Varicose veins (varicose veins of the lower extremities)– this is damage to the walls of the veins 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, causing the blood to flow back and stagnate. The walls of the veins expand, become thin and burst. Over time, blood clots form, which can block a vessel and lead to a stroke or heart attack. Women are most often at risk of varicose veins, but men can also experience it. The age of the disease is from 20 years and older, sometimes varicose veins can occur in adolescence. Varicose veins are most often caused by a sedentary lifestyle and professional characteristics, but the disease can also begin from other factors.
Causes of varicose veins
Veins in the body are essential for blood circulation and transport of nutrients from tissues to the heart. In the area of the lower extremities, this network is presented in the form of deep or superficial veins, which are connected to each other by an emergency blood discharge system. Basically, most of the load falls on the deep veins, since they are larger and stronger. Superficial veins perform about 15% of the work.
The heart is needed to pump and move blood through the veins, and some of the blood moves through the veins against gravity 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 returns downwards under the influence of gravity. But thanks to special valves it is held in place.
If the valves do not cope with their function, the veins begin to expand and become inflamed; they cannot hold blood. For this reason, stagnation of blood circulation occurs, the veins expand and rise above the skin.
Blood circulation is impaired and varicose veins occur. The causes of varicose veins can be:
- absence, defect or damage to venous valves - the reverse flow of blood into the legs is disrupted, blood stagnates in the veins and they stretch;
- constant stay in a vertical position - most often hairdressers, teachers, salesmen and others who cost a lot suffer from varicose veins;
- overweight and obesity - heavy weight puts pressure on the lower limbs, as a result of which the veins dilate and varicose veins occur;
- intestinal diseases, constipation - create intra-abdominal pressure, which leads to varicose veins;
- flat feet;
- pregnancy - the uterus with the fetus creates additional pressure on the legs, which causes varicose veins;
- lifting weights - excessive physical activity causes dilation of veins and stretching of the walls of blood vessels;
- Professional sports - running, jumping, tennis - cause varicose veins due to constant stress on the lower extremities.
Varicose veins in the legs can be caused by previous injuries and surgeries on the lower extremities. In old age, almost everyone suffers from varicose veins, as the valves become weak and work poorly. They become inelastic and stretch greatly.
Symptoms
At the initial stage, the veins located under the skin expand. If you establish venous circulation immediately, then other complaints will not arise.
If the disease progresses, the following symptoms appear
- fast fatiguability;
- feeling of heaviness in the lower extremities;
- cramps of the calf muscles (most often appear in the evening and at night);
- There is a feeling of tingling and numbness in the legs.
With the further development of this disease, trophic disorders begin, which are most often concentrated in the area of the inner surface of the lower leg.
Symptoms of trophic disorders
- thickening of the vein walls is formed;
- skin hyperpigmentation occurs in places;
- atrophy of the skin;
- dermatitis is a disease characterized by inflammation of the skin;
- in the later stages of the disease, a trophic ulcer may progress, which is practically untreatable.
In the chronic form of varicose veins, symptoms manifest themselves in the form of swelling of the lower extremities during prolonged standing. After an overnight rest, swelling usually disappears completely.
Varicose veins on men's legs
Varicose veins in men's legs occur in 32% of cases. Most often, the disease is observed at the age of 45 years and above. Male varicose veins occur for the same reasons as female ones - due to heavy load on the lower limbs. It is less common, as this is due to the peculiarities of the structure of the male body. However, due to smoking and heavy stress, varicose veins in men are observed already in middle age.
The development of varicose veins in men on the legs is associated with loss of elasticity and tone of the vascular wall for several reasons:
- professional characteristics - inactive work, staying in one position for a long time, standing work, lifting weights;
- excess weight;
- fatty and unhealthy foods that negatively affect 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. At first, a man may experience pain and swelling in his legs in the evening or after a long stay in an upright position. In later stages, varicose veins in men on the legs cause hair loss and burning in painful areas, itching in the vein nodes. Due to poor skin nutrition, trophic ulcers occur that itch and hurt. It becomes more difficult for the patient to walk, then the mobility of the limbs disappears. There is a loss of sensation and numbness in the legs.
Leg ulcers due to varicose veins
Ulcers on the legs 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 region. Before their appearance, dermatitis occurs, which is accompanied by eczema and severe itching. Ulcers can be single or multiple, most often 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 when they trap fiber. Over time, the induration of subcutaneous tissue increases.
Trophic ulcers occur with characteristic symptoms; they 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 amputation. How to treat an ulcer with varicose veins should be decided by a phlebologist after a comprehensive diagnosis of the veins.
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, pain is practically not bothersome.
- Stage 2 - a feeling of heaviness, fullness, pain, cramps during sleep.
- Stage 3 – the formation of edema, a feeling of fullness, thickening of the skin and subcutaneous tissue, the formation of dark spots.
- Stage 4 – the appearance of trophic ulcers, burning and itching, severe pain, protruding veins, changes in gait, difficulty walking.
The most common symptoms of varicose veins on the legs include the following:
- heaviness and fatigue in the legs, cramps in the calf muscles during sleep and after waking up;
- dull, arching pain in the calves, intensifying with prolonged standing and disappearing when lying down;
- feeling of burning and itching in the legs in the evening;
- severe fatigue with light loads and short walking.
Another prominent symptom of varicose veins is that the veins become less noticeable when a person lies down or raises their legs and become larger when standing up, especially during prolonged standing.
Varicose veins in the legs cause swelling of the soft tissues in the feet, ankles and lower legs. Most often it is noticeable in the evening after a working day. Swelling can occur in people who spend a lot of time standing and those who are overweight. Comfortable shoes begin to squeeze in the evening and become tight. When you stay in one position for a long time, your legs immediately swell or swell. You can check for leg swelling yourself. To do this, you need to measure the circumference of your shins with a measuring tape: the narrowest part of the shin - the place above the ankles and the widest part - the calf muscle. You need to measure 2 times a day: in the evening before going to bed and immediately after you wake up. If within a few days the calf circumference varies by more than 1 cm, then there is a reason to check 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 occur 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, bluish in color, and swelling may occur. With the development of varicose veins, trophic ulcers may appear, which itch and itch unpleasantly.
Complications
Varicose veins are a serious disease, as it can cause a number of consequences: eczema, skin ulcers, severe venous bleeding from injuries of the lower extremities, thrombophlebitis.
Thrombophlebitis is especially dangerous, since blood clots form in the vessels and can break off at any time. Blockage of the pulmonary artery is fatal.
Varicose veins of the lower extremities can lead to diseases such as
- hemorrhoids – a disease characterized by varicose veins of the rectum;
- varicocele – varicose veins of the spermatic cord;
- portal hypertension is a syndrome in which the pressure in the portal vein system increases.
With varicose veins in the legs, it becomes difficult to walk, and in later stages the person becomes disabled.
Treatment of varicose veins on the legs
The nature of treatment for varicose veins in the legs depends on the stage of the disease and symptoms. There are many procedures by which dilated veins are glued, sealed, and removed. The most common methods are:
Sclerosis
A procedure in which doctors glue small vessels together to eliminate the "stars. "A special substance is injected into the vein to glue the walls of the vein together. After some time, this vein forms a cord and resolves. Sclerotherapy is a painless method and takes place without anesthesia within 15 minutes.
Phlebectomy
If varicose veins require radical treatment, then surgical intervention is used. Varicose vein surgery involves removing the veins. To do this, a procedure called phlebectomy is performed - this is a surgical operation in which the saphenous veins are removed. This helps prevent stress on the deeper venous layers.
Endovasal laser coagulation
The next method of vein removal is endovasal laser coagulation. A method of modern treatment, the essence of which is the effect of thermal energy of laser radiation. The laser affects only areas of the venous wall, without affecting the tissues and nerve endings that are nearby. Under the influence of radiation, the vein closes and is excluded from the bloodstream. The procedure is performed using local anesthesia and without hospitalization. An ultra-thin laser light guide is inserted into a vein through a skin puncture. The procedure gives good results and is popular due to the possibility of outpatient treatment and quick rehabilitation.
Conservative treatment
In some cases, conservative treatment is used with medications prescribed by your attending physician. It is suitable for those patients who are contraindicated for surgery, with insufficiency of the deep vein valves, with varicose veins at the initial stage, which have only a cosmetic defect, and who refuse to undergo surgery.
Drugs for the treatment of varicose veins are divided into several groups:
- phlebotonics
- anticoagulants
- anti-edema remedies
- disaggregants
- during trophic changes
- antioxidants
- non-steroidal 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 of blood.
Treatment of varicose veins in men involves wearing special compression garments, performing regular exercises, maintaining proper nutrition, and avoiding alcohol and smoking.
Treatment for varicose veins in the legs involves following a diet to lose excess weight and reduce swelling and tension in the legs. It is necessary to give up salt and sugar and reduce fluid intake. It is necessary to include foods with vitamin P, C, E, protein, and microelements in your diet to strengthen the vascular wall. Smoking and drinking alcohol are prohibited, as they stretch the walls of blood vessels and impair patency.
At the initial stages of the development of varicose veins and during treatment, it is necessary to regularly perform a complex of therapeutic exercises. Exercises should be done in compression garments at a calm pace until you feel tired. In this case, jumping, running, dancing, ballet, aerobics and step are excluded, as they increase the load on the veins in the legs. You cannot do strength training or lift barbells or dumbbells. Lifting weights of more than 3-5 kg is excluded. Exercises in the pool, an exercise bike with back support, and cycling will be extremely useful. You can do normal walking on a treadmill. Walking outdoors with alternating fast and slow paces is best.
After treatment and vein surgery, precautions should be taken. Wear the right shoes, high-heeled shoes are excluded, the platform should not be higher than 4 cm. To improve blood circulation, you must constantly wear class 1 or 2 compression garments, depending on the stage of development of varicose veins on the legs. It is best to wear it during the cold season, as it is more comfortable and convenient. It is recommended to give preference to high stockings and tights, as knee socks will pinch your leg at the knee.
Treatment of varicose veins with laser
For varicose veins, endovenous laser coagulation can be prescribed - laser surgery and echo sclerotherapy. Some patients are shown surgical removal of dilated veins under local anesthesia through pinpoint punctures of the skin surface - miniphlebectomy. Microsclerotherapy can be used to remove spider veins and intradermal veins.
Laser energy is absorbed by the hemoglobin of red blood cells and within a second is converted into heat (95-100 degrees), which leads to boiling of plasma and blood elements, causing a thermal burn of the endothelium - the walls of the veins. A dense blood clot is created at the site of laser exposure, then the veins dissolve and become invisible. If the vessels are large and located in several layers, the procedure must be repeated after a month.
Treatment of varicose veins with a laser refers to surgical methods, which are comparable to the method of treating the disease without surgery due to its low invasiveness, the absence of general anesthesia, and strictly local exposure of the laser only to the wall of varicose veins.
Laser surgery is performed using an ultrasonic duplex scanner. The doctor inserts a thin light guide through a skin puncture into the lumen of the vein. Radiation of a certain laser wavelength, which is partially absorbed by the wall of the dilated vein, seals the diseased veins. Clinics use a new generation laser that selectively affects the walls of veins without damaging the surrounding tissue.
There are several advantages of laser treatment for varicose veins:
- outpatient treatment – the patient does not require hospitalization and can immediately go home after the procedure;
- local anesthesia is used - general anesthesia or spinal anesthesia is not required;
- short duration of the procedure - laser treatment is performed in 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, disappearing after 2-3 months.
After laser surgery for varicose veins, it is necessary to ensure compression of the varicose veins that have been treated.
To do this, the patient wears compression stockings. They are thin, elastic and maintain the required degree of pressure for a long time. Special latex pads or cotton rolls are placed in the area where large varicose veins are located. Immediately after the treatment procedure, the patient must walk at least 4–5 kilometers. The walk should be brisk and fast so that the blood begins to circulate well and the veins develop. After laser surgery, in the first days you must walk for an hour every day.
After laser treatment of varicose veins, it is necessary to regularly undergo vascular diagnostics. Therapeutic gymnastics, walking, swimming, cycling are shown. It is worth giving up running, jumping, strength exercises in the gym, weight lifting, dancing, and any type of martial arts. Gymnastics should be performed every day at a moderate pace, with rest breaks. Its goal is to reduce blood stagnation in the veins, but not to pump up the legs, so you shouldn’t overwork. After classes, you need to lie down with your legs raised up at an angle of 90 degrees for several minutes.
Radiofrequency coagulation
Another way to remove varicose veins is radiofrequency coagulation. The essence of the method is that the vascular walls of the veins are exposed to radiofrequency radiation. Since the main goal is to stop blood flow, when using this method, the vein is, as it were, welded under radiation. Gradually, the vein resolves and completely disappears within six months to one year. The advantage of this method is the complete absence of surgical intervention, as well as the possibility of carrying out the procedure for any concomitant pathologies. This technique does not have a systemic effect on the patient’s body.
Since the most difficult 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 carried out, which consists of surgical cleansing of the ulcer and skin grafting on 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 specialized underwear made from compression knitwear and bandages made from special bandages will help 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 it 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 at work, you can do a simple exercise for varicose veins. Rise 20 times on your toes, lifting your heels off the floor. This exercise will help get rid of varicose veins, as it acts like a pump and improves vascular tone. At the end of the day, try to keep your feet elevated or on a pillow. It will be useful to perform the "bicycle" exercise or exercise on an exercise bike with back support.
You need to exercise in a gentle manner, excluding running, jumping, lifting barbells and dumbbells, strength exercises, squats and deadlifts in the gym. The most effective and health-improving sports would be swimming, swimming, walking, and cycling. Swimming trains the blood vessels of the legs, while being gentle on the lower limbs, unlike running and strength exercises. It helps eliminate swelling, 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. Exercises should be performed until your legs feel tired. After the gymnastics complex, you need to rest and lie down with your feet on a pillow or armrests of the sofa. It is useful to complete the exercises with a contrast shower or foot bath.
It is important to adhere to proper nutrition. It is necessary to exclude salty, hot and spicy foods, smoked foods, fatty, fried, flour and sweet foods, as they destroy the walls of blood vessels and retain fluid in the body. It is prohibited to drink alcohol and smoke to avoid the formation of blood clots in the vessels. The diet should be rich in foods with vitamins C, B, E, protein, 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 is useful to have juice days 2 times a week, after consulting with your doctor to see if you have any stomach diseases.
Prevention of varicose veins
Since varicose veins are most often caused by stagnation of blood in the extremities, throw your legs at home on the back of the sofa or on a low table or chair. This relieves fatigue and tension in the legs. Before going to bed, place a pillow or folded blanket under your feet to elevate your legs a little.
Prevention of varicose veins includes losing weight, as excess weight creates additional stress on the legs. Women should not carry weights weighing more than 3 kilograms in one hand. You need to give up tight clothes and shoes, tight-fitting stockings and socks. The heel should not exceed 4 cm. They create an obstacle to normal blood circulation. Compression knitwear trains and fixes veins well, improves their tone. Underwear should be purchased at a pharmacy or specialty store.
Sedentary work requires regular warm-ups, stretching, and it is useful to get up and walk. If possible, place a low bench under your feet, this will improve blood flow. Walk more often, do regular exercise, swim and climb stairs. This will prevent the development of varicose veins and improve muscle tone.
To avoid varicose veins, it is necessary to follow preventive measures. You should try to minimize hot baths, saunas and steam rooms, as well as prolonged exposure to the sun. This will help reduce venous tone, which leads to stagnation of blood in the legs.
To prevent varicose veins in your legs, avoid wearing tight-fitting items such as socks or stockings with tight elastic bands, as they put too much pressure on the veins and can lead to poor circulation and dilation. High heels are excluded; shoes for every day should not be higher than 4 cm. Shoes with heels can be worn for festive events.