Varicose veins of the lower extremities, according to information on resorting 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 have characteristic symptoms.
The peculiarity of this disease is the growth from comfortable living conditions. Studies in Asian countries have shown a lower prevalence among poor people who are engaged in manual labor, taking long walks.
Why are the leg veins loaded?
The anatomical structure of the venous wall is characterized by a reinforced muscular skeleton and a valvular apparatus. The opportunity lies in the need not only to maintain the blood flow in the vertical position of a person, but also to organize its ascent against gravity in the direction towards the heart.
The valves block the return flow to avoid overfilling at the most distant points of the body. This "uncomfortable" place is the legs and feet.
The mechanism of formation of varicose veins in the legs
At the age of 40, the human body begins to synthesize limited plastic materials, the main of which is collagen protein. It is essential for a good tone of the venous valve. Absence leads to loss of tone, sagging and inability to delay the reverse flow of blood and overlying mass.
The venous network of the legs consists of superficial vessels that lie 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 valves of the superficial veins. Congestion manifests itself in areas with dilated thin veins, visible to the eye in the form of a fine network.
Further development of the pathology leads to blood retention in the periphery and causes tissue edema (leakage of fluids through the walls of the veins), malnutrition (the outflow of toxins is reduced, oxygen and nutrients are retained by the crushed arteries).
How complications come together
The stagnation of venous blood in the legs causes a slowing of 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 rupture of the thrombus and its movement through the great vessels to the heart increases. If a person has defects associated with the 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 a local infection to 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 people's activities and behavior.
- Reduced physical activity or, conversely, hard physical work leads to a violation of the tone of the leg veins.
- Prolonged forced standing, sitting during working hours causes stagnation of blood in the legs and impaired outflow.
- Pregnancy puts greater pressure on the pelvic organs and large veins, preventing drainage from the lower veins.
- Doctors of Asian countries associate 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.
- Comfortable high toilets require increased tension of the muscles of the abdominal wall during bowel movements, exertion 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 fruits and vegetables in the diet lead to constipation and prolonged stress.
- Smokers expose the whole body to the effects of nicotine, which acts on the veins like a paralyzing poison.
- Fashionable high-heeled footwear leads to improper stress on the leg muscles and alters the tone of the veins.
- Common pills, hormonal contraceptives, treatment with hormonal drugs for menopause, osteoporosis lead to a reduced synthesis of collagen.
- The advertised slimming underwear and the use of skinny jeans cause blood to stagnate in the underlying parts of the body.
Who should be included in the risk group
Considering the listed reasons for the development of venous pathology, the group of people with an increased likelihood of developing varicose veins of the legs should include:
- people professionally associated with a long stay in an upright or sitting position (shop assistants, teachers, hairdressers, drivers, employees);
- women who prefer tight jeans, modeling underwear and high-heeled shoes;
- people involved in weight lifting and bodybuilding;
- people who are used to sitting "side to side";
- women with frequent pregnancies and childbirths, as well as 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 evident at a young age. At the initial stage, they appear with increased stress on the legs:
- by the end of the shift, pains in the feet and legs, muscle fatigue appear;
- when changing shoes, swelling of the feet is found due to the tightness of the shoes;
- in the evening your feet "burn", you want to dip them in cold water;
- "spiders" form on the skin of the thighs and legs.
At the next stage, an image of chronic venous insufficiency develops, symptoms of internal varicose veins appear:
- disturbed by night cramps in the calves, cramps are possible 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, it is necessary to think about thrombophlebitis.
Diagnostics
In diagnostics, it is customary to distinguish between true (primary) varicose veins, depending on the lesion of the valvular apparatus, and secondary, resulting from trauma and tumors.
The examination involves surgeons from polyclinics, vascular surgeons, phlebologists. 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 extent of local changes, the presence of a thrombus, the temperature of the skin above the nodes (signs of thrombophlebitis) are assessed.
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.
Doppler examination allows you to check the structure of the veins, to make a diagnosis in the initial stage of the disease.
The spiral computed tomography method is performed in case of difficulty 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 best to start the treatment of varicose veins of the legs at the initial stage. To do this, you will need to think about the necessary changes in habits, nutrition and movement.
Mode
In order not to cause swelling of the legs by the end of the working day, it is advisable for "sedentary" and "standing professional" people to take breaks for physical culture or warm-up with foot massage in an elevated position. The drivers, the employees should go around during the breaks.
The simplest exercises can be performed at work:
- barefoot on the floor alternately standing on toes and heels;
- sitting on a chair, raise your legs and make circles with your feet in one direction, then in the other.
Morning exercises should include exercises in a lying position: alternating leg raises, "bicycles", shaking of the raised legs. Exercises with squats, bent knees are not suitable.
Strength training lovers should refuse them. The most shown are swimming, cycling and hiking.
Selecting a balanced diet
Limit all foods that gain weight, promote fluid retention, and increase blood viscosity.
Fatty meat and dairy products, spicy and salty foods, canned food, sweets, baked goods, carbonated drinks are not recommended.
In the daily diet, you should use more fruits and vegetables, berries, onions, garlic, fermented milk products, cereals, vegetable oil is shown instead of butter, nuts.
Venous support methods
Compression or golf socks are recommended to support blood flow. They are sized to be worn lying on the back.
Silicone-filled treads are advertised 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 at the initial stage of the disease. In the presence of superficial lymph nodes and edema on the legs, their use is completely useless.
The use of drugs
Pharmacological treatment consists in taking drugs orally from the group of "venotonics" in a therapeutic dose selected by the doctor. They help relieve fatigue, discomfort in the feet, but do not eliminate the disease.
Surgeons attribute varicose vein medications to underlying conservative treatment, but the main one is one of the least traumatic ways to affect the affected veins. The efficacy is confirmed in 95% of patients. More serious interventions are used in only 5% of patients.
As for the less traumatic operations
The less traumatic methods for the treatment of varicose veins allow you to avoid surgery, rightly in the first place in terms of effectiveness. They do not require a skin incision, can be done in a polyclinic and are virtually painless. The patient is not limited in terms of work, movements. There is no need for a long recovery period 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 turned on during the reverse movement.
Action of the method: 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 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 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 diameter of the vessel is up to 1 cm. After the introduction, it is necessary to walk for an hour. Phlebologists recommend wearing compression stockings for another month.
Microflebectomy method
Under local anesthesia, an incision is made in the skin of several mm, through which a diseased vein is grasped by a hook, 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 stockings or stockings for 10 days.
Radio frequency ablation method
It is performed in a similar way 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 microwave exposure, the vessel lumen is sealed. After 7 days, rehabilitation is considered complete. You can play sports.
In which cases is the operation indicated?
With unsuccessful treatment with 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. Usually two incisions are 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 hospitalized 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 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.
Methods of prevention
Prevention of varicose veins of the legs is mainly necessary for people with risk factors in the profession.
It is recommended to walk more. There is a massage and strengthening of the walls of the veins.
During breaks, vendors and hairdressers are shown a foot and shin massage. It is performed with slow, fluid 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 pit of the foot.
Drivers have to get out of the car, walk, stretch their legs. Leg exercises are shown.
Fashionistas should think about the consequences before wearing high heels and wearing tight-fitting clothes.
At home, you can take contrast baths or foot baths. Apply a compress on tired legs with decoctions of chamomile, chestnut, wormwood, burdock.
A timely visit to the surgeon allows you to eliminate painful problems, restore activity and movement.