Varicose veins of the lower extremities, according to the information for appeal in medical institutions, are found in every fifth man and 28% of women of working age.
If we take into account the entire population, then half of the adults will have characteristic symptoms.
The peculiarity of this disease is the growth of comfortable living conditions. Studies in Asian countries show a lower prevalence among the poor who are engaged in manual labor and take long walks.
Why are the veins in the legs loaded?
The anatomical structure of the venous wall is characterized by a reinforced skeleton of muscles and a valvular apparatus. The expediency consists in the need not only to maintain the blood flow in a vertical position of a person, but also to organize his rise against gravity in the direction of the heart.
The valves block the backflow to prevent overflow at the farthest points of the body. This "uncomfortable" place is the legs and feet.
The mechanism of formation 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, sagging and inability to slow down the return flow of blood and proper mass.
The venous network in the legs consists of superficial vessels lying 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 occurs in areas with varicose 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 swelling of the tissues (leakage of fluid through the walls of the veins), malnutrition (leakage of toxins is reduced, oxygen and nutrients are retained by the constricted arteries).
How complications join
Stagnation of venous blood in the legs causes slow blood flow in the vessels and this creates favorable conditions for aggregation (adhesion) of platelets. Blood clots complicate the 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 related to the communication of the right and left ventricles, 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 area of the venous wall, followed by the development of phlebitis or thrombophlebitis.
Causes of the disease
There is only one non-human cause of varicose veins in the lower extremities - a genetic deficiency in the structure of collagen. It occurs not only in varicose veins, but also in relatively early signs of skin aging (dryness, deep wrinkles).
Other reasons are related to people's activities and behavior.
- Reduced physical activity or, conversely, heavy physical labor leads to a violation of the tone of the veins of the legs.
- Prolonged forced standing, sitting during working hours causes blood stasis in the legs and impaired outflow.
- Pregnancy puts increased pressure on the pelvic organs and large veins, preventing drainage from the inferior veins.
- Doctors in Asian countries have linked the growth of varicose veins in patients with a 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 defecation, the tension contributes to stagnation in the legs. While squatting, the act of defecation is more physiological.
- 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, which acts on the veins as a paralyzing poison.
- Fashionable high-heeled shoes lead to improper loading of the leg muscles and disrupt the tone of the veins.
- The usual pills, hormonal contraceptives, treatment with hormonal drugs for menopause, osteoporosis lead to impaired collagen synthesis.
- Advertised slimming underwear and wearing skinny jeans cause blood stasis in the underlying parts of the body.
Who should be included in the risk group
Given the listed reasons for the development of venous pathology, the group of persons with an increased likelihood of developing varicose veins of the legs should include:
- people professionally involved in a long stay in an upright or sitting position (tradesmen, teachers, hairdressers, drivers, office workers);
- women who prefer skinny jeans, fitting lingerie and high heels;
- people involved in weightlifting and bodybuilding;
- people who are used to sitting "side by side";
- women with frequent pregnancies and births, as well as those taking hormonal contraceptives;
- smokers, lovers of strong coffee and alcohol;
- constipation.
Preventive measures are needed for these populations.
Symptoms
The first symptoms of varicose veins in the legs are noticeable at an early age. In the initial stage, they appear with increased stress on the legs:
- by the end of the shift there is pain in the feet and legs, muscle fatigue;
- when changing shoes, swelling of the feet is found due to the tightness of the shoes;
- in the evening the legs "burn", you want to immerse them in cold water;
- "spiders" form on the skin of the thighs and legs.
At the next stage a picture of chronic venous insufficiency develops, symptoms of internal varicose veins appear:
- disturbed by nocturnal spasms in the calves, spasms when walking are possible;
- 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 is found an increase in body temperature, you should consider thrombophlebitis.
Diagnosis
In diagnosis, it is common to distinguish between true (primary) varicose veins, depending on the lesion of the valvular apparatus, and secondary, as a result of trauma and tumors.
The examination includes surgeons of polyclinics, vascular surgeons, phlebologists. The doctor sees subcutaneous venous nodules, vascular networks, skin pigmentation, initial ulcers, dermatitis.
On palpation, the tension of the superficial veins, the density of the wall, the size of the local changes, the presence of a thrombus, the temperature of the skin above the nodes (signs of thrombophlebitis) are assessed.
The general blood test will show the onset of inflammation (leukocytosis, accelerated ESR), a tendency to form blood clots according to a coagulogram.
Vascular ultrasound allows you to monitor blood flow, venous valve function and detect blood clots.
Doppler examination allows you to check the structure of the veins, to diagnose 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 in the choice of surgical treatment.
Treatment of varicose veins of 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 consider the necessary changes in habits, diet and exercise.
Mode
In order not to cause the feet to swell by the end of the working day, people from "sedentary" and "standing professions" are advised to take breaks for physical culture or warm up with a foot massage in a raised position. Drivers, office workers have to walk during breaks.
The simplest exercises can be done during work:
- barefoot on the floor, stand on your toes and heels;
- sitting 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 the supine position: alternative leg raises, "bicycles", shaking the raised legs. Exercises with squats, bent knees are not suitable.
Fans of strength training should refuse them. Swimming, cycling and hiking are most often shown.
Choosing a balanced diet
Limit all foods that increase weight, promote fluid retention and increase blood viscosity.
Not recommended fatty meats and dairy products, spicy and salty foods, canned food, pastries, baked goods, carbonated beverages.
In the daily diet you should use more vegetables and fruits, berries, onions, garlic, fermented dairy products, cereals, vegetable oil is shown instead of butter, nuts.
Methods to support the veins
Wearing compression stockings or golf is recommended to support blood flow. They are sized to wear while lying on your back.
Protectors filled with silicon are advertised as a means of creating an electric charge on the surface of the foot.
Specialists pay attention to the possible impact of these aids only in the initial stage of the disease. In the presence of superficial nodules and swelling of the legs, their use is completely useless.
The use of drugs
Drug treatment consists of taking oral drugs from the group of "venotonics" in a therapeutic dose selected by the doctor. They help relieve fatigue, discomfort in the legs, but do not eliminate the disease.
Surgeons prescribe drugs for varicose veins on the background of conservative treatment, but the main one is one of the less traumatic ways to affect the affected veins. Efficacy was confirmed in 95% of patients. More serious interventions are used in only 5% of patients.
As for low-trauma operations
Low-trauma methods of treating varicose veins allow you to avoid surgery, rightly ranking first in effectiveness. They do not require a skin incision, can be performed in a clinic and are virtually painless. The patient is not limited in terms of work, movements. No long recovery period is required 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, which 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.
Microphlebectomy method
Under local anesthesia, an incision of the skin is made with a few mm, through which a diseased vein is hooked, 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 should wear compression stockings or socks for 10 days.
Radiofrequency ablation method
It is performed similarly to the laser, but differs in the effect of microwave radio frequencies. This method does not cause tissue burns, making it less traumatic than laser. After 30 minutes of microwave exposure, the vessel lumen is sealed. After 7 days the rehabilitation is considered complete. You can play sports.
In which cases is the operation indicated?
In case of unsuccessful treatment with conservative methods and impossibility to use minimally invasive techniques, phlebectomy surgery is prescribed. It allows you to remove large areas of varicose veins, bundles.
The patient was 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. Threads are applied to the incisions. The patient is treated in hospital for one week. Drugs are used that reduce blood clotting. The sutures are removed after at least 7 days.
Phlebectomy is not performed:
- in the elderly 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 necessary primarily 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.
Massage of the feet and shins is shown to the sellers and hairdressers during the holidays. It is performed with slow, smooth movements in the direction from the fingers to the knee and along the thigh. The knuckles of the fist are massaged in circular motions to the central fossa of the foot.
Drivers have to get out of the car, walk, stretch their legs. Leg exercises are shown.
Fashionistas need to think about the consequences before getting on high heels and wearing tight clothes.
At home you can make contrasting baths or foot showers. Apply a compress on tired legs with decoctions of chamomile, chestnut, wormwood, burdock.
A timely visit to the surgeon allows you to get rid of painful problems, restore activity and movement.