Varicose veins of the lower extremities, according to information on appeal to medical institutions, are found in one in five men and in 28% of women of working age.
If we consider the entire population, half of the adults will present characteristic symptoms.
The peculiarity of this disease is the growth from comfortable living conditions. Studies in Asian countries have shown a lower prevalence among the poor who do manual labor and take long walks.
Why are the veins in my legs loaded?
The anatomical structure of the vein wall is characterized by a reinforced skeleton of muscles and a valve apparatus. Convenience lies in the need not only to maintain blood flow in the vertical position of a person, but also to organize its ascent against gravity in the direction of the heart.
The valves block the return flow to prevent overfilling at the most distant points of the body. This "uncomfortable" place is the legs and feet.
The mechanism of formation of varicose veins of the legs.
At the age of 40, the human body begins to synthesize plastic materials in a limited way, the main of which is collagen protein. It is essential for a good tone of the venous valve. The absence leads to loss of tone, sagging, and inability to delay the reverse flow of blood and the overlying mass.
The venous network of the legs consists of superficial vessels that are located directly under the skin and deep veins located in the thickness of the muscle layer.
Varicose veins of the lower extremities are characterized by an initial injury to the valves of the superficial veins. Congestion manifests itself in areas with dilated fine veins, visible to the naked eye as a fine mesh.
Further development of the pathology leads to retention of blood in the periphery and causes tissue edema (leakage of fluid through the walls of the veins), malnutrition (the output of toxins is reduced, the squeezed arteries retain oxygen and nutrients) .
How complications come together
Venous blood stagnation in the legs causes slower blood flow in the vessels and this creates favorable conditions for the aggregation (adhesion) of platelets. Blood clots complicate an already compromised blood supply.
It increases the risk of rupturing the embolus and its movement through the great vessels to the heart. If a person has defects associated with the communication of the right and left chambers, it is possible that an embolus enters the arterial blood and the development of necrotic changes in the organs.
The most common concomitant complication is the addition of a local infection in the affected area of the venous wall, followed by the development of phlebitis or thrombophlebitis.
Causes of the disease
For varicose veins of the lower extremities, there is only one reason independent of a person - a genetic deficiency in the structure of collagen. It manifests itself not only in varicose veins, but also in the relatively early signs of skin aging (dryness, deep wrinkles).
Other reasons are related to the activities and behavior of people.
- Decreased physical activity or, conversely, hard physical work leads to a violation of the tone of the veins of the legs.
- Forcibly standing for a long time, sitting during working hours causes stagnation of blood in the legs and poor outflow.
- Pregnancy puts increased pressure on the pelvic organs and large veins, preventing drainage from the lower veins.
- Doctors from Asian countries associate the growth of varicose veins in the legs in patients with an addiction to the European habit of sitting on a chair or chair instead of bent knees.
- Tall and comfortable toilets require greater tension of the abdominal wall muscles during bowel movements, the effort contributes to stagnation of the legs. While squatting, the act of defecation is more physiological.
- The habit of fast food, a decrease in the proportion of raw vegetables and fruits in the diet leads to constipation and prolonged stress.
- Smokers expose the entire body to the effects of nicotine, which acts on the veins like a paralyzing poison.
- Fashionable high-heeled footwear puts inadequate strain on the leg muscles and alters the tone of the veins.
- Common pills, hormonal contraceptives, treatment with hormonal drugs for menopause and osteoporosis cause a disturbance in collagen synthesis.
- The advertised slimming underwear and the use of tight jeans cause blood to pool in the underlying parts of the body.
Who should be included in the risk group
Taking into account the listed reasons for the development of venous pathology, the group of people with a higher probability of developing varicose veins of the legs should include:
- people professionally associated with a prolonged stay in a standing or sitting position (salespeople, teachers, hairdressers, drivers, office workers);
- women who prefer skinny jeans, shaping underwear, and heels;
- people involved in weightlifting and bodybuilding;
- people who are used to sitting "side to side";
- women with frequent pregnancies and deliveries, in addition to taking hormonal contraceptives;
- smokers, lovers of strong coffee and alcohol;
- constipated.
Preventive measures are needed for these populations.
Symptoms
The first symptoms of varicose veins in the legs are noticed at an early age. In the initial stage, they appear with increased stress on the legs:
- at the end of the shift, pains in the feet and legs appear, muscle fatigue;
- when changing shoes, swelling of the feet is found due to the tension of the shoes;
- at night, the feet "burn", you want to immerse them in cold water;
- Spiders form on the skin of the thighs and legs.
At the next stage, a picture of chronic venous insufficiency develops, symptoms of internal varicose veins appear:
- disturbed by night cramps in the calves, it is possible cramps when walking;
- dark spots, dryness, peeling appear on the skin of the feet and legs;
- the appearance of trophic ulcers, very painful, with loose edges, difficult to treat.
If, against the background of local pain, swelling, redness of the skin, an increase in body temperature is found, you need to think about thrombophlebitis.
Diagnostics
In diagnosis, it is customary to distinguish between true (primary) varicose veins, based on the lesion of the valve apparatus, and secondary, as a result of trauma and tumors.
Polyclinic surgeons, vascular surgeons, and phlebologists participate in the examination. The doctor sees subcutaneous venous nodes, vascular networks, skin pigmentation, initial ulcers, dermatitis.
On palpation, the tension of the superficial veins, the density of the wall, the size of the local changes, the presence of a thrombus, the temperature of the skin over the nodes (signs of thrombophlebitis) are evaluated.
A general blood test will show the onset of inflammation (leukocytosis, accelerated ESR), a tendency for thrombus formation according to a coagulogram.
Vascular ultrasound allows you to track blood flow, function of venous valves, and detect blood clots.
The Doppler examination allows you to check the structure of the veins to make a diagnosis in the early stage of the disease.
The spiral computed tomography method is carried out in case of difficulties in diagnosis. It allows to obtain a three-dimensional image of the anatomical region and helps in the choice of surgical treatment.
Treatment of varicose veins of the legs.
It is better to start the treatment of varicose veins of the legs at the initial stage. To do this, you will have to think about the necessary changes in habits, nutrition and movement.
Mode
So that the legs do not swell at the end of the workday, people in "sedentary professions" and "standing" are advised to take physical culture breaks or warm-ups with foot massage in an elevated position. Drivers and office workers must walk during breaks.
The simplest exercises can be performed at work:
- barefoot on the floor, alternately stand on your toes and heels;
- Sitting in a chair, lift your legs and circle your feet in one direction, then the other.
Morning exercises should include exercises in a lying position: alternate leg raises, "bikes", raised leg shakes. Squat exercises, bent knees are not suitable.
Strength training lovers should reject them. Most of those shown are swimming, biking, and hiking.
Selecting a balanced diet
Limit all foods that gain weight, promote fluid retention, and increase blood viscosity.
Fatty meats and dairy products, spicy and salty foods, canned foods, sweets, baked goods, and carbonated beverages are not recommended.
In the daily diet, you should use more vegetables and fruits, berries, onions, garlic, fermented dairy products, cereals, vegetable oil is shown instead of butter, nuts.
Vein support methods
Compression or golf stockings are recommended to promote blood flow. They are sized to be worn while lying on your back.
Silicone-filled footprints are touted as a remedy that creates an electrical charge on the surface of the foot.
Specialists pay attention to the possible impact of these aids only in the initial stage of the disease. In the presence of superficial nodules and edema on the legs, its use is completely useless.
The use of medications
Pharmacological treatment consists of taking drugs from the group of "venotonics" orally in a therapeutic dose selected by the doctor. They help to relieve fatigue, foot discomfort, but do not eliminate the disease.
Surgeons attribute varicose vein medications to conservative background treatment, but the main one is one of the least traumatic ways to influence affected veins. Efficacy is confirmed in 95% of patients. The most serious interventions are used in only 5% of patients.
What is referred to as mildly traumatic operations?
Low-traumatic methods of treating varicose veins allow you to avoid surgery, ranking first in terms of effectiveness. They do not require an incision in the skin, can be performed in a polyclinic and are practically painless. The patient is not limited in terms of work, movements. A long recovery period is not required after surgery.
Laser ablation method
It is performed under local anesthesia. A light guide is inserted into the varicose vein and a circular laser beam is fired during the reverse movement.
Method of action: the beam causes a pronounced burn of the inner lining of the vein, hardening it even more. The duration of the intervention is about two hours. The method is applicable in the treatment of veins of any size.
Sclerotherapy technique
A substance is injected into the affected vein that can cause the walls to collapse with subsequent scarring. Foam preparations are especially recommended, which quickly and safely fill the lumen of the diseased vein. The method is applicable when the diameter of the container is up to 1 cm. After the introduction, it is necessary to walk for an hour. Phlebologists recommend wearing compression socks for another month.
Microflebectomy method
Under local anesthesia, a several mm skin incision is made, through which a diseased vein is hooked, brought to the surface of the skin, and excised. The method is suitable for venous nodes of any size and diameter. A small scar will remain at the incision site. You must wear compression socks or stockings for 10 days.
Radiofrequency ablation method
It is carried out in a similar way to lasers, but differs in effect from microwave radio frequencies. This method does not cause tissue burns, so it is less traumatic than laser. After 30 minutes of microwave exposure, the lumen of the container is sealed. After 7 days, the rehabilitation is considered complete. You can play sports.
In which cases is the operation indicated?
With an unsuccessful treatment by conservative methods and the impossibility of using minimally invasive techniques, a phlebectomy operation is prescribed. Allows you to remove large areas of varicose veins, bundles.
The patient is hospitalized. Surgical treatment is performed under general anesthesia. Usually, two incisions are made: in the groin area and below the knee. The vein is tied off on both sides, pulled out, and removed. Sutures are applied to the incisions. The patient receives treatment in a hospital for a week. Drugs that reduce blood clotting are used. The stitches are removed after at least 7 days.
Phlebectomy is not performed:
- in the old age of the patient;
- with massive damage to the deep and superficial veins;
- During pregnancy;
- with atherosclerosis of the vessels of the legs, diabetes mellitus;
- if there are skin diseases at the site of the proposed operation.
Prevention methods
The prevention of varicose veins of the legs is mainly necessary for people with risk factors in the profession.
More walking is recommended. There is a massage and strengthening of the vein walls.
During breaks, vendors and hairdressers are shown foot and shin massage. It is done with slow and gentle movements in the direction from the fingers to the knee and along the thigh. The knuckles of the fist are massaged in a circular motion up to the central fossa of the foot.
Drivers need to get out of the car, walk, stretch their legs. Leg exercises are shown.
Fashionistas should think about the consequences before putting on high heels and wearing tight clothing.
At home you can do contrast baths or foot baths. Apply a compress to tired legs with decoctions of chamomile, chestnut, wormwood, burdock.
A timely visit to the surgeon allows you to get rid of painful problems, restore activity and movement.