Varicose veins

Varicose veins (varicose veins of the lower extremities)– This is damage to the venous walls of the lower extremities, weakening of the venous valves, leading to impaired blood flow and blood stagnation. The function of the venous valves is impaired, so that the blood flows back and stagnates. The walls of the veins expand, become thinner and rupture. Over time, blood clots form that can block a vessel and lead to a stroke or heart attack. Women are most commonly affected by varicose veins, but men can also be affected. The age of onset is 20 years and older; varicose veins can sometimes appear in adolescence. Varicose veins are most often caused by a sedentary lifestyle and occupational characteristics, but the disease can also arise from other factors.

Causes of varicose veins

Veins in the body are essential for circulating blood and transporting nutrients from tissues to the heart. In the lower extremities, this network takes the form of deep or superficial veins that are connected to each other by an emergency blood drainage system. Basically, most of the stress 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 transport blood through the veins, and some of the blood moves against gravity through the veins due to the work of surrounding muscles during walking and other movements. When the muscles are relaxed, the person moves little or stands, the blood flows back downwards under the influence of gravity. Thanks to special valves, it is held in place.

If the valves do not fulfill their function, the veins begin to expand and become inflamed; they can no longer hold blood. Because of this, blood circulation stagnates, the veins expand and protrude beyond the skin.

Blood circulation is impaired and varicose veins develop. The causes of varicose veins can be:

• Absence, defect or damage to the venous valves – the return of blood to the legs is disrupted, the 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, causing veins to dilate and varicose veins to form;
• Intestinal diseases, constipation – create intra-abdominal pressure leading to varicose veins;
• Flat feet;
• Pregnancy – the uterus containing the fetus puts additional pressure on the legs, which leads to varicose veins;
• Lifting weights – excessive physical activity leads to dilation of veins and stretching of the walls of blood vessels;
• Professional sports - running, jumping, tennis - cause varicose veins due to the constant stress on the lower extremities.

Varicose veins in the legs can be caused by previous injuries and surgery to the lower extremities. As we age, almost everyone suffers from varicose veins as the valves become weaker and function more poorly. They become inelastic and stretch a lot.

Symptoms

In the early stages, the veins under the skin expand. If you establish venous circulation immediately, no further symptoms will occur.

As the disease progresses, the following symptoms occur

• rapid fatigability;
• Feeling of heaviness in the lower extremities;
• Cramps in the calf muscles (occur most often in the evening and at night);
• There is a tingling and numbness in the legs.

With the further development of this disease, trophic disorders begin, which are usually concentrated in the area of the inner surface of the lower leg.

Symptoms of trophic disorders

• there is a thickening of the vein walls;
• in places there is hyperpigmentation of the skin;
• atrophy of the skin;
• Dermatitis is a disease characterized by inflammation of the skin.
• In later stages of the disease, a trophic ulcer may develop, which is practically untreatable.

In the chronic form of varicose veins, the symptoms manifest themselves in the form of swelling of the lower extremities when standing for long periods. After resting overnight, the swelling usually disappears completely.

Varicose veins on the legs of men

Varicose veins on the legs of men occur in 32% of cases. Most often the disease is observed at the age of 45 and older. Varicose veins in men arise for the same reasons as in women - due to the heavy load on the lower limbs. It occurs less often, as this is due to the peculiarities of the structure of the male body. However, due to smoking and severe stress, varicose veins appear in men already 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:

• professional characteristics - inactive work, prolonged stay in one position, standing work, weight lifting;
• obesity;
• 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, bodybuilding, heavy physical activity;
• arterial hypertension;
• hereditary factor;
• Smoking and alcohol.

The disease can last for several years. Initially, a man may experience pain and swelling in his legs in the evening or after staying in an upright position for a long time. In later stages, varicose veins in men on the legs cause hair loss and burning in painful areas, as well as itching in the venous nodes. Due to poor nutrition of the skin, trophic ulcers develop that itch and hurt. Walking becomes more difficult for the patient, then mobility of the limbs disappears. There is loss of feeling 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 leg in the supramalleolar area. Before their appearance, dermatitis occurs, which is accompanied by eczema and severe itching. Ulcers can be single or multiple, usually flat, the bottom is smooth, the edges are uneven, flat, the discharge is scanty, serous or purulent. Trophic ulcers are difficult to heal and can increase in size. They become more painful as they trap fibers. Over time, the hardening of the subcutaneous tissue increases.

Trophic ulcers appear with characteristic symptoms and are difficult to miss. At the site of the future ulcer, the skin becomes dense, reddish and swollen, and increased pigmentation may occur. An ulcer on the leg with varicose veins itches and itches, causing aching pain. Can be dangerous due to blood poisoning and limb amputations. How an ulcer with varicose veins should be treated should be decided by a phlebologist after a comprehensive venous diagnosis.

Symptoms of varicose veins on the legs

The manifestation of 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 bothersome.
• Stage 2 – Heaviness, fullness, pain and cramps during sleep.
• Stage 3 – Edema formation, feeling of fullness, thickening of the skin and subcutaneous tissue, formation of dark spots.
• Stage 4 – appearance of trophic ulcers, burning and itching, severe pain, bulging veins, gait changes, difficulty walking.

The most common symptoms of varicose veins on the legs include:

• Feeling of heaviness and tiredness in the legs, cramps in the calf muscles during sleep and after waking up;
• dull, arching pain in the calves that increases when standing for long periods of time and disappears when lying down;
• Feeling of burning and itching in the legs in the evening;
• severe fatigue with light exertion and short walking.

Another noticeable symptom of varicose veins is that the veins become less visible when lying down or lifting the legs and become larger when standing up, especially when standing for long periods of time.

Varicose veins in the legs cause swelling of the soft tissues of the feet, ankles, and lower legs. It most often becomes noticeable in the evening after a day at work. Swelling can occur in people who spend a lot of time standing and are overweight. Comfortable shoes start to pinch in the evening and become tight. If you stay in one position for a long time, your legs will immediately swell or swell. You can determine for yourself whether there is leg swelling. To do this, you need to measure the circumference of your shins with a tape measure: the narrowest part of the shinbone - the place above the ankles and the widest part - the calf muscles. You need to measure twice a day: in the evening before going to bed and immediately after waking up. If the calf circumference fluctuates by more than 1 cm within a few days, there is a reason to examine 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 appear in 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, has a bluish color and swelling may occur. With the development of varicose veins, trophic ulcers may appear, which cause unpleasant itching and itching.

Complications

Varicose veins are a serious disease as they can cause a number of consequences: eczema, skin ulcers, severe venous bleeding due to injuries to the lower extremities, thrombophlebitis.

Thrombophlebitis is particularly dangerous because blood clots form in the vessels and can break off at any time. A blockage of the pulmonary artery is fatal.

Varicose veins in the lower extremities can lead to diseases such as:

• Hemorrhoids – a disease characterized by varicose veins in the rectum;
• Varicocele – varicose veins of the spermatic cord;
• Portal hypertension is a syndrome in which pressure within the portal venous system increases.

With varicose veins in the legs, walking becomes difficult and in later stages the person becomes disabled.

Treatment of varicose veins on the legs

The type of treatment for varicose veins in the legs depends on the stage of the disease and the symptoms. There are many procedures that can be used to glue, seal, and remove enlarged veins. The most common methods are:

sclerosis

A procedure in which doctors glue small vessels together to remove the "stars". A special substance is injected into the vein to glue the vein walls together. After some time, this vein forms a strand and dissolves. Sclerotherapyis a painless method and takes place within 15 minutes without anesthesia.

Phlebectomy

If varicose veins require radical treatment, surgical intervention is used. During varicose vein surgery, the veins are removed. To do this, a procedure called phlebectomy is carried out - this is a surgical procedure in which the saphenous veins are removed. This prevents strain on the deeper layers of the veins.

Endovascular laser coagulation

The next method of vein removal is endovascular laser coagulation. A method of modern treatment, the essence of which is the effect of thermal energy of laser radiation. The laser only affects areas of the vein wall without affecting the surrounding tissues and nerve endings. Under the influence of radiation, the vein closes and is excluded from the blood circulation. The procedure is carried out under local anesthesia and without hospitalization. An ultra-thin laser light guide is inserted into a vein through a skin puncture. The procedure provides good results and is very popular due to the possibility of outpatient treatment and rapid rehabilitation.

Conservative treatment

In some cases, conservative treatment is carried out with medication prescribed by your doctor. It is suitable for patients for whom surgery is contraindicated, who have insufficiency of deep venous valves, who have varicose veins in the initial stages, who have only a cosmetic defect and who refuse surgery.

Drugs for the treatment of varicose veins are divided into several groups:

• Phlebotonics
• Anticoagulants
• Anti-edema remedies
• Disaggregators
• in trophic changes
• Antioxidants
• nonsteroidal 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 exercises for the foot and lower leg to improve blood circulation in the legs and eliminate venous stagnation blood.

Treatment for varicose veins in men includes wearing special compression clothing, regular exercises, proper nutrition, and avoiding alcohol and smoking.

Treatment for varicose veins in the legs includes following a diet to reduce excess weight and reduce swelling and tension in the legs. It is necessary to avoid salt and sugar and reduce fluid intake. To strengthen the vascular wall, it is necessary to include foods containing vitamins P, C, E, proteins and microelements in your diet. Smoking and drinking alcohol are prohibited, as they stretch the walls of blood vessels and impair patency.

At the initial stage of development of varicose veins and during treatment, it is necessary to regularly perform a set of therapeutic exercises. Exercises should be performed in compression clothing at a leisurely pace until you feel tired. In this case, jumping, running, dancing, ballet, aerobics and step are excluded, as these increase the strain on the veins in the legs. You cannot do strength training or lift barbells or dumbbells. Lifting weights over 3-5 kg is prohibited. Exercises in the pool, an exercise bike with back support and cycling are extremely useful. You can walk normally on a treadmill. It is best to walk outdoors with alternating fast and slow steps.

Precautions should be taken after treatment and vein surgery. Wear the right shoes, shoes with high heels are excluded, the platform should not be higher than 4 cm. To improve blood circulation, you need to constantly wear class 1 or 2 compression clothing, depending on the stage of development of varicose veins on the legs. It is best to wear it in the cold season as it is more comfortable and comfortable. It is advisable to give preference to high stockings and tights, as knee-highs pinch the leg at the knee.

Treatment of varicose veins with laser

For varicose veins, endovenous laser coagulation can be prescribed - laser surgery and echosclerotherapy. In some patients, surgical removal of dilated veins under local anesthesia through punctures of the skin surface is shown - miniphlebectomy. Microsclerotherapy can be used to remove spider veins and intradermal veins.

Laser energy is absorbed by the hemoglobin of red blood cells and converted into heat (95-100 degrees) within a second, causing boiling of plasma and blood components and causing thermal combustion of the endothelium - the vein walls. A dense blood clot forms at the point of impact of the laser, the veins dissolve and become invisible. If the vessels are large and lie in several layers, the procedure must be repeated after a month.

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 their low invasiveness, the absence of general anesthesia and the strictly local impact of the laser only on the wall of 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. Radiation of a specific laser wavelength, partially absorbed by the wall of the dilated vein, closes the diseased veins. Clinics use a new generation laser that targets the vein walls without damaging the surrounding tissue.

Laser treatment of varicose veins offers several advantages:

• outpatient treatment – the patient does not require hospitalization and can go home immediately after the procedure;
• A local anesthetic is used. General or spinal anesthesia is not required.
• short duration of the procedure – the laser treatment lasts 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 strip of skin may appear that disappears after 2-3 months.

After laser surgery for varicose veins, care must be taken to ensure compression of the treated varicose veins.

The patient also wears compression stockings. They are thin, elastic and maintain the required pressure for a long time. Special latex pads or cotton rolls are placed in the area of large varicose veins. Immediately after treatment, the patient must walk at least 4-5 kilometers. The walk should be quick and brisk so that the blood can circulate well and the veins can develop. After laser surgery, you will need to walk for an hour every day for the first few days.

After laser treatment of varicose veins, regular vascular diagnostics are required. Remedial gymnastics, walking, swimming and cycling are shown. It is worth giving up running, jumping, strength exercises in the gym, weight lifting, dancing and any kind of martial arts. Gymnastics should be performed daily at a moderate pace and with breaks. Its goal is to reduce blood stagnation in the veins, but not to pump up the legs, so you should not overexert yourself. After class, you need to lie down with your legs raised at a 90 degree angle for a few minutes.

Radiofrequency coagulation

Another option for removing varicose veins is radiofrequency coagulation. The essence of the method is that the vascular walls of the veins are exposed to high-frequency radiation. Since the main goal is to stop blood flow, this method involves, as it were, welding the vein under radiation. Gradually the vein recedes 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 the event of any concomitant diseases. This technique does not have a 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 surgical cleaning of the ulcer and skin grafting to the affected areas of the body. For this complication, the specialist prescribes the following medications:

• 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 used to eliminate heaviness, swelling and pain in the lower extremities when walking. Wearing special underwear made of compression knitwear and bandages made of special bandages helps to significantly alleviate the course of the disease and prevent further spread of complications.

How to treat varicose veins on the legs at home

Varicose veins require physical activity, but this should be gentle, so strength exercises, 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 vessels. During a break from work, you can do a simple exercise against varicose veins. Stand on your toes 20 times, lifting your heels off the floor. This exercise helps get rid of varicose veins as it acts like a pump and improves vascular tone. At the end of the day, try putting your feet up or lying on a pillow. It makes sense to do the "bicycle" exercise or workout on an exercise bike with back support.

You need to exercise gently, excluding running, jumping, barbell and dumbbell lifting, strength exercises, squats and deadlifts in the gym. The most effective and health-promoting sports would be swimming, swimming, walking and cycling. Swimming trains the blood vessels in the legs and, in contrast to running and strength exercises, protects the lower limbs. It helps to eliminate swelling and heaviness in the legs, increases vascular tone and eliminates cosmetic defects.

Every day it is necessary to perform a set of therapeutic exercises for the legs to eliminate swelling, improve blood circulation and strengthen the vascular wall. The exercises should be performed until your legs feel tired. After the gymnastics complex, you need to rest, lying with your feet on a pillow or the armrests of the sofa. It makes sense to round off the exercises with a contrast shower or a foot bath.

It is important to pay attention to proper nutrition. It is necessary to exclude salty, hot and spicy foods, smoked foods, fatty, fried foods, pastries 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 containing vitamins C, B, E, protein and microelements: citrus fruits, sour berries and fruits, 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's a good idea to do juice days twice a week after checking with your doctor to see if you have any stomach problems.

Prevention of varicose veins

Since varicose veins are most often caused by blood congestion in the extremities, rest your legs on the back of the sofa or on a low table or chair at home. This relieves fatigue and tension in the legs. Before bed, place a pillow or folded blanket under your feet to raise your legs slightly.

Preventing varicose veins also includes losing weight, as excess weight puts additional strain on the legs. Women should not carry weights weighing more than 3 kilograms in one hand. You must avoid tight clothing and shoes, tight-fitting stockings and socks. The heels should not exceed 4 cm as they hinder normal blood circulation. Compression knitwear trains and fixes the veins well, improving their tone. Underwear should be purchased at a pharmacy or specialty store.

Sedentary activities require regular warm-up and stretching, and it is also useful to get up and walk. If possible, place a low bench under your feet to promote blood circulation. Walk more often, exercise regularly, swim and climb stairs. This prevents the development of varicose veins and improves muscle tone.

To prevent varicose veins, it is necessary to take preventive measures. You should try to keep hot baths, saunas and steam rooms, and prolonged exposure to the sun to a minimum. This helps reduce venous tone, causing blood congestion in the legs.

To prevent varicose veins in the legs, avoid wearing tight-fitting clothing such as socks or stockings with tight elastic bands, as these can put too much pressure on the veins and cause poor circulation and dilatation. High heels are excluded; everyday shoes should not be higher than 4 cm. Shoes with heels can be worn on festive occasions.