood clot forms at the site of laser exposure, then the vessels melt and become invisible. If the vessels are large and located in several layers, the procedure should be repeated after a month.
Laser treatment of varicose veins refers to surgical methods comparable to the method of treating the disease without surgical intervention due to its low invasiveness, lack of general anesthesia, and the fact that the laser only has a serious local effect on the wall of varicose veins. .
Laser surgery is performed using an ultrasound duplex scanner. The doctor inserts a thin light guide into the lumen of the vein through a skin puncture. Radiation of a certain laser wavelength, which is partially absorbed by the wall of the dilated vessel, seals the diseased vessels. Clinics use a new generation laser that has a selective effect on the walls of the vessels without damaging the surrounding tissues.
Laser treatment of varicose veins has several advantages:
- outpatient treatment - the patient is not required to be hospitalized and can go home immediately after the procedure;
- local anesthesia is used - general anesthesia or spinal anesthesia is not required;
- short duration of the procedure - laser treatment is carried out 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 treated varicose veins.
For this, the patient wears compression stockings. They are thin, flexible and maintain the required level of pressure for a long time. Special latex pads or cotton rolls are placed in the area where large varicose veins are located. Immediately after the treatment procedure, the patient should walk at least 4-5 kilometers. Walking should be fast and fast so that the blood begins to circulate well and the veins develop. In the first days after laser surgery, you need to walk for an hour every day.
After laser treatment of varicose veins, it is necessary to undergo vascular diagnostics regularly. Therapeutic gymnastics, walking, swimming, cycling are shown. It is worth giving up running, jumping, strength training in the gym, weight lifting, dancing and all kinds of martial arts. Gymnastics should be done 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 work too hard. After classes, you should stretch your legs for a few minutes at an angle of 90 degrees.
Radiofrequency coagulation
Another way to eliminate varicose veins is radiofrequency coagulation. The essence of the method is that the vascular walls of the vessels are exposed to radiofrequency radiation. Since the main goal is to stop the blood flow, when using this method, the vessel is welded as if under radiation. Gradually, the vein dissolves and disappears completely in six months to a year. The advantage of this method is the complete absence 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 trophic ulcers are the most difficult result of chronic venous insufficiency, their treatment is complex, including endovenous laser coagulation, scleropathy and miniphlebectomy. Local treatment is often performed, which consists of surgical debridement of the ulcer and skin grafting on 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 applied to relieve heaviness, swelling and pain in the lower extremities during walking. Wearing special underwear made of compression knitwear and bandages made of special bandages will help to significantly ease the course of the disease and prevent complications from spreading further.
How to treat varicose veins in the legs at home
Varicose veins require physical activity, but it should be gentle, so strength training, weight lifting 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 veins. You can do a simple exercise for varicose veins during a break at work. Rise on your toes 20 times, lift your heels off the floor. This exercise will help you get rid of varicose veins, because it works as a pump and improves the tone of the veins. Try to keep your feet up or on a pillow at the end of the day. It will be useful to do the "bicycle" exercise or exercise on an exercise bike with a back support.
In the gym, you should exercise gently, except for running, jumping, lifting barbells and dumbbells, strength training, squats and deadlifts. The most effective and healthy sports would be swimming, swimming, walking and cycling. Unlike swimming, running, and strength training, it exercises the blood vessels of the legs while being gentle on the lower extremities. It helps to remove swelling and heaviness in the legs, increases vascular tone and removes cosmetic defects.
Every day, it is necessary to perform a series of therapeutic exercises for the feet to eliminate swelling, improve blood circulation and strengthen the vascular wall. Exercises should be done until your legs are tired. After the gymnastics complex, you need to rest and lie down with your legs on a pillow or on the armrests of the sofa. It is useful to complete 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 foods, fatty, fried, flour and sweet foods, because they destroy the walls of blood vessels and retain fluid in the body. In order to prevent the formation of blood clots in the veins, alcohol and smoking are prohibited. The diet should be rich in foods containing vitamins C, B, E, protein, trace elements: citrus fruits, sour berries and fruits, nuts, seeds, greens, vegetables. As for drinks, it is better to give preference to fruit drinks, jelly, green and herbal teas. Sugar should be replaced with honey.
After consulting your doctor, it is useful to have juice days twice a week to find out if you have stomach problems.
Prevention of varicose veins
Since varicose veins are most often caused by blood stagnation in the extremities, put your feet up on the back of the sofa or on a low table or chair at home. It relieves fatigue and tension in the legs. Place a pillow or folded blanket under your feet to elevate your legs a bit before bed.
Prevention of varicose veins involves losing weight, as excess weight puts extra stress on the legs. Women should not carry more than 3 kilograms of weight in one hand. It is necessary to give up tight clothes and shoes, tight socks and stockings. The heel should not exceed 4 cm. They create an obstacle to normal blood circulation. Compressor knits well straightens and straightens veins, improves tone. Underwear should be purchased at a pharmacy or specialized store.
Sitting work requires regular warming up, stretching, it is useful to get up and walk. If possible, put 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.
Preventive measures should be taken to prevent varicose veins. 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 causes blood stagnation in the legs.
To prevent varicose veins in your legs, avoid wearing stockings or tights with tight elastic bands, as they put too much pressure on the veins and can cause poor circulation and dilation. High-heeled shoes are excluded, shoes for every day should not be higher than 4 cm. Heeled shoes can be worn for festive events.