Varicose veins of the lower extremities, according to information on complaints 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 from comfortable living conditions. Studies in Asian countries have shown a lower prevalence among the poor engaged in manual labor, making long walks.
Why are the veins on my legs loaded?
The anatomical structure of the vein wall is characterized by a strengthened muscle skeleton and valve apparatus. Expediency lies in the need not only to keep the blood flow in a person's vertical position, but also to organize its ascent against gravity in the direction of the heart.
Valves block backflow to prevent overcharging at the farthest points of the body. This "uncomfortable" place is the legs and feet.
Mechanism of varicose veins of the legs
At the age of 40, the human body begins to synthesize limited plastic materials, the main protein of which is collagen. It is necessary for good tone of venous valves. Absence leads to loss of tone, relaxation, and inability to delay reverse blood flow and overweight.
The venous network in the legs consists of superficial veins 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 is manifested in areas with dilated fine 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 (fluid escape through the walls of the veins), malnutrition (reduced outflow of toxins, oxygen and nutrients retain constricted arteries).
How complications come together
Stagnation of venous blood in the legs causes slowed blood flow in the blood vessels, which creates favorable conditions for aggregation (adhesion) of platelets. Blood clots complicate an already disrupted blood supply.
The risk of rupture of the embolus and its movement through the large vessels to the heart increases. If a person has defects associated with right and left ventricular communication, it is possible for the embolus to enter the arterial blood and develop necrotic changes in the organs.
The most common accompanying 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 disease
There is only one independent reason for varicose veins in the lower extremities - a genetic defect in the structure of collagen. It is manifested 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 work leads to a violation of the tone of the leg veins.
- Prolonged forced standing, sitting during working hours causes blood stagnation in the legs and reduced outflow.
- Pregnancy increases the pressure on the pelvic organs and large veins, preventing drainage from the inferior veins.
- Doctors from Asian countries associate the growth of varicose veins in leg patients with addiction with the European habit of sitting on a chair or stool instead of bent knees.
- Comfortable high toilets require increased tension of the abdominal wall muscles during emptying, the strain contributes to the stagnation of 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 long-term stress.
- Smokers expose the whole body to the influence of nicotine, it acts on the veins as a paralyzing poison.
- Fashion shoes with high heels lead to improper stress on the leg muscles and disrupt the tone of the veins.
- The usual pills, hormonal contraceptives, treatment with hormonal drugs for menopause, osteoporosis lead to disorders of collagen synthesis.
- Advertised underwear for weight loss and wearing tight jeans cause blood stagnation in the lower parts of the body.
Who should be included in the risk group
Taking into account the above reasons for the development of venous pathology, the group of persons with an increased probability of developing varicose veins of the legs should include:
- persons who are professionally associated with a long stay in a standing or sitting position (salespeople, teachers, hairdressers, drivers, office workers);
- women who prefer skinny jeans, lingerie and high-heeled shoes;
- people who do 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;
- prison.
Preventive measures are needed for these populations.
Symptoms
The first symptoms of varicose veins on the legs are noticeable in youth. In the initial stage, they appear with increased stress on the legs:
- by the end of the shift there are pains in the feet and legs, muscle fatigue;
- when changing, the feet swell due to the firmness of the shoes;
- in the evening the feet "bake", you want to dip them in cold water;
- "spiders" form on the skin of the thighs and legs.
In the next stage, the picture of chronic venous insufficiency develops, the symptoms of internal varicose veins appear:
- disturbed by nocturnal cramps in the leaves, 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, they are difficult to treat.
If on the background of local pain, swelling, redness of the skin there is an increase in body temperature, you need to think about thrombophlebitis.
Diagnosis
In diagnosis, it is common to distinguish between true (primary) varicose veins, depending on the valve lesion, and secondary, resulting from trauma and tumor.
The examination includes polyclinic surgeons, vascular surgeons, phlebologists. The doctor sees subcutaneous venous nodules, vascular networks, skin pigmentation, ulcers at the beginning, 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 over the nodules (signs of thrombophlebitis) are assessed.
A general blood test will show the onset of inflammation (leukocytosis, accelerated ESR), a tendency to form a thrombus according to the coagulogram.
Blood vessel 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 make a diagnosis in the initial stage of the disease.
The method of spiral computed tomography is performed in case of difficulties 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 better to start the treatment of varicose veins in the initial phase. To do this, you will need to consider the necessary changes in habits, diet and movement.
Mode
In order not to swell the legs by the end of the working day, people of the "sitting" and "standing profession" are advised to take breaks or warm up physical culture by massaging their feet in an elevated position. Drivers, office workers should walk around the break.
The simplest exercises can be performed at work:
- barefoot on the floor you alternately stand on your toes and heels;
- sitting on a chair, lift your legs and make circles with your feet in one direction and then in the other.
Morning exercises should include exercises in the supine position: alternately lifting the legs, "bikes", shaking the raised legs. Exercises with squats, bent knees are not appropriate.
Fans of strength training should reject them. Swimming, cycling and hiking are the most popular.
Choosing a balanced diet
Limit all foods that increase weight, encourage fluid retention and increase blood viscosity.
Fatty meat 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 is shown instead of butter, nuts.
Vein support methods
Wearing compression stockings or golf is recommended to improve blood flow. Sizes are wearable while lying on your back.
Silicone-filled treads are advertised as a drug that creates an electric charge on the surface of the foot.
Experts pay attention to the possible impact of these aids only in the initial stage of the disease. In the presence of superficial nodules and edema on the legs, their use is completely useless.
Use of drugs
Drug treatment consists of taking drugs from the "venotonic" group orally in a therapeutic dose selected by the doctor. They help relieve fatigue, discomfort in the feet, but they do not eliminate the disease.
Surgeons attribute varicose vein medications to background 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 surgery
Low-trauma methods of treating varicose veins allow you to avoid surgery and are rightly in the first place in terms of effectiveness. They do not require an incision in the skin, can be performed in a polyclinic and are practically painless. The patient is not limited in terms of work, movement. 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 motion.
Action of the method: the bundle causes a pronounced burn of the inner mucosa of the vein, additionally hardening. The intervention lasts 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 with subsequent scarring. Foam preparations that fill the lumen of the diseased vein quickly and safely are especially recommended. The method is applied 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 is made in the skin of a few mm, through which the diseased vein is caught with a hook, pulled to the surface of the skin and cut out. 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 socks for 10 days.
Radiofrequency ablation method
It is performed similarly 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 a laser. After 30 minutes of microwave exposure, the vessel lumen was sealed. After 7 days the rehabilitation is considered complete. You can play sports.
In which cases is surgery indicated?
With unsuccessful treatment with conservative methods and the inability 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 veins are tied on both sides, pulled out and removed. Sutures are applied to the incisions. The patient is treated in the hospital for a week. Drugs that reduce blood clotting are used. Sutures are removed after at least 7 days.
Phlebectomy is not performed:
- in the patient's age;
- with severe damage to the deep and superficial veins;
- during pregnancy;
- with atherosclerosis of the blood vessels of the legs, diabetes mellitus;
- if there are skin diseases at the site of the proposed surgery.
Prevention methods
Prevention of varicose veins of the legs is first and foremost necessary for people with risk factors in the profession.
More hiking is recommended. There is a massage and strengthening of the vein walls.
During breaks, sellers and hairdressers are shown a foot and lower leg massage. It is done in slow, smooth movements in the direction from the fingers to the knees and along the thigh. The wrists are massaged in a circular motion to the central fossa of the foot.
Drivers have to get out of the car, walk, stretch their legs. Leg exercises are shown.
Fashion should consider the consequences before getting into heels and wearing tight clothing.
You can make contrasting foot baths or showers at home. On tired legs put a compress 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.