Varicose veins of the lower extremities, according to information addressed to medical institutions, are found in every fifth man and in 28% of women of working age.
If we take into account the whole population, then half of the adults will have characteristic symptoms.
The peculiarity of this disease is the development of comfortable living conditions. Studies in Asian countries have shown a lower prevalence among the poor engaged in manual labor, taking long walks.
Why are the leg veins loaded?
The anatomical structure of the vein wall is characterized by a strengthened muscle skeleton and valve device. The expediency lies in the need not only to maintain the blood flow in a person's vertical position, but also to organize his ascent against gravity to the heart.
The valves block the return flow to prevent overfilling in the most remote parts of the body. This "uncomfortable" part is the legs and feet.
The mechanism of varicose veins of 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 good venous valve tone. Absence leads to loss of tone, relaxation and inability to delay reverse blood flow and overlying mass.
The venous network in the legs consists of superficial vessels located just below the skin and deep veins located in the thickness of the muscle layer.
Varicose veins of the lower extremities are characterized by an initial damage to the valves of the superficial veins. Congestion occurs in areas with dilated thin veins, visible to the eye in the form of a fine mesh.
Further development of the pathology leads to retention of blood in the periphery and causes tissue swelling (fluid leakage through the walls of the veins), malnutrition (toxin outflow is reduced, oxygen and nutrients are retained by compressed arteries).
How complications are related
The stagnation of the venous blood in the legs causes a slowing down of the blood flow in the vessels and this creates favorable conditions for the accumulation (adhesion) of platelets. Blood clots complicate an already compromised blood supply.
The risk of rupture of the embolus and its movement through large vessels to the heart increases. If a person has defects associated with right and left ventricular communication, it is possible for an 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 area of the venous wall, followed by the development of varicose veins or thrombophlebitis.
Causes of the disease
For varicose veins of the lower extremities, there is only one reason independent of an individual - a genetic defect in the structure of collagen. It manifests itself not only in varicose veins, but also in relatively early signs of skin aging (dryness, deep wrinkles).
Other reasons relate to people's activities and behavior.
- Reduced physical activity or, conversely, hard physical work leads to a violation of the tone of the veins of the legs.
- Prolonged forced standing, sedentary working hours cause stagnation of blood in the legs and disturbance of outflow.
- Pregnancy puts increased pressure on the pelvic organs and large veins, preventing drainage from the lower veins.
- Doctors from Asian countries link the development of varicose veins in patients addicted to the European habit of sitting in a chair or in a chair instead of bent knees.
- Comfortable tall toilets require increased tension of the abdominal wall muscles during defecation, strain contributes to stagnation in the legs. During occupation, the act of defecation is more normal.
- The habit of fast food, reducing the proportion of raw vegetables and fruits in the diet lead to constipation and prolonged stress.
- Smokers expose the whole body to the effects of nicotine, it acts on the veins as a paralytic poison.
- Fashionable high-heeled shoes lead to inappropriate stress on the leg muscles and disrupt the tone of the veins.
- Common pills, hormonal contraceptives, treatment with hormonal drugs for menopause, osteoporosis lead to disruption of collagen synthesis.
- Slimming promotional underwear and the use of skinny jeans cause blood stasis in the underlying parts of the body.
Who should be included in the risk group
Considering the reported reasons for the development of venous pathology, the group of people with an increased chance of developing varicose veins of the legs should include:
- persons professionally associated with long stays in an upright or sitting position (salesmen, teachers, hairdressers, drivers, clerks);
- women who prefer skinny jeans, underwear and high heels.
- men engaged in weightlifting and bodybuilding.
- people who are used to sitting "side by side".
- women with frequent pregnancies and childbirth, as well as taking hormonal contraceptives;
- smokers, lovers of strong coffee and alcohol.
- constipated.
Precautionary measures are needed for these populations.
Symptoms
The first symptoms of varicose veins in the legs are felt at a young age. In the initial stage, they appear with increased stress on the legs:
- by the end of the shift, there are pains in the legs and feet, muscle fatigue.
- When you change shoes, your feet become swollen due to the tightness of your shoes.
- at night the feet "burn", you want to dip them in cold water.
- "Spiders" form on the skin of the thighs and legs.
In the next stage, a picture of chronic venous insufficiency develops, symptoms of internal varicose veins appear:
- disturbed by nocturnal cramps in calves, cramps are possible when walking.
- appear dark spots, dryness, peeling on the skin of the feet and legs.
- the appearance of food ulcers, very painful, with loose edges, difficult to treat.
If, against the background of local pain, swelling, redness of the skin, body temperature rises, you should consider thrombophlebitis.
Diagnostics
In diagnostics, it is common to distinguish between true (primary) varicose veins, depending on the damage to the valve device and secondary varicose veins, resulting from injuries and tumors.
Polyclinic surgeons, vascular surgeons, and venologists participate in the examination. The doctor sees subcutaneous venous nodules, vascular networks, skin pigmentation, initial ulcers, dermatitis.
On palpation, the tendency of the superficial veins, the density of the wall, the size of the local changes, the presence of a clot, 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 for clots to form according to a gel.
Vascular ultrasound allows you to detect blood flow, venous valve function, and blood clots.
Doppler examination allows you to check the structure of the veins, to make a diagnosis in the early stages of the disease.
The method of spiral computed tomography is performed in case of difficulties in diagnosis. It allows a three-dimensional image of the anatomical area 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 early stages. To do this, you need to think about the necessary changes in habits, diet and exercise.
Way
In order not to swell the legs until the end of the working day, people with "sitting" and "standing occupations" recommend taking physical breaks or warming up with a foot massage in an elevated position. Drivers, clerks should travel during breaks.
The simplest exercises can be done at work:
- barefoot on the floor alternately stand on toes and heels.
- Sit in a chair, lift your legs and circle your legs in one direction and then the other.
Morning exercises should include exercises in a lying position: alternative leg lifts, "bicycles", shaking of the raised legs. Exercises with squats, bent knees are not suitable.
Strength training enthusiasts should refuse them. Most are swimming, cycling and hiking.
Choosing a balanced diet
Limit all foods that increase weight, promote fluid retention and increase blood viscosity.
Fatty meats and dairy products, spicy and salty foods, canned foods, sweets, pastries, 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 appears instead of butter, nuts.
Vein support methods
It is recommended to wear compression stockings or golf to support blood flow. They are sized to be worn while lying on your back.
Silicon-filled soles are referred to as a drug that creates an electric charge on the surface of the foot.
Experts warn of the possible effect of these aids only in the early stages of the disease. In the presence of superficial nodules and swelling in the legs, their use is completely useless.
The use of drugs
Medication consists of taking oral medication from the group of "phlebotonics" at a therapeutic dose chosen by the doctor. They help relieve fatigue, discomfort in the legs, but do not eliminate the disease.
Surgeons attribute varicose vein drugs to conservative treatment in the background, but the main one is one of the least traumatic ways of influencing the affected veins. Efficacy is confirmed in 95% of patients. More serious interventions are used in only 5% of patients.
What about low trauma surgeries
Low-trauma varicose vein treatment methods allow you to avoid surgery, rightfully ranking first in terms of effectiveness. They do not require an incision in the skin, they can be done in a polyclinic and are practically painless. The patient is not limited in terms of work, movements. No long recovery period is required after surgery.
Laser removal method
It is done under local anesthesia. A light guide is inserted into the varicose vein and a circular laser beam lights up in reverse motion.
Method of action: the beam causes intense burning of the inner lining of the vein, further hardening. The duration of the intervention is about two hours. The method is applied to the treatment of veins of any size.
Sclerotherapy technique
A substance is injected into the affected vein which can cause the walls to collapse with subsequent scarring. Special foam preparations are recommended, which fill the lumen of the diseased vein quickly and safely. The method is applied when the diameter of the vessel is up to 1 cm. After insertion, it is necessary to walk for an hour. Venereologists recommend wearing compression stockings for another month.
Microflevectomy method
Under local anesthesia, a multi-mm incision is made in the skin, through which a diseased vein is grabbed by a hook, brought to the surface of the skin and cut off. The method is suitable for venous nodes of any size and diameter. A small scar will remain at the intersection. You must wear compression stockings or socks for 10 days.
Radiofrequency catalysis method
It performs similar to a 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 lumen of the vessel is sealed. After 7 days, the recovery is considered complete. You can play sports.
In which cases is surgery indicated?
With unsuccessful treatment with conservative methods and inability to use minimally invasive techniques, phlebectomy is prescribed. Allows you to remove large areas of varicose veins, bundles.
The patient is hospitalized. The surgical treatment is performed under general anesthesia. Usually two incisions are made: in the groin and below the knee. The vein is tied on both sides, pulled out and removed. The incisions are applied to the incisions. The patient is hospitalized for one week. Drugs that reduce blood clotting are used. 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, diabetes mellitus.
- if there are skin conditions at the site of the proposed surgery.
Prevention methods
Prevention of varicose veins is primarily necessary for people with risk factors in the profession.
More walking is recommended. There is massage and strengthening of the walls of the veins.
During breaks, salespeople and hairdressers do foot and jaw massages. It is done with slow, smooth movements in the direction from the fingers to the knee and along the thigh. The joints of the fist are massaged in a circular motion in the central hole of the foot.
Drivers have to get out of the car, walk, stretch their legs. Exercises for the legs appear.
Fashionistas need to think about the consequences before getting into high heels and wearing tight clothes.
At home, you can take contrast baths or foot showers. Apply a compress on tired legs with a decoction of chamomile, chestnut, wormwood, burdock.
Early visit to the surgeon allows you to get rid of painful problems, restore activity and movement.