Varicose veins can appear in different parts of the body, but the most common are varicose veins of the lower extremities. This disease is characterized by a violation of blood flow, which gets stuck in the veins of the legs. In medicine, varicose veins of the lower extremities are interpreted as a disease that is associated with an increase in length, the appearance of serpentine tortuosity of the saphenous veins, as well as an increase in their sac-shaped lumen. The disease is observed in 17-25% of the population. Moreover, women are affected by this disease 3 times more often than men.
Causes of the disease
The main causes of the disease are:
- inheritance;
- old age;
- excess weight;
- wearing tight underwear, as well as uncomfortable shoes, especially tight, with high heels.
The influence of heredity on the appearance and development of varicose veins has not yet been proven. However, it is noted that some families quite often have varicose veins in several generations. It is noted that the dominant factors in the occurrence of the disease are food, specific lifestyle and changes in the hormonal cycle.
The main risk factor in the development of the disease is obesity, and the incidence of varicose veins increases depending on the severity of obesity.
Excess weight is associated with a sedentary lifestyle and improperly organized food. For example, in the modern world, processed foods prevail and there is a lack of consumption of vegetable fibers contained in vegetables, berries and raw fruits. Plant fibers are essential for strengthening the vascular walls and reducing intra-abdominal pressure, which also helps reduce the risk of diseases.
In addition to proper nutrition, the work process must be properly organized. As a rule, a person spends a considerable period of working time in a standing or sitting position, which has a bad effect on the functioning of the valve apparatus of the veins. Hard physical work accompanied by heavy load on the legs while lifting heavy objects is considered equally unfavorable. Another risk factor that affects the development of the disease is long trips or flights, which are associated with the appearance of blood stagnation in the veins of the legs.
Another pressing cause of the disease is fashion. Thus, tight underwear compresses the veins in the area of the inguinal folds, and corsets significantly increase intra-abdominal pressure, leading to varicose veins. Wearing high-heeled shoes is considered extremely harmful, especially in combination with uncomfortable arch supports.
A proven risk factor for venous disease is repeated pregnancy, which leads to changes in intra-abdominal pressure, while the progesterone hormone negatively affects the vein walls and destroys collagen and elastic fibers.
Symptoms of varicose veins of the lower extremities
The main symptoms of this disease are:
- veins coming out from under the skin,
- swelling,
- leg pain, especially in the evening,
- feeling tired
- changes in the appearance of the skin - pigmentation, thickening,
- loss of skin elasticity, hair loss in the areas where the enlarged veins are located.
The main visible signs of varicose veins are sac-shaped or cylindrical enlargements of the superficial veins. The veins become unnaturally tortuous, protruding above the surface of the skin in the area of the legs and feet. Larger varicose veins are fixed after a long physical work.
In the first stage of varicose veins, the symptoms are few and non-specific. The only symptom of this stage is the feeling of heaviness in the legs. Rapid fatigue, a burning sensation in the legs, which is disturbing after physical activity, is also worrying. Sometimes short-term swelling and aching pain occur along the veins. It is characterized by slight swelling of the back of the foot and ankles, which often appears in the evening after prolonged monotonous exercise. In the morning, the swelling goes away without leaving a trace, and the visible expansion of the veins is not observed.
If these signs appear, it is necessary to consult a specialist at the right time, this will prevent the progression and development of the disease. In case of improper treatment, a neglected situation results in chronic venous insufficiency.
An important symptom of venous insufficiency is spider veins - a network of enlarged capillaries (0. 1 mm or more) that are visible through the skin. Women consider such "stars" as a cosmetic defect, but men simply do not notice them. Sometimes this is just a manifestation of hormonal disorders, abuse of the sauna or sunroom. However, in most cases, spider veins are one of the first signs of vein blockage and the development of varicose veins. If there is a relatively small area of such a disorder on the skin, you should definitely consult a specialist.
Diagnosis of varicose veins
A vascular surgeon can diagnose varicose veins through a routine examination, ultrasound of the veins and also by using phlebography, which is the injection of special drugs into the vein and monitoring their response.
When you visit a doctor, you will be offered a special examination consisting of several procedures.
- A blood test (general), which will show the degree of thickening, blood clotting (susceptibility to thrombosis), the presence or absence of inflammation (confirmatory thrombophlebitis).
- Ultrasound of the veins, which identifies the affected areas. Vascular ultrasound is recommended to be performed to identify signs of varicose veins, even if spider veins have already appeared.
- Rheovasography is a method that determines the insufficiency of blood supply (nutrition) to tissues by mathematical calculation. This is how the stage of the disease is determined, which is necessary for the selection of treatment methods.
- Surgical methods, such as venography (see above), are very rarely used to assess the state of the venous system.
Varicose veins treatment methods
Treatment of varicose veins is quite difficult, so its prevention is recommended. Conservative methods of treatment include tablets and special ointments prescribed by the doctor, wearing tights and stockings with a special drawstring. Surgical treatment of varicose veins is also possible, in which the enlarged veins are removed from a person using the traction method. Laser therapy and sclerotherapy are considered very effective.
Varicose veins are extremely disturbing to patients from a cosmetic point of view. Doctors consider it necessary to perform an operation. To reduce the risk of complications and speed up healing, specialists prescribe a special micronized drug that helps increase the tone in the veins, relieve inflammatory reactions and stimulate lymphatic flow.
Non-surgical treatment
Non-surgical treatment of varicose veins is successful only at the beginning of the disease, if the skin manifestations are mild, moderately reducing the ability to work. Conservative therapy is performed if surgical treatment is contraindicated. This method is also mandatory for the period after the operation to prevent the return of the disease.
Conservative treatment is:
- reducing the impact of risk factors,
- sufficient physical activity,
- elastic compression,
- medications,
- the use of physiotherapy.
People who have risk factors for the development of varicose veins or a hereditary predisposition should consult a phlebologist twice a year, undergoing an ultrasound scan of the veins.
With conservative treatment, it is necessary to constantly train the veins, keep the legs elevated for a long time and wear only comfortable and comfortable shoes.
Walking is indicated, as well as swimming or cycling. Physical activity should be performed only in conditions of elastic compression. Elastic compression is a conservative method of treating varicose veins using an elastic bandage or medical hosiery. Participation in traumatic sports such as football, volleyball and others is contraindicated.
For varicose veins, the use of phlebotonic medications is recommended. The action of such drugs is aimed at strengthening the vein walls.
All folk remedies, including medicinal herbs, will never be as effective as pharmaceutical drugs. You should not self-medicate; any drug therapy is used only as prescribed by a doctor. Local treatment is performed only if there is no thrombosis or thrombophlebitis.
Surgical methods of treatment
Complete healing of varicose veins of the lower extremities is achieved only with surgical treatment.
The following methods of surgical treatment are used:
Phlebectomy- removal of varicose veins during surgery. This procedure is contraindicated if the patient has a serious co-morbidity or a late stage of varicose veins.
The operation is not performed during pregnancy, the presence of purulent processes in the body, or for the elderly.The use of endoscopic treatment methods makes such an operation as safe as possible, but also cosmetically beneficial. The set of measures for quick recovery after surgery depends entirely on the complexity of the surgical procedure, taking into account the general principles. The final stitches are formed after 6 months, therefore, to avoid damage and cosmetic defects, it is necessary to exclude rough mechanical influences on them (use of a hard sponge, tight, uncomfortable clothing). Do not wash with hot water. After surgery, elastic compression should be used for 6 months. In the future, compression stockings will be necessary for "harmful" loads (heavy lifting, long trips).
Sclerosis- injection into the vein of a special substance (sclerosant) that causes the venous walls to "stick" to stop blood flow. In this way, the cosmetic defect is removed, as the vein becomes invisible. This method is effective only when the small branches of the main venous trunks are enlarged. After the vein sclerosis procedure, patients do not need rehabilitation.
Laser coagulation- the destruction of the vein wall under the action of a laser, due to which the lumen of the veins is "sealed". It is indicated for those whose dilation of veins is not more than 10 mm. The procedure requires anesthesia, early patient activation, and long-term elastic compression.
Prevention of varicose veins of the lower extremities
Currently, great importance is attached to the prevention of varicose veins. It is necessary to regularly carry out simple measures that can significantly reduce not only the risk of occurrence, but also the development and progression of the disease.
- An active lifestyle, measured alternation of long static loads with other types of physical activity, such as walking, running, cycling, swimming and performing simple exercises at work.
- Frequent keeping of the legs in an elevated position.
- Maintaining a diet and monitoring weight.
- Wearing comfortable shoes with a heel no more than 4 cm, using orthopedic insoles is helpful.
- When using estrogens, contraceptives or during pregnancy, you should undergo an ultrasound scan of the veins of the lower extremities.
Our health depends only on us, and in order to remain a happy person who is not bothered by any disease, it is important to carefully monitor your lifestyle, be physically active and eat properly.