The main feature of varicose veins of the legs is its width. Superficial and deep veins undergo changes to a large extent. Because the legs have a fairly large and elongated load, the valves in the circulatory system can begin to weaken as early as childhood. Therefore, the discovery of varicose veins in the legs often occurs in young men and girls.
To effectively treat varicose veins in the legs, the doctor will need to discover the causes of its occurrence. Since even when using radical methods, 80% of patients experience a recurrence of varicose veins, special attention should be paid to reducing the impact of factors that provoke varicose veins on the processes. This includes:
- Hereditary predisposition is in fact an uncontrollable factor, which, however, may be contained by standard preventive measures;
- physical impacts - increased load on the legs (standing posture and lowering, habit of crossing legs, excess weight, lifting weights);
- physiological effects - hormonal changes and use of hormonal drugs (most often contraceptives), metabolic disorders, lack of physical activity;
- pathological reasons - chronic diseases of the liver, kidneys, trauma and systematic retraction of soft tissues of the lower extremities, tumors that compress the veins in the abdominal cavity.
they cannot be completely closed, so part of the blood remains in the vessels of the legs. The pressure in the veins increases, the walls stretch even more, elongations are formed, in which blood clots form over time. Thrombosis is dangerous, but far from the only thing that threatens the patient with varicose veins in the legs. The clot can break down and enter the heart or other organ, causing a heart attack, or blocking the vessels of the limb, which causes gangrene.
Depending on the location of such "stretched" veins, doctors distinguish several types of varicose veins in the legs:
- Surface. It is expressed by the appearance of a bluish or red varicose veins on the legs, which at first resembles a kobure, and then a plexus of rather thick wrapping lines.
- Deep It is expressed with the defeat of vascular plexuses not visible during external examination. Pain in the veins of the lower extremities with varicose veins of this type is stronger, the risk of complications is higher.
- Combined, when deep and superficial veins are affected.
Establishing the causes of varicose veins of the legs and eliminating it are closely related. First of all, it is important to exclude the factors that have the greatest negative impact on the condition of the veins.
When diagnosing venous changes, it is important to distinguish them from other diseases. For example, varicose veins below the knee look just like Becker cysts and are associated with similar symptoms.
The appearance of the first signs of varicose veins in the legs occurs in progressive stages, when the venous valves perform their functions by less than 50%. In the first or zero stage of varicose veins, which is known as the "compensation phase", no unpleasant sensations arise as well as noticeable changes. Detection of the initial stage of varicose veins in the leg occurs with a close examination of the limbs by a phlebologist.
In the second stage of varicose veins, which is known as "undercompensation", the changes are quite well expressed:
- the contours of large veins are visible under the skin, but they may not protrude above the surface of the skin;
- on the surface of the skin on the thighs and below the knees, a pattern of a thin varicose network of blue or red capillaries is clearly visible;
- in the evening, the feet swell;
- at night the calf muscles cramp.
This stage of varicose veins of the lower extremities is distinguished by increasing symptoms, which weaken after rest.
In the final stage of varicose veins, decompensation occurs: the body cannot meet the oxygen needs of the tissues and the valves in the veins lose their functions by 90%. The condition of the limbs worsens due to insufficient blood supply. This stage of varicose veins is characterized by a decrease in the ability of the tissue to regenerate. The abundance of complications worsens the overall condition of the patient. The symptoms in the final stage of varicose veins persist continuously.
If we talk about varicose veins in principle, this term in medicine means a disease of the veins, in which the functions of transporting blood from these vessels are impaired due to their deformation with varying severity. In other words, the veins dilate, dilate, their walls become thinner, the work of the valves placed inside breaks down, and so on. All this leads to the fact that the blood moves worse upwards, heading towards the heart and its stagnation occurs in the vessels.
Most people imagine varicose veins of the lower extremities as an extension of individual vessels and the vascular network near the surface of the skin. At the same time, swollen and deformed veins are clearly visible to the naked eye and this idea is correct, if we speak simply of aesthetic manifestations.
As for deep varicose veins, or more precisely, varicose veins, we are talking about similar disorders, but now they affect the venous vessels located in the thickness of the muscle tissue. This means that even in the most severe stage of the pathological process, these veins will not appear on the surface.
Such a pathological process is dangerous not only for its secrecy. The deep veins, including the small and large tibia, gastrocnemius, soleus, and others, are much larger. Therefore, they allow more blood, take a more important part in the systemic circulation and their loss has a stronger effect on the state of human health.
This means that with deep vein varicose veins, stagnant blood processes are much more serious. In this case, a person may feel severe pain, increased fatigue in the legs, etc. But even more dangerous consequences are that with an excessively increased pressure in the veins, their thin walls may not stay, which threatens to rupture the latter and internal bleeding.
Veins with deep varicose veins in the legs
First of all, the obvious symptoms of varicose veins in the legs is the appearance of a network of small veins on the surface of the skin of the feet. Such manifestations occur mainly in the thigh area. Veins with such varicose veins are easier to see in people suffering from cellulite. Sometimes it is cellulite that becomes a kind of warning of varicose veins. Often, fat deposits in cellulite squeeze the venous vessels, and as a result, blood flow is complicated and varicose veins occur.
The capillary networks in the legs that appear at the beginning of varicose veins are called telangiectasia. However, it should be borne in mind that such external manifestations may be signs of varicose veins and a manifestation of a temporary inflammatory process.
In some cases, the onset of varicose veins is indicated by swelling in the leg. However, such a sign can be a symptom of other diseases (heart failure, kidney stones). Therefore, in this case, it is impossible to speak clearly about the development of varicose veins before the diagnosis is made.
Manifestation of pain in the legs often becomes a symptom of varicose veins. Painful sensations can be sharp, and also have attractive signs. Most often, with varicose veins, pain in the calves is manifested. It mainly occurs in the afternoon, after a certain load on the foot.
Thus, a person observing the appearance of a capillary network, periodic manifestations of pain and edema, should consult a doctor and the necessary research.
Often varicose veins give the patient a certain cosmetic concern. But in addition, he may have a severe feeling of heaviness in the legs, convulsions may occur at night, trophic changes gradually appear in the legs.
Visually, varicose veins can be manifested by invisible "stars" of small vessels and by very large joints and plexuses, which are especially prominent when the patient is in a vertical position.
If the veins are palpated, then their elastic stability is determined, they are easily compressed. Each of the varicose vein nodes may have a higher temperature than the rest of the areas. If a person assumes a horizontal position, then the venous tension decreases, and the joints become less pronounced.
If, during the development of the disease, a person does not think about how to treat varicose veins, the disease progresses and gradually appears a feeling of rapid fatigue, a constant weight of the legs and a swelling in their tissues cramps. If swelling appears, then they disappear after a long rest at night.
It is relatively easy to diagnose this disease. The specialist necessarily examines and interviews the patient, examines the anamnesis. In the process of additional studies, the condition of the valves of the main and communication veins is determined and the level of openness of the deep veins is assessed. There are a number of different tests that can assess the condition of the veins and the degree of disease development.
If the patient has veins with uncomplicated varicose veins, then in most cases no instrumental diagnostic methods are used.
Conservative treatment of varicose veins is prescribed mainly to those people who have clear contraindications to surgery.
Also, such a treatment is indicated if the patient has a slight dilation of the veins, which is an exclusively cosmetic defect. The goal of conservative therapy is also to prevent further progression of this disease. For this purpose, patients are advised to apply bandages to the legs affected by varicose veins with an elastic bandage.
In addition, compression stockings for varicose veins are indicated. People who have a tendency to varicose veins or are already sick with this disease should regularly put their feet in an uplift throughout the day, thus resting for a few minutes. There are also special exercises for the lower leg and foot, aimed at activating the muscular-venous pump. This is the periodic extension and flexion of the ankle and knee joints.
Diet for varicose veins of the lower extremities
The history of varicose veins began in the time of Byzantium, Ancient Egypt, Old Testament Israel, as evidenced by archaeological excavations. In different eras, people tried to cure this disease, in particular, Avicenna and Hippocrates dealt with it. In the second half of the 19th century, Russian and German physicians began to talk about the effectiveness of connecting the great saphenous vein.
In the early 20th century, very traumatic surgeries were performed, during which the tissues of the thigh and lower leg were deeply severed, the veins were damaged, which were then connected, the nerve endings, arteries and lymphatic ducts. Healing lasted a very long time, leaving large and visible wounds.
Foreign physicians in 1908 proposed removing a large saphenous vein and putting into practice a metal probe, which reduced trauma to the patient. This was the first step towards minimally invasive surgery.
The breakthrough came when X-rays became possible. It was first made for varicose veins in 1924. At the same time, a contrast-based solution of strontium bromide was injected into a vein. Then ultrasound appeared, and the technique was further improved.
In the late 1990s, laser therapy appeared, which became a modern breakthrough in the treatment of varicose veins.
In European countries and the United States, 25% of the population suffers from this disease. In our country, varicose veins are diagnosed in 30 million people. Moreover, women get sick more often than men. According to global statistics, 70-80% of women and 50-60% of men suffer from varicose veins.
The main cause of varicose veins is a genetic predisposition.
There are a number of other provocative factors:
- sedentary lifestyle;
- hormonal imbalance;
- endocrine diseases;
- taking oral contraceptives and other hormonal medications;
- work in hot shops;
- strong physical activity;
- work accompanied by long stay or, conversely, reduction;
- chronic diseases of the bronchi and lungs, accompanied by prolonged cough.
Thrombophlebitis is a life-threatening condition. With it, blood clots form in the veins, which can rupture and block the pulmonary vessels, leading to myocardial infarction. If a large ship is affected, death is possible.
Venous thrombosis is a blockage of a vessel by a blood clot. It is manifested by pain in the limbs, which increases with physical exertion, edema.
Pulmonary embolism - overlap of the pulmonary artery lumen by a detached thrombus. Death can occur in the first 30 minutes. If the thrombus is small, then a pulmonary infarction occurs, the patient needs resuscitation measures. The condition is associated with pneumonia and chronic heart failure.
Trophic ulcer - thickening of the subcutaneous tissue, darkening and thinning of the skin, followed by the appearance of an ulcer. Such ulcers exist for a long time, do not respond to treatment and close very slowly.
In the official classification, it is customary to distinguish three stages of varicose veins:
- I - compensation;
- II - undercompensation;
- III - decompensation.
Sometimes complications are isolated in stage IV.
The most common localization. It usually appears at a young age, and in women - during pregnancy or after childbirth. In the initial stages, the symptoms are few and not specific - leg fatigue, heaviness in the legs, burning, rash, night cramps. Already at the beginning of varicose veins, pain appears along the vein, swelling. Usually affected ankles, feet, legs.
The most common symptom in this case is numbness of the hands. It can be partial and complete, most often during sleep. The patient becomes meteorological, his hands ache and ache with every change of weather. It becomes difficult to handle even with light objects. Then the most characteristic symptoms develop - blood vessels swell, joints form, pain begins, intensifying over time, veins become twisted, stamped.
Groen and pelvis
Manifestations of the disease differ in men and women.
A complete cure for varicose veins is possible only after surgical treatment. It can be done in three ways:
- Phlebectomy - removal of the varicose vein.
- Sclerotherapy - the insertion of a sclerosant into a varicose vein - a special substance that "sticks" to its walls, stopping blood flow through it. As a result, the vein collapses, and even the cosmetic defect disappears.
- Laser coagulation - the walls of the vein are destroyed by heat, as a result of which the venous lumen is "sealed". Such an operation can be performed only if the vein widens no more than 10 mm.
Also, one of the most modern methods of treating veins with chronic varicose veins is the disappearance of contagious veins. You can find a lot of additional information online about this procedure.
The main role in the treatment of drugs is played by venotonics, who are taken in the form of tablets and act systematically. They correct disturbances in the work of the circulatory system. As a result, the vessels of the whole organism heal. Venotonics are also available in the form of gels and oils, but they are less effective and only work at the application site for a short time.
Phlebotonics - venotonic drugs are also used. They are indicated for thinning the walls of blood vessels, reducing elasticity, increasing permeability, blood stasis. Drugs strengthen the venous walls, increase their elasticity, eliminate congestion, reduce swelling and other negative symptoms. An additional property of phlebotonics is the normalization of microcirculation in the affected area.
Antiplatelet agents are used to dilute the blood. Drugs are used when necessary to reduce the intensity of blood clots. Indicated for patients with increased blood viscosity. Antiplatelet agents can be used only in the absence of a tendency to bleeding.
Anticoagulants are also prescribed to stop the process of thrombus formation. They destroy blood clots, reduce blood viscosity.
A good helper in the fight against varicose veins is compression stockings. The principle of operation of such products:
- Throughout the compression stock, pressure is exerted on the superficial and deep veins.
- The greatest pressure is at the bottom, where the veins are narrower and blood flow is faster.
- Narrowing of the veins increases the efficiency of the valves.
- Exhaustion, pain, fatigue in the legs pass.
Venous blood rises from the legs to the heart under the influence of blood pressure. If a person is healthy, then this mechanism works well. In the presence of pathologies, the body is forced to stimulate this process: it increases the pressure and lifts the blood up with pushing movements. The result is valve failure.
- Hereditary predisposition - some are susceptible to the onset of this disease. They have congenital valve dystrophy, weak vascular walls. For this reason, varicose veins in the legs can be noticed even at a young age.
- Hormonal changes - due to a malfunction, blood stasis occurs. The most dangerous are the period of pregnancy, puberty and after birth. In the female body (especially at this time), yellow body hormones predominate. They also have a relaxing effect on the veins.
- Joint diseases - rheumatoid arthritis, osteoporosis and other diseases.
- Wear tight shoes and very tight clothes.
- An unbalanced diet is the presence of fatty and high-calorie foods in it.
- Bad habits - smoking and alcohol abuse.
- Taking certain medications - hormonal contraceptives.
- Overweight - Overweight puts more pressure on your legs.
- Chronic liver diseases - cirrhosis, hepatitis.
This disease will not go away on its own. Without proper treatment, the situation will only get worse. Varicose veins in the legs can provoke the following complications:
- Eczema and dermatitis - redness, small blisters and cracks appear on the lower part of the foot.
- Trophic ulcers - single and multiple "islands" may appear. Most often they are crying (a clear or bloody fluid constantly appears on their surface). Although these ulcers are shallow, they are very painful.
- Thrombophlebitis - may be accompanied by an increase in body temperature, redness of the skin, painful sensations both when walking and at rest.
- Venous rupture - accompanied by profuse bleeding. If such a complication occurs, immediate medical attention is required.
Varicose veins in the legs include the following treatment:
- treatment of varicose veins with caterpillars;
- folk remedies;
The "gold standard" of diagnosis is ultrasound, which identifies the areas of the affected veins. If the results of non-invasive diagnostics are questionable, then a surgical study - phlebography - is used, which involves inserting a contrast agent into the vein to assess the general condition of the vascular system.
Diagnosis of deep varicose veins
- Initial examination with collection of anamnesis and patient complaints.
- Perform an ultrasound of the vessels of the legs.
- Doppler ultrasonography for the detection of blood clots.
- Urine analysis and blood chemistry may also be required.
In the initial stages, ESIA is not very pronounced. People attribute leg pain and other symptoms to common fatigue, overwork or age. They consult a doctor only when they have already had significant changes in the foot - thick swollen veins or joints.
But in most cases, the doctor is not limited to a visual examination and prescribes additional examinations:
- Ultrasonic flow diameter or Doppler analysis, which allows the detection of blood flow velocity and venous filling.
- In the early stages of VVVNK, tests of Perthes, Sheinis, Troyanov, Prett and others are described, which show the development of varicose veins.
- Phlebomanometry, which measures the pressure inside the veins.
- Scanning of veins, according to the results of which it is possible to determine the condition of venous valves and walls.
- Phlebography. This procedure consists of inserting a contrast agent into the veins, followed by X-rays.
- Echosclerotherapy - sclerosing is injected into the veins, then scanned.
- Thermography - examination using infrared radiation.
- Computer phlebography.
- Phleboscintigraphy - examination of lymph nodes and veins using radionuclides.
- Photoplethysmography - examination using photodiodes.
All types of examinations are never prescribed immediately. Usually, varicose veins are quite easy to diagnose already with one or two methods, which are determined by the doctor according to the patient's condition.
The ease of diagnosing varicose veins in the legs is exaggerated, as the vessels do not always come to the surface. To confirm the diagnosis, the doctor must perform an external examination and perform a number of instrumental studies:
- duplex scanning or ultrasound of the lower limb - with varicose veins, used first to determine the degree of stretching of the walls of blood vessels, the nature of blood flow in them and the detection of blood clots;
- Contrasting limb X-rays - the standard of functional examination for varicose veins of the lower extremities, which allows you to determine the openness of the vessels;
- MRI is the gold standard of modern diagnosis of varicose veins in the lower extremities, which allows you to assess the functionality of venous valves, identify foci of ischemia in soft tissues, detect blood clots and other pathological changes that haveborn on the background of varicose veins.
To clarify the full picture of the disease, laboratory tests are prescribed: a coagulogram to assess the risk of thrombus formation, a general and biochemical blood test.