Varicose veins (dilated veins of the lower extremities)– this is damage to the walls of the veins of the lower limbs, weakening of the venous valves, which leads to impaired blood flow and blood stagnation. The function of the venous valves is impaired, due to which the blood flows back and stagnates. The walls of the veins expand, thin and burst. Over time, blood clots form that can block a vessel and lead to a stroke or heart attack. Women are most often at risk of varicose veins, but men can get it too. 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 start from 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 limbs, this network is presented in the form of deep or superficial veins, which are interconnected by an emergency blood supply system. In general, most of the load falls on the deep veins, since 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 the surrounding muscles during walking and other movements. When the muscles are relaxed, the person moves a little or stands, the blood flows back down under the influence of gravity. But thanks to special valves, it stays 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, the veins expand and rise above the skin.
Blood circulation is disturbed 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 legs is disturbed, the blood stagnates in the veins and they stretch;
- constant stay in a vertical position - hairdressers, teachers, sellers and others who are worth a lot often suffer from varicose veins;
- overweight and obesity - high 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 expansion of veins and stretching of the walls of blood vessels;
- Professional sports - running, jumping, tennis - cause varicose veins due to constant stress on the lower limbs.
Varicose veins in the legs can be caused by previous injuries and surgeries of the lower extremities. In old age, almost everyone suffers from varicose veins, as the valves become weak and work poorly. They become inelastic and highly stretched.
Symptoms
In the initial stage, the veins located under the skin expand. If you immediately establish venous circulation, other complaints will not arise.
If the disease progresses, the following symptoms appear
- rapid fatigue;
- feeling of heaviness in the lower limbs;
- calf muscle cramps (most often occur in the evening and at night);
- There is a feeling of numbness and tingling 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
- thickening of the vein walls is formed;
- skin hyperpigmentation appears 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 progress, which is practically not treated.
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 on men's legs
Varicose veins on the legs of men occur in 32% of cases. Most often, the disease is observed at the age of 45 years. Male varicose veins appear for the same reasons as female ones - due to a large 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 observed even in middle age.
The development of varicose veins in men on the legs is associated with a loss of elasticity and tone of the vascular wall for several reasons:
- occupational characteristics - inactive work, staying in one position for a long time, working in an upright position, 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, heavy physical activity;
- hypertension;
- hereditary factor;
- smoking and alcohol.
The disease can last for several years. At first, a person may feel pain and swelling in their legs in the evening or after standing for a long time. In the later stages, varicose veins in men on the legs cause hair loss and burning in painful areas, itching in the venous nodes. Due to poor nutrition, trophic ulcers appear on the skin, which 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 area. Before their appearance, dermatitis occurs, which is 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 discharge is scanty, serous or purulent. Trophic ulcers are difficult to treat and can increase in size. They become more painful when they catch fibers. Over time, the induration of the subcutaneous tissue increases.
Trophic ulcers occur with characteristic symptoms, they are difficult to miss. At the site of the future ulcer, the skin becomes thick, reddish and swollen, increased pigmentation may appear. Leg ulcers with varicose veins itch and itch, causing excruciating pain. It can be dangerous due to blood poisoning and amputation of a limb. 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 on the legs
The 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, the pain is practically not unpleasant.
- Stage 2 - 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, 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 after waking up;
- dull, twisting pain in the calves, worse on prolonged standing and disappearing on lying down;
- burning and itching sensation in the legs in the evening;
- severe fatigue with light exertion and short walking.
Another important symptom of varicose veins is that the veins become less noticeable when a person lies down or raise their legs and become larger when standing up, especially when standing for a long time.
Varicose veins in the legs cause swelling of the soft tissues of the feet, ankles and lower legs. It is most often noticed in the evening after a working day. Bloating can occur in people who spend a lot of time standing and those who are overweight. Comfortable shoes begin to crumple in the evening and become tight. When you stay in one pose for a long time, your feet immediately swell or swell. You can check yourself for leg swelling. To do this, you need to measure the circumference of your shin with a tape measure: the narrowest part of the shin - 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 within a few days the circumference of the calf varies 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 limbs, 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 freckles. 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 unpleasantly.
Complications
Varicose veins are a serious disease, as they can cause a number of consequences: eczema, skin ulcers, severe venous bleeding from lower limb injuries, thrombophlebitis.
Thrombophlebitis is especially dangerous because blood clots form in the vessels and can break off at any time. Pulmonary artery occlusion is fatal.
Varicose veins of the lower extremities can lead to diseases such as
- hemorrhoids - a disease characterized by dilated veins of the rectum;
- varicocele - dilated 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 on the legs
The nature of the treatment of varicose veins of the legs depends on the stage of the disease and the symptoms. There are many procedures by which varicose veins are taped, sealed and removed. The most common methods are:
sclerosis
A procedure in which doctors glue small vessels to remove the "stars". A special substance is injected into the vein to glue the walls of the vein. After a while, this vein forms a string and dissolves. Sclerotherapy is a painless method and is carried out without anesthesiawithin 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
The next method of vein removal is endovasal laser coagulation. A method of modern treatment, the essence of which is the impact of the thermal energy of laser radiation. The laser affects only sections of the venous wall, without affecting the tissues and nerve endings that are nearby. Under the influence of radiation, the vein closes and is cut off from the blood stream. 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 with drugs prescribed by the attending physician is used. It is suitable for 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 refuse to undergo surgery.
Medicines for the treatment of varicose veins are divided into several groups:
- phlebotonics
- anticoagulants
- anti-edematous agents
- disaggregatants
- during trophic changes
- antioxidants
- non-steroidal analgesics;
- fibrinolytics
The patient should tie the lower limbs with an elastic bandage or wear elastic stockings, periodically raise the legs above the level of the heart and perform preventive exercises for the foot and lower leg to improve blood circulation in the legs and eliminate venous blood stasis.
Treatment for varicose veins in men includes wearing special compression clothing, regular exercise, 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 pressure in the legs. It is necessary to give up salt and sugar and reduce fluid intake. To strengthen the vascular wall, it is necessary to include foods with vitamin P, C, E, proteins and trace elements in your diet. 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 in compression clothing at a leisurely pace until fatigue is felt. 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 over 3-5 kg is excluded. Exercising in the pool, ergometer with back support, cycling will be extremely useful. You can do normal walking on a treadmill. Walking outdoors with alternating fast and slow steps is best.
Precautions should be taken after vein treatment and surgery. Wear the right shoes, high-heeled shoes are excluded, the platform should not be higher than 4 cm. To improve blood circulation, you should constantly wear compression clothing class 1 or 2, depending on the stage of development of varicose veins of the legs. . It is best to wear it in the cold season as it is more comfortable and convenient. It is recommended to give preference to high socks and tights, as knee socks will pinch your leg at the knee.
Laser treatment of varicose veins
Endovenous laser coagulation - laser surgery and echosclerotherapy can be prescribed for varicose veins. Some patients are shown surgical removal of varicose veins under local anesthesia through precise 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 the red blood cells and in a second it turns into heat (95-100 degrees), which causes the plasma and blood elements to boil, causing a thermal burn of the endothelium - the walls of the veins. A dense blood clot is created at the site of laser exposure, after which the veins dissolve and become invisible. If the vessels are large and are located in several layers, the procedure should be repeated after a month.
The treatment of varicose veins with a laser refers to surgical methods that are comparable to the method of treating the disease without surgery due to its low invasiveness, the absence of general anesthesia and the strict local effect of the laser only on the wall of the varicose veins. .
Laser surgery is performed using an ultrasound duplex scanner. The doctor inserts a thin light guide through a skin puncture into the lumen of the vein. The radiation of a certain wavelength of the laser, which is partially absorbed by the wall of the varicose vein, seals the diseased veins. In the clinics, a new generation laser is used, which 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 need hospitalization and can immediately go home after the procedure;
- local anesthesia is used - no general anesthesia or spinal anesthesia is required;
- short duration of the procedure - the laser treatment takes 60-90 minutes, after which the patient can go home;
- long-lasting cosmetic effect - after 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 degree of pressure for a long time. Special latex tampons or cotton rolls are placed in the area of large varicose veins. Immediately after the treatment procedure, the patient must walk at least 4-5 kilometers. The walk should be fast and brisk, so that the blood begins to circulate well and the veins develop. After laser surgery, in the first days you should walk every day for an hour.
After laser treatment of varicose veins, it is necessary to regularly undergo vascular diagnostics. Therapeutic gymnastics, walking, swimming, cycling are shown. It is worth giving up running, jumping, 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 breaks. Its purpose is to reduce the stagnation of blood 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 that the vascular walls of the veins are irradiated with radio frequency. Since the main goal is to stop the blood flow, when this method is used, the vein is, so to speak, welded under radiation. The vein gradually dissolves 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 in case of any concomitant pathologies. This technique has no systemic effect on the patient's body.
Since the most serious 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 surgically cleaning the ulcer and grafting skin to the affected areas of the body. With 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 are available 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 relieve heaviness, swelling, and pain in the lower extremities when walking. Wearing specialized underwear made of compression knitwear and bandages made of special bandages will help significantly ease the course of the disease and prevent 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 the work of the muscles and blood circulation in the vessels. During a break at work, you can do a simple exercise for varicose veins. Rise up 20 times on your toes, lifting your heels off the floor. This exercise will help you get rid of varicose veins as it acts as a pump and improves vascular tone. At the end of the day, try to keep your feet elevated or on a pillow. It will be useful to perform the "bicycle" exercise or to train on an ergometer with a back support.
You should exercise sparingly, excluding running, jumping, lifting barbells and dumbbells, strength training, squats and deadlifts in the gym. The most effective and healthy sports would be swimming, swimming, walking and cycling. Swimming exercises the blood vessels of the legs while being gentle on the lower limbs, unlike running and strength training. It helps to remove swelling, heaviness in the legs, increases vascular tone and removes cosmetic defects.
Every day it is necessary to perform a set of therapeutic exercises for the legs to remove swelling, improve blood circulation and strengthen the vascular wall. Exercises should be performed until your legs get tired. After the gymnastic complex, you need to rest and lie down with your feet on a pillow or armrests on the sofa. It is useful to finish the exercises with a contrast shower or foot bath.
It is important to stick to proper nutrition. It is necessary to exclude salty, hot and spicy foods, smoked foods, 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 in order to avoid the formation of blood clots in the vessels. The diet should be rich in foods with vitamins C, B, E, proteins, trace elements: citrus fruits, sour fruits and berries, 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 carry out juice days 2 times a week, after consulting a doctor to see if you have stomach diseases.
Prevention of varicose veins
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 bed, place a pillow or folded blanket under your feet to elevate your legs a bit.
Varicose vein prevention includes weight reduction, as excess weight puts additional stress on the legs. Women should not carry weights weighing more than 3 kilograms in one hand. You should give up tight clothes and shoes, tight-fitting socks and stockings. The heel should not exceed 4 cm. They create an obstacle for normal blood circulation. Compression knitwear trains and fixes the veins well, improves their tone. Underwear should be purchased at a pharmacy or specialty store.
A sedentary job requires regular warm-up, stretching, and it's helpful to get up and walk. If possible, place a low bench 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 sun exposure. This will help reduce venous tone, which leads to stagnation of blood in the legs.
To prevent varicose veins in your legs, avoid wearing tight clothing such as socks or stockings with thick elastic bands, as they put too much pressure on the veins and can lead to poor circulation and dilation. High heels are excluded, shoes for every day should not be higher than 4 cm. Heeled shoes can be worn for festive events.