Varicose veins in the lower extremities, according to the information on appeal to medical institutions, are found in every fifth man and 28% of women of working age.
If we consider the entire population, half of adults will have characteristic symptoms.
The peculiarity of this disease is growth from pleasant living conditions. Studies in Asian countries have shown a lower incidence among the poor who engage in manual labor and take long walks.
Why are the veins in the legs strained?
The anatomical structure of the vein wall is characterized by a reinforced skeleton of muscles and a valve apparatus. The convenience lies in the need not only to keep the blood flow in a person's vertical position, but also to organize its increase towards gravity towards the heart.
The valves block the return flow to prevent overfilling at the most remote points in the body. This "uncomfortable" place is 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 bulk of which is the collagen protein. It is essential for a good venous valve tone. The absence leads to loss of tone, sagging and inability to delay the reverse blood flow and the overlying mass.
The venous network in the legs consists of superficial vessels located directly under the skin and deep veins located in the thickness of the muscle layer.
Varicose veins in the lower extremities are characterized by an initial lesion of the valves of the superficial veins. Congestion manifests itself in areas with enlarged fine veins, visible to the eye in the form of a fine mask.
Further development of the pathology leads to blood retention in the periphery and causes tissue edema (fluid leakage through the walls of the veins), malnutrition (the outflow of toxins is reduced, oxygen and nutrients are retained by compressed arteries).
How complications are related
Stagnation of venous blood in the legs causes a slowed blood flow in the vessels, and this creates favorable conditions for aggregation (adhesion) of platelets. Blood clots complicate an already compromised blood supply.
The risk of embolus rupture and its movement through large vessels to the heart increases. If a person has defects associated with 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 in the affected area of the vein wall followed by the development of phlebitis or thrombophlebitis.
Causes of the disease
For varicose veins in the lower extremities, there is only one cause independent of a person - 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 causes are related to human activities and behavior.
- Decreased physical activity or, conversely, hard physical work leads to a violation of the tone of the veins in the legs.
- Prolonged forced standing, sitting during working hours causes stagnation of blood in the legs and decreased outflow.
- Pregnancy puts increased pressure on the pelvic organs and large veins and prevents drainage from the lower veins.
- Doctors from Asian countries associate the growth of varicose veins in patients with dependence on the European habit of sitting in a chair or on a chair instead of bent knees.
- Comfortable high toilets require increased tension in the muscles of the abdominal wall during bowel movements, strain contributes to stagnation in the legs. While squatting, the bowel movement is more physiological.
- The habit of fast food, a decrease in the proportion of raw vegetables and fruits in the diet leads to constipation and prolonged stress.
- Smokers expose the whole body to the effects of nicotine, it acts on the veins like a paralyzing poison.
- Fashionable high-heeled footwear leads to incorrect loading of the leg muscles and disturbs the tone of the veins.
- Ordinary pills, hormonal contraceptives, treatment with hormonal drugs for menopause, osteoporosis leads to decreased collagen synthesis.
- The advertised slimming underwear and wearing tight jeans causes blood to stagnate in the underlying parts of the body.
Who should be included in the risk group
Given the stated causes of the development of venous pathology, the group of individuals with an increased likelihood of developing varicose veins in the legs should include:
- people professionally attached to a longer stay in a standing or sitting position (salesmen, teachers, hairdressers, drivers, office workers);
- women who prefer skinny jeans, shaping underwear and high-heeled shoes;
- people involved in weightlifting and bodybuilding;
- people accustomed to sitting "side by side";
- women with frequent pregnancies and births, 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 noticeable at a young age. In the initial phase, they appear with increased stress on the legs:
- at the end of the shift appear pain in feet and legs, muscle fatigue;
- when changing shoes there is swelling of the feet due to the tightness of the shoe;
- in the evening 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:
- disturbed by night cramps in the calves, cramps when walking are possible;
- dark spots, dryness, peeling appear on the skin of the feet and legs;
- the appearance of trophic wounds, very painful, with loose edges, difficult to treat.
If on the background of local pain, swelling, redness of the skin, an increase in body temperature is found, think about thrombophlebitis.
Diagnostics
In diagnostics, it is usual to distinguish between true (primary) varicose veins, depending on the lesion of the valve apparatus, and secondary ones due to trauma and tumors.
Surgeons from polyclinics, vascular surgeons, phlebologists are involved in the study. The doctor sees subcutaneous venous nodules, vascular networks, skin pigmentation, incipient 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 above the nodes (signs of thrombophlebitis) are assessed.
A general blood test shows the onset of inflammation (leukocytosis, accelerated ESR), a tendency to thrombus formation according to a coagulogram.
Vascular ultrasound allows you to track blood flow, function of venous valves and detect blood clots.
Doppler examination allows you to check the structure of the vein, to make a diagnosis in the initial stage of the disease.
The spiral computed tomography method is performed in case of difficulties in diagnosis. It makes it possible to obtain a three-dimensional image of the anatomical area and helps with the choice of surgical treatment.
Treatment of varicose veins in the legs
It is better to start the treatment of varicose veins in the legs in the initial stage. To do this you will need to think about the necessary changes in habits, nutrition and movement.
Fashion
In order not to swell the legs at the end of the working day, people from "sedentary" and "standing occupations" are advised to take physical culture breaks or warm-ups with foot massage in an elevated position. Drivers, office workers should walk around during breaks.
The simplest exercises can be performed at work:
- barefoot on the floor alternately standing on toes and heels;
- sitting on a chair, lift your legs and make circles with your feet in one direction, then in the other.
Morning exercises should include lying down exercises: alternative leg lifts, "cycling", shaking swollen legs. Exercises with squats, bent knees are not suitable.
Lovers of strength training should refuse 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 meats and dairy products, spicy and salty foods, canned foods, sweets, baked goods, carbonated beverages are not recommended.
In the daily diet you should use more vegetables and fruits, berries, onions, garlic, fermented milk products, grains, vegetable oil appear instead of butter, walnuts.
Road support methods
It is recommended to wear compression stockings or golf to support blood flow. They have a size to be used while lying on your back.
Silicone-filled treads are proclaimed as a means of creating an electric charge on the surface of the foot.
Specialists are only aware of the possible impact of these aids in the initial stage of the disease. In the presence of superficial nodules and edema of the legs, their use is completely useless.
Use of medication
Drug treatment consists of taking oral medication from the group of "venotonics" in a therapeutic dose selected by the physician. They help relieve fatigue, discomfort in the feet, but they do not eliminate the disease.
Surgeons prescribe varicose veins medication for the background conservative treatment, but the most important is one of the less traumatic ways to affect the affected veins. The effect is confirmed in 95% of patients. More serious procedures are used in only 5% of patients.
As for low traumatic surgeries
Low-traumatic methods of treating varicose veins allow you to avoid surgery, rightly placing you first in terms of effectiveness. They do not require a skin incision, can be performed in an outpatient clinic and are virtually painless. The patient is not restricted in terms of work, movements. A long recovery period is not necessary after surgery.
Laser ablation method
It is performed under local anesthesia. A light guide is inserted into the varicose veins and a circular laser beam is turned on during reverse motion.
Method action: the beam causes a marked combustion of the inner lining of the vein, further hardens. The duration of the intervention is approximately two hours. The method is applicable 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. 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 container is up to 1 cm. After the introduction, it is necessary to walk for an hour. Phlebologists recommend using compression stockings for another month.
Method for microflebectomy
Under local anesthesia, an incision is made in the skin of several mm, through which a diseased vein is caught by a hook, brought to the surface of the skin and cut out. The method is suitable for venous nodules 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 the same way as laser, but differs in the effect of microwave radio frequencies. This method does not cause tissue burns, therefore it is less traumatic than laser. After 30 minutes of exposure to microwaves, the lumen of the container closes. After 7 days, the rehabilitation is considered completed. You can play sports.
In which cases is the operation indicated?
With failed treatment by 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 outward and removed. Sutures are applied to the incisions. The patient is treated in a hospital for a week. Drugs that reduce blood clots are used. The stitches 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 legs, diabetes mellitus;
- if there are skin diseases at the site of the intended operation.
Prevention methods
Prevention of varicose veins in the legs is primarily necessary for people with risk factors in the profession.
It is recommended to go more. There is massage and strengthening of the walls of the veins.
During the breaks, salesmen and hairdressers are shown foot and shin massage. This is done with slow, smooth movements in the direction from the fingers to the knee and along the thigh. The knuckles of the fists are massaged in a circular motion to the central fossa of the foot.
Drivers need to get out of the car, walk around, stretch their legs. Exercises for the legs are shown.
Fashionistas should think about the consequences before going in high heels and wearing tight clothing.
At home you can make contrast baths or foot showers. Apply a compress on tired legs with a decoction of chamomile, chestnut, wormwood, burdock.
A timely visit to the surgeon allows you to get rid of painful problems, restore activity and movement.