Varicose veins in the lower limbs, according to information from appeals to medical institutions, are found in one in five men and 28% of women of working age.
If we consider the entire population, half of the adults will have characteristic symptoms.
The peculiarity of this disease is the growth from comfortable living conditions. Studies in Asian countries show a lower prevalence among the poor who carry out manual work, taking long walks.
Why are the leg veins full?
The anatomical structure of the vein wall is characterized by a reinforced muscle skeleton and a valve apparatus. The expedient is in the need not only to keep the blood flow in the person's vertical position, but also to organize his ascent against gravity towards the heart.
The valves block the return flow to prevent overfilling at the furthest points in the body. That "uncomfortable" place is the legs and feet.
The mechanism of varicose vein formation in the legs
At the age of 40, the human body begins to synthesize plastic materials in a limited way, the main one being the collagen protein. It is essential for good tone of the venous valve. Absence leads to loss of tone, flaccidity, and an inability to slow the reverse flow of blood and underlying mass.
The venous network in the legs consists of superficial vessels 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 lesion of the superficial vein valves. Congestion manifests itself in areas with dilated fine veins, visible to the naked eye in the form of a fine mesh.
The further development of the pathology leads to blood retention in the periphery and causes tissue edema (fluid leaking from the walls of the veins), malnutrition (the outflow of toxins is reduced, oxygen and nutrients are retained by the compressed arteries).
How the complications come together
Stagnation of venous blood in the legs causes a decrease in blood flow in the vessels, and this creates favorable conditions for the aggregation (adhesion) of platelets. Blood clots complicate an already compromised blood supply.
The risk of the embolus rupture and its movement through large vessels to the heart increases. If a person has defects associated with communication of the right and left chambers, it is possible for an embolus to enter the arterial blood and the development of necrotic changes in the organs.
The most common concomitant complication is the addition of local infection in the affected area of the venous wall, followed by the development of phlebitis or thrombophlebitis.
Causes of disease
For lower extremity varicose veins, there is only one reason independent of a person - a genetic deficiency in the collagen structure. It manifests itself not only in varicose veins, but also in relatively early signs of skin aging (dryness, deep wrinkles).
Other reasons are related to people's activities and behavior.
- Decreased physical activity or, conversely, heavy physical work leads to a violation of the tone of the veins in the legs.
- Standing stiffly for an extended period of time, sitting during working hours, causes blood stagnation in the legs and decreased blood flow.
- Pregnancy increases the pressure on the pelvic organs and large veins, preventing the lower veins from draining.
- Doctors in Asian countries link the growth of varicose veins in the legs in patients with an addiction to the European habit of sitting in a chair or chair instead of bent knees.
- Loud, comfortable toilets require more tension in the muscles of the abdominal wall during bowel movements, which contributes to leg stagnation. During squats, the act of defecating is more physiological.
- Fast food habits, decreasing the proportion of raw vegetables and fruits in the diet lead to constipation and prolonged stress.
- The smoker exposes the whole body to the effects of nicotine, it acts in the veins as a paralyzing poison.
- Fashionable high-heeled shoes place undue stress on leg muscles and impair vein tone.
- Regular pills, hormonal contraceptives, hormonal drug treatment for menopause, osteoporosis lead to impaired collagen synthesis.
- The advertised slimming underwear and wearing tight jeans cause the blood to stagnate in the underlying parts of the body.
Who should be included in the risk group
Considering the reasons listed for developing venous pathology, the group of people most likely to develop varicose veins in the legs should include:
- people professionally associated with long standing or sitting (salespeople, teachers, hairdressers, drivers, office workers);
- women who prefer skinny jeans, modeling underwear and high-heeled shoes;
- people involved in weight lifting and weight lifting;
- people who are used to sitting "side by side";
- women with frequent pregnancies and births, as well as using 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 noticeable at a young age. In the initial stage, they appear with greater stress on the legs:
- at the end of the shift, there are pain in the feet and legs, muscle fatigue;
- when changing shoes, swelling of the feet is seen due to tightness of the shoes;
- at night your feet "burn", you want to dip them in cold water;
- "spiders" are formed on the skin of the thighs and legs.
In the next stage, a picture of chronic venous insufficiency develops, the symptoms of internal varicose veins appear:
- disturbed by nocturnal cramps in the calves, cramps on walking are possible;
- dark spots, dryness, scaling appear on the skin of the feet and legs;
- the appearance of trophic ulcers, very painful, with loose edges, difficult to treat.
If, in the context of local pain, swelling, redness of the skin, you see an increase in body temperature, you need to think about thrombophlebitis.
Diagnosis
During diagnosis, it is customary to distinguish between true (primary) varicose veins, depending on the damage to the valvular system, and secondary varicose veins, resulting from trauma and tumors.
Polyclinic surgeons, vascular surgeons, phlebologists are involved in the examination. The doctor sees subcutaneous venous nodules, vascular networks, skin pigmentation, early ulcers, dermatitis.
On palpation, the tension of the superficial veins, the density of the wall, the size of the local alterations, the presence of thrombus, the temperature of the skin over the nodules (signs of thrombophlebitis) are evaluated.
A general blood test will show the onset of inflammation (leukocytosis, accelerated ESR), a tendency to thrombus formation according to a coagulogram.
Vascular ultrasound allows you to track blood flow, the function of venous valves and detect blood clots.
The Doppler exam allows to check the structure of the veins, to make a diagnosis in the initial phase of the disease.
The spiral computed tomography method is performed in case of difficulties in diagnosis. It makes it possible to obtain a three-dimensional image of the anatomical region and helps in choosing the surgical treatment.
Treatment of varicose veins in the legs
It is best to start treatment for varicose veins in the legs at an early stage. To do this, you will have to think about the necessary changes in habits, nutrition and movement.
Mode
In order not to cause swelling in the legs at the end of the workday, people in the "sedentary" and "standing" professions are advised to take breaks for physical culture or warm-up with foot massage in an elevated position. Drivers and office workers must circulate during breaks.
The simplest exercises can be done at work:
- barefoot on the floor alternately stand on tiptoe and heel;
- Sitting in a chair, lift your legs and circle your feet in one direction, then the other.
Morning exercises should include exercises in the lying position: alternate leg raises, "bikes", shaking the raised legs. Squats and bent knees exercises are not suitable.
Strength training lovers must refuse them. Most examples are swimming, cycling and walking.
Selecting a balanced diet
Limit all foods that increase weight, promote fluid retention, and increase blood viscosity.
Fatty meats and dairy products, spicy and salty foods, canned foods, sweets, roasts 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
Wearing compression or golf socks is recommended to support blood flow. They are sized to be used while you are lying on your back.
Silicone-filled steps are considered 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 leg edema, its use is totally useless.
The use of medications
Drug treatment consists of taking orally drugs from the "venotonics" group in a therapeutic dose chosen by the physician. They help relieve tiredness, foot discomfort, but do not eliminate the disease.
Surgeons attribute varicose vein medication to basic conservative treatment, but the main one is one of the least traumatic ways of influencing affected veins. Efficacy is confirmed in 95% of patients. More serious interventions are used in only 5% of patients.
What about less traumatic operations
Less traumatic methods of treating varicose veins allow you to avoid surgery, which comes 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 after surgery is not necessary.
laser ablation method
It is performed under local anesthesia. A light guide is inserted into the varicose vein and a circular laser beam is turned on during reverse movement.
Method action: The beam causes a pronounced burn of the inner lining of the vein, further hardening. The duration of the intervention is about two hours. The method is applicable for treating veins of any size.
Sclerotherapy Technique
A substance is injected into the affected vein that can cause the walls to collapse, resulting in scarring. Foam preparations are especially recommended, which quickly and safely fill the lumen of the diseased vein. The method is applicable when the vessel diameter is up to 1 cm. After the introduction, it is necessary to walk for an hour. Phlebologists recommend wearing compression stockings for another month.
microphlebectomy method
Under local anesthesia, a skin incision of several mm is made, through which a diseased vein is grasped with a hook, brought to the surface of the skin and excised. The method is suitable for venous nodules of any size and diameter. A small scar will remain at the incision site. You must wear compression stockings or socks for 10 days.
Radiofrequency Ablation Method
It is performed similarly to the laser, but differs in the effect of microwave radio frequencies. This method does not cause tissue burns, so it is less traumatic than laser. After 30 minutes of exposure to microwaves, the vessel lumen is sealed. After 7 days, rehabilitation is considered complete. You can play sports.
In which cases is the operation indicated?
With the failure of treatment by conservative methods and the impossibility of using minimally invasive techniques, a phlebectomy operation is prescribed. It allows you to remove large areas of varicose veins, bundles.
The patient is hospitalized. Surgical treatment is performed under general anesthesia. Two incisions are usually made: in the groin area and below the knee. The vein is tied on both sides, pulled out and removed. Sutures are applied to the incisions. The patient is treated in a hospital for a week. Medications that reduce blood clotting are used. The stitches are removed after at least 7 days.
Phlebectomy is not performed:
- in the patient's old age;
- with massive damage to the deep and superficial veins;
- During the pregnancy;
- with atherosclerosis of the leg vessels, diabetes mellitus;
- whether there are dermatoses at the site of the proposed operation.
prevention methods
The prevention of varicose veins in the legs is mainly needed for people with risk factors in the profession.
It is recommended to walk more. There is a massage and strengthening of the vein walls.
During breaks, vendors and hairdressers receive foot and shin massages. It is done with slow, gentle movements from the fingers to the knee and along the thigh. The knuckles of the wrists are massaged in a circular motion into 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 stepping into high heels and wearing tight clothes.
At home, you can do contrast baths or foot showers. 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.