From the article you will learn what to do with varicose veins in the legs, how to remove puffiness, features of conservative and surgical therapy, preventive measures.
Varicose veins are a chronic venous pathology, which is based on a malfunction of the valve apparatus, which causes stagnation of blood flow with dilation and inflammation of blood vessels, an increase in tissue plasticity.
Initial manifestations are the formation of spider veins, swelling of the saphenous veins, the formation of nodules, soreness of the veins, heaviness in the legs. As the disease progresses, signs of chronic venous insufficiency combine: swelling of the legs and feet, cramps in the calf muscles, trophic ulcers, thrombophlebitis, rupture of varicose veins. According to various studies in the field of clinical phlebology, 30 to 40% of women and 10 to 20% of men over the age of 18 suffer from varicose veins.
Usually, when talking about varicose veins, they mean an independent disease - varicose veins of the lower extremities. Varicose veins are manifested by the feeling of heaviness in the legs and their fatigue, edema of the legs and feet, night cramps in the legs, visual subcutaneous veins with the formation of venous nodes.
Why do veins dilate?
To deal with this issue, you have to imagine how the blood, which has successfully supplied oxygen to the tissues of the body, returns back to the heart. To overcome the force of gravity, rising from the legs to the chest, she needs support mechanisms. First of all, we are talking about the muscles of the lower limbs, which act as a pump: their contraction while walking moves blood to the heart. In addition, valves located inside the veins play an important role in this process: they prevent the return of blood flow.
Varicose veins are a disease of valves that have ceased to function. As a result of such a violation, fluid accumulates in the vessels, which leads to their expansion.
In the future, trophic ulcers may develop in the area of deformed veins and blood clots formed due to blood stagnation contribute to the appearance of a severe and deadly complication of varicose veins - pulmonary embolism.
Varicose veins of the legs are common among women and men - signs of pathology are observed in more than half of people over 18 years of age. At the same time, the number of patients is increasing every year - this is due to the sedentary nature of professional activity.
Often, varicose veins of the lower extremities are accompanied by another known disease - hemorrhoids. The nature of occurrence in both diseases is the same, as are the risk factors that predispose to their development. As in the case of varicose veins, people often ignore the symptoms of hemorrhoids to the last, hoping that the pathology disappears on its own. However, these diseases are irreversible without radical intervention and only progress over time.
It is believed that the main causes of varicose veins are: congenital weakness of connective tissue, hormonal changes, decreased or forced prolonged standing. Long legs and height are a risk factor for varicose veins. When a person is standing, the valves in the veins are open. The higher the blood column in the vessels, the higher the pressure. Overweight also increases the pressure in the veins of the legs - fat deposits, especially in the abdomen, make it difficult to drain blood. Increases in the female hormones estrogen and progesterone during the menstrual cycle relax the venous wall. Hormonal contraceptive drugs can also work - it is best to consult a phlebologist before taking them.
Lack of physical activity accelerates the development of varicose veins of the lower extremities. However, experts point out the significant role of the hereditary factor: if your parents have noticed "stars" and "worms" unattractive from the vessels under the skin, then with a high degree of probability both you and your children will one day encounter in personthis problem. The tendency for varicose veins is transmitted through the female line - a gene is associated with the sex X chromosome, which can lead to venous wall weakness.
Among others, varicose veins are more common in smokers, obese people, pregnant women and those who have other chronic diseases of the cardiovascular system. The professions whose representatives are predisposed to varicose veins are: surgeon, cashier, driver, programmer, stewardess, loader, salesman, hairdresser, school teacher.
The veins of the lower extremities form a branched network, which consists of saphenous and deep veins, interconnected by perforating (communicating) veins. Through superficial veins, blood flows from the subcutaneous tissue and skin, through deep veins - from the rest of the tissue. Communication vessels serve to equalize the pressure between the deep and superficial veins. Blood flows through them normally only in one direction: from superficial veins to deep ones.
The muscular layer of the venous wall is poorly expressed and cannot force the blood to move upwards. Blood flow from the periphery to the center is carried out due to the residual blood pressure and pressure of the tendons located near the vessels. The most important role is played by the so-called muscle pump. With physical exertion, the muscles contract and the blood is squeezed up, as the venous valves prevent movement down. Maintenance of normal blood circulation and constant venous pressure is affected by venous tone. The pressure in the veins is regulated by the vasomotor center located in the brain.
Insufficiency of valves and weakness of the vascular wall leads to the fact that the blood under the action of the muscle pump begins to flow not only upwards but also downwards, exerting excessive pressure on the vessel walls, leading to varicose veins forming joints andprogression of valvular insufficiency.
Disruption of blood flow through the communication veins. The reflux of blood from the deep vessels to the superficial vessels leads to a further increase in pressure in the superficial veins. Nerves located in the walls of the veins send signals to the vasomotor center, which gives the command to increase the venous tone. Veins can not cope with the increased load; they gradually expand, lengthen and become shaky. Increased pressure leads to atrophy of the muscle fibers of the venous wall and death of the nerves involved in the regulation of venous tone.
There are several classifications of varicose veins. This diversity is due to the polyetiology of the disease and the numerous variants of varicose vein flow.
During the examination, veins with pronounced varicose veins are visible in the legs. Patients complain of a feeling of satiety, paresthesia ("chills") in the bones, night cramps. In the evening there is a slight swelling of the feet, ankles and lower legs. In the morning, the swelling disappears.
Decompensation phase. Dermatitis, eczema join the listed signs. Patients are concerned about itching. The skin becomes dry, shiny, sticks tightly to the subcutaneous tissue. Minor hemorrhages and subsequent deposition of hemosiderin cause hyperpigmentation.
Classification by form
The following forms of varicose veins are distinguished:
- Segmental damage to subcutaneous and intradermal vessels without reflux.
- Segmental venous lesion with pathological discharge along the superficial or communicating veins.
- Disseminated lesions of veins with pathological discharge through superficial or communicating veins.
- Prolonged venous involvement with abnormal deep vein discharge.
There is an internationally recognized classification of varicose veins used by doctors in many parts of the world:
Grade 0. No signs of varicose veins. Patients complain of standing weight.
Class 1. Messages of veins and spider veins (telangiectasias) are visually defined. Some patients have muscle cramps at night.
Class 2. On examination of the patient, varicose veins are visible.
Class 3. Swelling of the feet, ankles and lower legs appears, which does not disappear after a short rest.
Class 4. Examination reveals signs of lipodermatosclerosis (dermatitis, hyperpigmentation of the feet).
Class 5. Previews are formed.
Grade 6. Persistent trophic ulcers develop.
Symptoms and clinical manifestations
Varicose veins, which affect the veins of the lower extremities, are classified in international practice according to the stages, based on the neglect of the pathology and the severity of the manifestation. Each stage is diagnosed separately, they are all characterized by different symptoms, based on which the method of treatment is chosen.
So, the symptoms that are a sign of varicose veins in different stages:
- In the first stage, the saphenous veins in the lower extremities have a barely visible pattern and protrude slightly above the skin, slight redness is observed. There are complaints to the doctor about weight on the legs, swelling in the evening after a hard day. Too tight shoes can cause swelling in the foot in the ankle area, and cramps are also possible. It should be noted that often painful sensations can appear much earlier than the obvious signs.
- In the second stage, a typical appearance is already observed for diseased veins in the legs: they are conspicuously visible on the skin and palpable with the fingers, they look like joints or beads. With progression, the saphenous vein of the lower limb becomes visible and takes on a sinusoidal shape of a dark blue or even black color.
- In the third stage, varicose veins are complicated, there are signs such as trophic changes in the veins in the legs, the skin becomes dry and pale, daily swelling, cramps. Often, the symptoms are manifested in the fact that the feet become covered with a rash, the skin itches and itches.
- The symptoms in the fourth stage, the most severe are the inflammatory processes of the saphenous veins of the lower extremity, non-healing trophic ulcers, which are already difficult to treat. A key feature of this stage of the disease is the addition of a secondary infection and thrombophlebitis. With these manifestations, urgent hospitalization is required, the complex use of treatment methods for the whole organism.
Specialists identify the main risk factors:
- hereditary diseases associated with varicose veins in different parts of the body;
- hormonal disorders can increase blood clotting, reduce the elasticity of veins in the legs;
- overweight, ascites, which increases the load on the legs, accompanied by dilation of the walls of the veins;
- pregnancy or lifting heavy objects increases the pressure inside the abdominal cavity, which also contributes to the weakening of the walls of blood vessels and varicose veins;
- without load on the foot, sitting work is fraught with dilation of the veins in the foot;
- tight underwear, smaller shoes that narrow the vein, worn with the foot, which causes stagnation of blood circulation in the veins of the foot;
- Varicose veins are often caused by kidney or cardiovascular disease, which causes edema, observed in the dilation of the veins of the lower extremities.
The main methods that include the diagnosis of varicose veins of the legs are:
- External examination of varicose veins of the legs, which should be performed by qualified doctors in the hospital.
- Doppler ultrasound, which allows you to detect wall thickening in the veins of the lower extremities. Such diagnosis allows you to clearly define the stage of the violation.
- Duplex scanning of the leg veins, which is performed by a doctor of a specialized clinic, allows you to clearly identify varicose veins. With this method, which combines ultrasound and Doppler examination, it is possible to control what happens to the veins: the rate of blood circulation, the diameter of the vein in the leg, the functioning of the valves, and the condition that characterizes varicose veins.
- Phleboscintigraphic examination, which allows to perform a high-precision analysis and, in the initial stage, to learn about varicose veins of the legs and to take timely preventive measures. It is performed by injecting a special dye under the skin, such a fluid in the vein is highlighted on the monitor with a contrasting color.
- Occlusive plethysmography.
- With the help of tomographic diagnosis of diseases (MRI, computed tomography), the complications associated with varicose veins can be identified.
- Bandage or stone tests for the diagnosis of diseases are used in combination as an adjunct to various methods for determining the stage of varicose veins.
Deciphering the results of the diagnosis of varicose veins, as a rule, does not require much time. Most procedures take 10 to 40 minutes, after which the attending physician announces the diagnosis based on the information received. Diagnosis should only be trusted by an experienced clinician who will be able to give a clear and unmistakable diagnosis because treatment at different stages involves different methods, principles of treatment, and medication.
In the treatment of patients with varicose veins, three main methods are used:
Conservative therapy includes general recommendations (normalization of physical activity, reduction of static load), physiotherapy exercises, use of elastic compression devices (compression stockings, elastic bandages), treatment of phlebotonics (diosmin + hesperidin, chestnut extract).
Conservative therapy can not lead to a complete cure and restore already dilated veins. It is used as a prophylactic agent during preparation for surgery and when surgical treatment of varicose veins is impossible.
Sclerotherapy with compression
With this method of treatment, a special drug is injected into the varicose vein. The doctor through a syringe injects elastic foam into the vein, which fills the affected vessel and causes it to spasm. The patient is then put on a compression sock that keeps the vein in a collapsed state. After 3 days, the walls of the veins are glued together. The patient wears socks for 1-1, 5 months until dense adhesions form.
Indications for compression sclerotherapy are varicose veins uncomplicated by reflux from deep to superficial vessels through the communication veins. In the presence of such a pathological discharge, the effectiveness of compression sclerotherapy is significantly reduced.
The main method of treatment complicated by reflux through the communication veins of varicose veins is surgery. For the treatment of varicose veins, many surgical techniques are used, including the use of microsurgical techniques, radiofrequency, and laser coagulation of the affected veins.
In the initial stage of varicose veins, photocoagulation or laser spider vein removal is performed. With severe varicose veins, phlebectomy is indicated - the removal of altered veins. Nowadays, this operation is increasingly performed using a less invasive technique - miniflebectomy.
Once you have found varicose veins in yourself, you need to take care of cleansing the body and normalizing blood circulation. For this, first of all, the diet is reviewed. The most useful for varicose veins are fresh products of plant origin:
- Vegetables - cabbage, tomatoes, peppers, herbs.
- Fruits - citrus, apricots, apples, peaches, cherries, cherries, apples.
- Berries - strawberries, raisins, currants.
- There are many recipes for traditional medicine, based on fresh herbal ingredients.
Unfortunately, varicose veins are a chronic disease, and therefore "goes from toe to toe" with a person throughout his life. Without prevention, the disease can lead to the development of more serious complications.
- It is not recommended to take a very hot bath, as well as visit the sauna or stay in the sun for a long time in the heat. This leads to a decrease in venous tone, which will certainly lead to foot overload.
- Make an active lifestyle, that is, move a lot. So, regular exercises will help not only in strengthening the blood vessels, but also in improving the condition of the body as a whole. Moderate aerobics, swimming, cycling or brisk running are excellent for preventing varicose veins. However, it is contraindicated to deal with weightlifting as well as to lift very heavy things.
- Weight loss. People with a lot of body fat are more susceptible to this disease, as more blood circulates in their body than a person of normal weight. This is why there is a strong cargo on the ship. In order for the pressure on the venous vessels to be less, obese people must get rid of extra pounds as well as adhere to the correct diet. As for the menu, it is advisable to minimize the consumption of very spicy food. It is recommended to replace animal fats with vegetable oils.
- You should not wear tight clothing, or socks or stockings with tight elastic bands, as these can forcefully press on the veins, thus interfering with blood circulation.
- While sitting, you should not cross your legs, as normal blood flow is also disturbed during this position.
- Prolonged stay also has an extremely negative effect on the condition of the veins. If you have a foot job, try to move more often. Continuous reduction is no less harmful.
- Nutrition should be normalized. So regular constipation and intestinal dysbiosis can lead to the development of varicose veins. You should include in your menu foods rich in fiber, which help to improve bowel movement, ie digestion in general.
- Women should wear shoes that are as tight as possible, as well as shoes with heels. If you can not refuse such shoes, then the heel should be no more than 3-4 sensations in height.
- After heavy standing or sitting work, wash your feet with cold water to keep your veins in good shape. Baths with the addition of pine salt are also helpful. You can lubricate your feet with cold water in the morning.
- Prevention of varicose veins involves giving up bad habits, namely smoking, which has an extremely negative effect not only on the condition of the veins, but also on the whole human body.
- Light massage is considered an excellent preventative measure for this disease. This massage can be performed independently by stroking the skin of the lower extremities from the bottom up, and then in the opposite direction for 10 minutes. Such self-massage is very useful in combination with massage procedures on the spine, which are performed by a professional chiropractor or massage therapist.
- Prevention of varicose veins also includes taking special medications that allow you to maintain venous tone.
- Try to get rid of chronic fatigue and frequent stress.
- Doctors advise to avoid overheating and colds.
- In the presence of varicose veins, you should visit a phlebologist at least 2 times a year, who will monitor the condition of the veins and the stage of development of the disease.
To avoid the disease, walk more, take a contrast bath, visit the pool. Even if you do not know how to swim, it is useful to stay alone in the water - the water column exerts a pressure of 60-70 mm Hg on the foot. ArtiThis is enough to pump stagnant blood into the veins. Gymnastics has the same effect during the evenings - lift your legs while lying down, do the "bike" exercise.
In case of venous insufficiency, preventive sweater should be used (special tight socks and sweater create a kind of frame around the veins, preventing their expansion).
By the way, this type of jersey is very useful during pregnancy. Even in the first three months, when hormones are already giving a negative effect. As the fetus grows, the density of the knitted fabric should increase. During childbirth, it is also necessary, because at the same time blood pressure in the veins increases significantly.