Varicose veins of the lower extremities, according to referrals to medical institutions, occur in one in five men and 28% of women of working age.
If we consider the whole population, then half of the adults will have characteristic symptoms.
A feature of this disease is an increase from comfortable living conditions. Studies in Asian countries have shown a low prevalence among the poor who are engaged in manual labor and doing long walks.
Why are the leg veins overloaded?
The anatomical structure of the venous wall is characterized by a strengthened skeleton of muscles and a valve apparatus. The expediency lies in the fact that it is necessary not only to maintain blood flow in the vertical position of the person, but also to organize it against gravity in the direction of the heart.
The valves block the return flow to prevent overfilling at the farthest points of the body. This "uncomfortable" place is the feet and ankles.
Mechanism of varicose veins of the legs
At the age of 40, the human body begins to synthesize a limited amount of plastic material, the most important of which is collagen protein. This is essential for good venous valve tone. Absence causes loss of tone, impairment and inability to stop reverse blood flow and excess mass.
The venous network of the legs consists of superficial vessels that lie directly under the skin and deep veins that are located in the thickness of the muscular layer.
Varicose veins of the lower extremities are characterized by initial damage to the superficial venous valves. Swelling is manifested in areas with enlarged thin veins, in the form of a thin mesh noticeable to the eye.
Further development of the pathology leads to blood retention in the periphery and causes swelling of the tissues (fluid drainage into the walls of the veins), inadequate nutrition (reduction of toxin drainage, oxygen and nutrients stored in the stored arteries).
How complications join
Venous blood stagnation in the legs causes a slowing of blood flow in the blood vessels and this creates favorable conditions for platelet aggregation (adhesion). Blood clotting complicates an already disrupted blood supply.
The risk of rupture of the embolus and its movement through large vessels in the heart increases. If a person has defects related to the communication of the right and left chambers, it is possible for the embolus to enter the arterial blood and develop necrotic changes in the organs.
The most common concomitant complication is the addition of a local infection to the affected side of the venous wall, followed by the development of phlebitis or thrombophlebitis.
Causes of the disease
For varicose veins of the lower extremities, a person has only one cause - a genetic deficiency in the structure of collagen. It is manifested not only in varicose veins, but also in the relatively early signs of skin aging (dryness, deep wrinkles).
Other reasons relate to human activities and behavior.
- Decreased physical activity or, conversely, strenuous physical labor leads to a violation of the tone of the veins of the legs.
- Prolonged forced standing, sitting during working hours causes blood stagnation in the legs and drainage disorders.
- Pregnancy increases the pressure on the pelvic organs and large veins, preventing drainage from the lower veins.
- Doctors in Asian countries have linked the growth of varicose veins in the legs in patients with European habit instead of bent knees while sitting on a chair or bench.
- Comfortable high toilets require tension of the abdominal wall muscles during bowel movements, tension contributes to stagnation of the legs. The act of defecation during sitting is more physiological.
- The habit of fast food, reducing the proportion of raw vegetables and fruits in the diet leads to constipation and prolonged stress.
- Smokers expose the whole body under the influence of nicotine, it acts on the veins as a paralyzing poison.
- Fashionable high-heeled shoes cause improper stress on the leg muscles and disrupt the tone of the veins.
- Conventional pills, hormonal contraceptives, treatment with menopausal hormonal drugs, osteoporosis leads to disruption of collagen synthesis.
- Advertised slimming underwear and wearing skinny jeans cause blood stagnation in the lower 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 persons with a probability of developing varicose veins of the legs should include:
- People who are professionally associated with a long or sitting position (salespeople, teachers, hairdressers, drivers, office workers);
- Women who prefer skinny jeans, underwear design and high heels;
- People involved in weightlifting and bodybuilding;
- People who are accustomed to sitting "side by side";
- Women who have frequent pregnancies and childbirth also take hormonal contraceptives;
- Smokers, strong coffee and alcohol lovers;
- Constipation.
Preventive measures are needed for this population.
Symptoms
The first symptoms of varicose veins are noticeable at a young age. At the initial stage they appear with increased stress on the legs:
- At the end of the shift, pain appears in the legs and feet, muscle fatigue;
- When changing shoes, swelling of the feet occurs due to tightening of the shoes;
- In the evening the feet are "burning", you want to throw them in cold water;
- "Spiders" form on the skin of the thighs and legs.
At the next stage, the picture of chronic venous insufficiency develops, the symptoms of internal varicose veins are revealed:
- Concerned about night cramps in calves, convulsions while walking are possible;
- Dark spots, dryness, peeling appear on the skin of the feet and legs;
- The appearance of trophic ulcers, with very painful, loose edges, is difficult to treat.
If against the background of local pain, swelling, redness of the skin, increase in body temperature, you should think about thrombophlebitis.
Diagnosis
In diagnosis, it is common to distinguish true (primary) varicose veins from damage to the valve apparatus and secondary, as a result of trauma and tumor.
Polyclinic surgeons, vascular surgeons, phlebologists participate in the examination. The doctor sees subcutaneous venous nodes, vascular networks, skin pigmentation, starting ulcers, dermatitis.
On palpation, the tension of the superficial veins, the density of the wall, the size of local changes, the presence of a thrombus, the temperature of the skin at the nodes (signs of thrombophlebitis) are assessed.
A general blood test shows the onset of inflammation (leukocytosis, accelerated ESR), the tendency to thrombus formation according to the coagulogram.
Vascular ultrasound allows you to monitor blood flow, venous valve function, and detect blood clots.
Doppler examination allows you to examine the structure of the veins, to make a diagnosis at the initial stage of the disease.
The spiral computed tomography method is performed in case of diagnostic difficulties. This makes it possible 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 treating varicose veins in the legs at an early stage. To do this, you need to think about the necessary changes in habits, nutrition and movement.
Mode
In order not to swell the legs at the end of the working day, people of "sitting" and "standing profession" are advised to perform physical culture breaks or warm-ups in an elevated position with a foot massage. Drivers, office workers have to walk during breaks.
The simplest exercises can be performed on the job:
- Stand on the bare feet alternately on your toes and heels;
- Sit on a chair, lift your legs and make circles with your legs in one direction, then in the other.
Morning exercises should include exercises in a supine position: alternate leg lifting, "bikes", shaking raised legs. Exercises with sitting, bent knees are not suitable.
Strength training enthusiasts should give up on them. Most shown are swimming, cycling and hiking.
Choosing a balanced diet
Limit all foods that increase weight, promote fluid retention, and increase blood viscosity.
Fatty meat and dairy products, spicy and salty foods, canned foods, sweets, baked goods, carbonated drinks are not recommended.
In the daily diet you should use more vegetables and fruits, berries, onions, garlic, fermented dairy products, cereals, vegetable oil shown instead of butter, walnuts.
Auxiliary methods of veins
It is recommended to wear compression stockings or golf to support blood flow. They are the size to wear when lying on your back.
Silicone-filled steps have been declared as a means of creating an electric charge on the surface of the foot.
Specialists pay attention to the possible impact of this aid only in the early stages of the disease. Their use is completely useless in the presence of superficial nodules and swelling on the feet.
Use of medications
Drug treatment involves taking oral medications from the "venotonics" group at a therapeutic dose selected by your doctor. They contribute to fatigue, discomfort in the legs, but they do not eliminate the disease.
Surgeons attribute varicose vein treatments to conservative treatment, but the main one is one of the less traumatic ways of affecting the affected veins. Efficacy has been proven in 95% of patients. More serious interventions are used in only 5% of patients.
As for low traumatic surgeries
Low-trauma methods of treating varicose veins allow you to avoid surgery, effectively occupying the first place in terms of efficiency. They do not require a skin wound, can be held in a clinic and are virtually painless. The patient is not limited in terms of work, movements. A long recovery period after surgery is not required.
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 motion.
Action of the method: The beam causes a sharp burning of the inner membrane of the vein, further hardening. The duration of the intervention is about two hours. The method is used to treat veins of any size.
Sclerotherapy techniques
The injection takes place in an infected vein, which can cause the walls to collapse with further scarring. Foam preparations that fill the diseased venous lumen quickly and safely are especially recommended. The method is used 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, a wound is made in the skin of a few mm, through which the diseased vein is caught with 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 wound site. You should wear compression stockings or socks for 10 days.
Radiofrequency ablation method
It is conducted like a laser, but differs in the action of a microwave radio frequency. This method does not cause tissue burns, so it is less traumatic than laser. After 30 minutes of exposure to the microwave, the vessel lumen is sealed. After 7 days the rehabilitation is considered complete. You can do sports.
In what cases is surgery indicated?
With unsuccessful treatment by conservative methods and inability to use minimally invasive techniques, phlebectomy surgery is prescribed. This allows you to remove large areas of the varicose veins, bundles.
The patient is hospitalized. Surgical treatment is performed under general anesthesia. Usually, two wounds are made: in the groin area and under the knee. The vein is tied on both sides, pulled out and removed. Sutures are applied to the wounds. The patient is treated in the hospital for one week. Medications are used that reduce blood clotting. The sutures are removed after at least 7 days.
Phlebectomy is not performed:
- In the patient's old age;
- With massive damage to deep and superficial veins;
- During pregnancy;
- With atherosclerosis of the vessels of the legs, with diabetes mellitus;
- If there are skin diseases at the site of the proposed surgery.
Prevention methods
Prevention of varicose veins of the legs is primarily necessary for people with occupational risk factors.
More walking is recommended. There is massage and strengthening of the vein walls.
During breaks, sellers and hairdressers are shown foot and leg massage. It is done in slow, smooth movements from the fingers to the knee and along the thigh. The fists of the fist are massaged in a circular motion on the central fossa of the foot.
Drivers have to get out of the car, walk, stretch their legs. Exercises for the legs are shown.
Fashion lovers should think about the consequences before getting on high heels and wearing tight clothes.
At home, you can do contrast baths or foot showers. Apply the compress on tired feet with decoctions of chamomile, chestnut, worm, burdock.
A timely visit to the surgeon allows you to get rid of painful problems, restore activity and movement.