Varicose veins (knotted veins in the lower legs)– this is damage to the vein wall of the lower leg, weakening the venous valve, which leads to impaired blood flow and blood stagnation. Venous valve function is impaired, causing blood to flow back and stagnate. The vein wall expands, becomes thin and ruptures. Over time, blood clots form, which can block the vessels and lead to a stroke or heart attack. Women are most often at risk of developing varicose veins, but men can also develop them. The age of the disease is from 20 years and above, sometimes varicose veins can occur in adolescence. Varicose veins are most often caused by a sedentary lifestyle and professional characteristics, but the disease can also start from other factors.
Causes of varicose veins
Veins in the body are important for blood circulation and the transport of nutrients from tissues to the heart. In the area of the lower leg, this network is laid out in the form of deep or superficial veins, which are connected to each other by an emergency blood drainage system. Basically, most of the load falls on the deep veins, because they are larger and stronger. Superficial veins do about 15% of the work.
The heart is needed to pump and move blood through the veins, and some of the blood moves through the veins against gravity due to the work of the surrounding muscles during walking and other movements. When the muscles are relaxed, the person moves a little or stands, the blood returns to the bottom under the influence of gravity. But thanks to a special valve it is held in place.
If the valve cannot cope with its function, the veins begin to expand and become inflamed, they cannot hold the blood. For this reason, stagnation of blood circulation occurs, veins expand and rise above the skin.
Blood circulation is disturbed and varicose veins occur. The causes of varicose veins can be:
- absence, defect or damage to the venous valve - the return flow of blood into the legs is disturbed, blood stagnates in the veins and they stretch;
- fixed in a vertical position - often hairdressers, teachers, salesmen and others with high costs suffer from varicose veins;
- overweight and obesity - heavy weight puts pressure on the lower limbs, as a result of which veins dilate and varicose veins occur;
- bowel disease, constipation - creates intra-abdominal pressure, which leads to varicose veins;
- Flat feet;
- pregnancy - the uterus with the fetus creates additional pressure on the legs, which causes varicose veins;
- lifting weights - excessive physical activity causes dilation of veins and stretching of blood vessel walls;
- Professional sports - running, jumping, tennis - cause varicose veins due to constant pressure on the lower part of the legs.
Varicose veins in the legs can be caused by previous injuries and surgeries on the lower legs. In old age, almost everyone has varicose veins, because the valves become weak and work poorly. They become inelastic and very stretchy.
symptoms
In the early stages, the veins located under the skin expand. If you establish venous circulation immediately, then other complaints will not arise.
If the disease continues, the following symptoms appear
- fatigue quickly;
- a feeling of heaviness in the lower part of the leg;
- calf muscle cramps (most often appear in the evening and at night);
- There is tingling and numbness in the legs.
With the further development of the disease, trophic disorders begin, which are most often concentrated in the area of the inner surface of the lower legs.
Symptoms of trophic disorders
- thickening of the vein wall is formed;
- skin hyperpigmentation occurs in places;
- skin atrophy;
- dermatitis is a disease characterized by inflammation of the skin;
- in the final stages of the disease, trophic ulcers may develop, which are practically untreatable.
In the chronic form of varicose veins, symptoms appear in the form of swelling on the lower part of the leg during prolonged standing. After resting overnight, the swelling usually disappears completely.
Varicose veins in men's legs
Varicose veins in men's legs occur in 32% of cases. Most often, this disease is observed at the age of 45 and above. Men's varicose veins occur for the same reason as women - due to the heavy load on the lower limbs. It is less common, because this is due to the peculiarity of the structure of the male body. However, due to smoking and heavy stress, varicose veins in men are observed already in middle age.
The development of varicose veins in men on the legs is associated with a loss of elasticity and tone of the vascular wall due to several reasons:
- professional characteristics - sedentary work, staying in one position for a long time, standing work, heavy lifting;
- overweight;
- fatty and unhealthy foods that negatively affect the walls of blood vessels;
- liver disease: hepatitis and cirrhosis;
- metabolic diseases, diabetes;
- active sports, bodybuilding, heavy physical activity;
- arterial hypertension;
- hereditary factors;
- smoking and alcohol.
This disease can last for several years. Initially, a man may experience pain and swelling in his legs in the evening or after being in an upright position for a long time. At a later stage, varicose veins in men on the legs cause hair loss and burning in the painful area, itching in the vein nodes. Due to poor skin nutrition, trophic ulcers occur that are itchy and painful. It becomes more difficult for the patient to walk, then the mobility of the limbs is lost. There is loss of sensation and numbness in the legs.
Leg ulcers due to varicose veins
Leg ulcers are the most dangerous consequence of varicose veins. They are localized on the inner surface of the lower third of the foot, in the supramalleolar area. Before their appearance, dermatitis occurs, which is accompanied by eczema and severe itching. Ulcers can be single or multiple, often flat, with a smooth bottom, uneven edges, flat, with little discharge, serous or purulent. Trophic ulcers are difficult to heal and can grow in size. They become more painful when they trap fibers. Over time, induration of the subcutaneous tissue increases.
Trophic ulcers occur with characteristic symptoms; it's hard to miss. At the site of future ulcers, the skin becomes dense, red and swollen, and increased pigmentation may occur. Ulcers on the legs with varicose veins itch and itch, causing excruciating pain. Can be dangerous due to blood poisoning and amputation. How to treat ulcers with varicose veins should be decided by a phlebologist after a comprehensive diagnosis of the veins.
Symptoms of varicose veins in the legs
Manifestation of symptoms of varicose veins on the legs depends on the stage of development of the disease:
- Stage 1 - some noticeable cosmetic defects, the pain is practically not bothersome.
- Stage 2 - heaviness, fullness, pain, cramps during sleep.
- Stage 3 - the formation of edema, a feeling of fullness, thickening of the skin and subcutaneous tissue, the formation of dark spots.
- Stage 4 - the appearance of trophic ulcers, burning and itching, severe pain, protruding veins, changes in gait, difficulty walking.
The most common symptoms of varicose veins in the legs include the following:
- heaviness and fatigue in the legs, cramps in the calf muscles during sleep and after waking up;
- dull, arching pain in the calf, aggravated by prolonged standing and relieved by lying down;
- burning and itching in the legs in the evening;
- severe fatigue with light loads and short walks.
Another major symptom of varicose veins is that the veins become less noticeable when a person lies down or raise their legs and become larger when standing, especially when standing for a long time.
Varicose veins in the legs cause swelling of the soft tissues in the legs, ankles and lower legs. Most often it appears in the evening after a working day. Swelling can occur in people who spend a lot of time standing and those who are overweight. Comfortable shoes begin to squeeze in the evening and become tight. When you are in one position for a long time, your feet immediately swell or swell. You can check for leg swelling yourself. To do this, you need to measure the circumference of your shin with a tape measure: the narrowest part of the shin - the place above the ankle and the widest part - the calf muscle. You need to measure 2 times a day: in the evening before going to bed and right after you wake up. If in a few days the circumference of the calf changes by more than 1 cm, then there is a reason to check your channels and veins.
If varicose veins are not treated, the disease develops and new symptoms appear. Due to poor nutrition of the tissues of the lower part of the feet, trophic ulcers occur on the skin of the feet and legs. First, the skin begins to thicken and spots appear in the form of dark spots. The skin becomes dry, bluish in color, and swelling may occur. With the development of varicose veins, trophic ulcers may appear, which itch and itch unpleasantly.
Complications
Varicose veins are a serious disease, because they can cause several consequences: eczema, skin ulcers, severe venous bleeding due to injuries on the lower part of the legs, thrombophlebitis.
Thrombophlebitis is very dangerous, because blood clots form in the vessels and can break at any time. Pulmonary artery occlusion is fatal.
Varicose veins of the lower part can lead to diseases such as
- hemorrhoids – a disease characterized by rectal varicose veins;
- varicocele - varicose veins of the spermatic cord;
- Portal hypertension is a syndrome in which the pressure in the portal venous system increases.
With varicose veins in the legs, it becomes difficult to walk, and at a later stage the person becomes disabled.
Treatment of varicose veins on the legs
The nature of treatment for varicose veins in the legs depends on the stage of the disease and symptoms. There are many procedures in which varicose veins are taped, sealed, and removed. The most common methods are:
Sclerosis
A procedure in which the doctor attaches small vessels to remove the "star". A special substance is injected into the vein to glue the vein walls together. After some time, these veins form cords and resolve. Sclerotherapy is a painless method and takes place without anesthesia within 15 minutes.
Phlebectomy
If varicose veins require radical treatment, then surgical intervention is used. Varicose vein surgery involves removing the vein. To do this, a procedure called phlebectomy is performed - this is a surgical operation in which the saphenous vein is removed. This helps prevent pressure on the deeper layers of the veins.
Endovascular laser coagulation
The next vein removal method is endovascular laser coagulation. Modern treatment methods, the essence of which is the effect of thermal energy of laser radiation. The laser only affects the area of the vein wall, without affecting nearby tissues and nerve endings. Under the influence of radiation, the vein closes and is excluded from the blood stream. The procedure is performed using local anesthesia and without hospitalization. An ultra-thin laser light guide is inserted into a vein through a skin puncture. This procedure provides good results and is popular due to the possibility of outpatient treatment and quick recovery.
Conservative treatment
In some cases, conservative treatment is used with medications prescribed by your doctor. It is suitable for patients who are contraindicated for surgery, with a lack of deep vein valves, with varicose veins at an early stage, who only have cosmetic defects, and who refuse to undergo surgery.
Medicines for the treatment of varicose veins are divided into several groups:
- phlebotonics
- anticoagulants
- anti-edema drugs
- separator
- during trophic changes
- antioxidants
- non-steroidal analgesics;
- fibrinolytic
The patient should wrap the lower part of the leg with an elastic bandage or wear elastic stockings, periodically raise the leg above the level of the heart, and perform preventive exercises for the leg and lower leg to improve blood circulation in the leg and eliminate venous stagnation. blood.
Treatment of varicose veins in men involves wearing special compression garments, exercising regularly, maintaining a proper diet, and avoiding alcohol and smoking.
Treatment for varicose veins in the legs involves following a diet to lose excess weight and reduce swelling and tension in the legs. It is necessary to give up salt and sugar and reduce fluid intake. It is necessary to include foods with vitamins P, C, E, protein, and microelements in your diet to strengthen the vascular walls. Smoking and drinking alcohol are prohibited, as they stretch the walls of blood vessels and affect patency.
In the early stages of the development of varicose veins and during treatment, it is necessary to regularly perform a complex of therapeutic exercises. Exercise should be done in compression clothing at a leisurely pace until you feel tired. In this case, jumping, running, dancing, ballet, aerobics and steps are excluded, because they increase the load on the veins in the legs. You can't do strength training or lift barbells or dumbbells. Lifting weights of more than 3-5 kg is excluded. Exercise in the pool, exercise bike with back support, and cycling will be very useful. You can do normal walking on a treadmill. Walking outdoors at a brisk and slow pace is best.
After vein treatment and surgery, precautions should be taken. Wear the right shoes, high-heeled shoes are excluded, platforms should not be higher than 4 cm. To improve blood circulation, you must always wear class 1 or 2 compression garments, depending on the stage of development of varicose veins in the legs. . It is better to wear it during winter, because it is more comfortable and convenient. It is recommended to give preference to high socks and tight pants, because knee socks will pinch your legs at the knees.
Laser treatment of varicose veins
For varicose veins, endovenous laser coagulation can be prescribed - laser surgery and echo sclerotherapy. Some patients are shown vein removal surgery dilated under local anesthesia through a puncture right on the surface of the skin - miniphlebectomy. Microsclerotherapy can be used to remove spider veins and intradermal veins.
Laser energy is absorbed by the hemoglobin of red blood cells and in a second is converted into heat (95-100 degrees), which leads to boiling of plasma and blood elements, causing thermal burning of the endothelium - vein walls. A dense blood clot is created at the site of laser exposure, then the vein dissolves and becomes invisible. If the vessel is large and located in several layers, the procedure must be repeated after a month.
Varicose vein treatment with laser refers to a surgical method, which is comparable to the method of treating the disease without surgery due to its low invasiveness, absence of general anesthesia, and strict local exposure of the laser only to the varicose vein wall. .
Laser surgery is performed using an ultrasonic duplex scanner. The doctor inserts a thin light guide through a skin puncture into the lumen of the vein. Certain laser wavelengths, which are partially absorbed by the dilated vein wall, close the diseased vein. The clinic uses a new generation laser that selectively affects the vein wall without damaging the surrounding tissue.
There are several advantages of laser treatment for varicose veins:
- outpatient treatment - patients do not need hospitalization and can immediately go home after the procedure;
- local anesthesia is used - general anesthesia or spinal anesthesia is not required;
- short duration of the procedure - laser treatment is performed in 60-90 minutes, after which the patient can go home;
- lasting cosmetic effect - after removing varicose veins with a laser, there is no permanent effect on the skin; sometimes dark skin stripes may appear, disappear after 2-3 months.
After laser surgery for varicose veins, it is necessary to ensure compression of the treated varicose veins.
To do this, the patient wears compression stockings. They are thin, elastic and maintain the required level of pressure for a long time. A special latex pad or cotton roll is placed in the area where there are large varicose veins. Immediately after the treatment procedure, the patient must walk at least 4-5 kilometers. Walking should be fast and fast so that the blood begins to circulate well and the veins develop. After laser surgery, in the first days you must walk for an hour every day.
After laser treatment of varicose veins, it is necessary to regularly undergo vascular diagnostics. Therapeutic gymnastics, walking, swimming, cycling are shown. It is worth giving up running, jumping, strength training at the gym, lifting weights, dancing, and any type of martial arts. Gymnastics should be done every day at a moderate pace, with rest breaks. The goal is to reduce blood pooling in the veins, but not to pump the legs, so you can't overwork. After the class, you need to lie with your legs raised at an angle of 90 degrees for a few minutes.
Radio frequency freezing
Another way to remove varicose veins is radio frequency freezing. The essence of the method is that the vascular wall of the vein is exposed to radiofrequency radiation. Since the main goal is to stop the blood flow, when using this method, the vein is, as it were, welded under radiation. Gradually, the veins disappear and disappear completely within six months to one year. The advantage of this method is the complete absence of surgical intervention, as well as the possibility of carrying out the procedure for any concomitant pathology. This technique has no systemic effect on the patient's body.
Since the most difficult consequence of chronic venous insufficiency is trophic ulcers, their treatment is carried out comprehensively, including the method of endovenous laser coagulation, scleropathy and miniphlebectomy. Local treatment is often carried out, which consists of surgical debridement of the ulcer and skin grafting on the affected part of the body. For this complication, experts prescribe the following drugs:
- Phlebotonics are drugs that have a positive effect on the vein walls and have a tonic effect. They come in different forms (ointment, gel, tablet);
- antihistamine - to block histamine receptors;
- antibiotics – to stop and control the inflammatory process in the body.
Compression therapy is used to relieve heaviness, swelling and pain in the lower leg when walking. Wearing special underwear made of compression knitwear and bandages made of special bandages will help significantly reduce the course of the disease and prevent the spread of further complications.
How to treat varicose veins on the legs at home
Varicose veins require physical activity, but it should be gentle, so strength training, weight lifting in the gym, running, jumping and dancing are excluded. The most effective method is regular walking, which improves muscle function and blood circulation in the vessel. During breaks at work, you can do simple exercises for varicose veins. Rise 20 times on your toes, lifting your heels off the floor. This exercise will help get rid of varicose veins, because it acts like a pump and increases vascular tone. At the end of the day, try to keep your feet elevated or on a pillow. It is useful to do "bicycle" exercises or exercises on an exercise bike with back support.
You should exercise gently, excluding running, jumping, lifting barbells and dumbbells, strength training, squats and deadlifts at the gym. The most effective and health-promoting sports are swimming, swimming, walking and cycling. Swimming trains the blood vessels of the legs, while being gentle on the lower limbs, unlike running and strength training. It helps to remove swelling, heaviness in the legs, improve vascular tone and remove cosmetic defects.
Every day it is necessary to perform a set of therapeutic exercises for the legs to remove swelling, improve blood circulation, and strengthen the vascular walls. Exercise should be done until your legs feel tired. After the gymnastic complex, you need to rest and lie with your feet on a pillow or armrest on the sofa. It is useful to complete the exercise with a contrast bath or foot bath.
It is important to follow a proper diet. It is necessary to exclude salty, hot and spicy foods, smoked, fatty, fried, flour and sweet foods, because they destroy the walls of blood vessels and retain fluid in the body. It is forbidden to drink alcohol and smoke to avoid the formation of blood clots in the vessels. The diet should be rich in foods with vitamins C, B, E, protein, microelements: citrus fruits, sour berries and fruits, nuts, seeds, herbs, vegetables. For drinks, it is better to give preference to fruit drinks, jelly, green tea and herbs. Sugar should be replaced with honey.
It is useful to take juice day 2 times a week, after consulting your doctor to find out if you have any stomach disease.
Prevention of varicose veins
Since varicose veins are most often caused by blood pooling in the legs, put your legs at home behind the sofa or on a low table or chair. This relieves fatigue and tension in the legs. Before going to bed, place a pillow or a folded blanket under your legs to elevate your legs slightly.
Varicose vein prevention includes losing weight, as excess weight puts extra pressure on the legs. Women cannot carry more than 3 kilograms in one hand. You need to give up tight clothes and shoes, tight socks and stockings. Heels should not exceed 4 cm. They create obstacles to normal blood circulation. Compression knitwear trains and corrects veins well, increasing their tone. Underwear should be purchased at a pharmacy or specialty store.
Sedentary work requires regular warm-up, stretching, and it is useful to get up and walk. If possible, place a low stool under your feet, this will increase blood flow. Walk more often, do regular exercise, swim and climb stairs. This will prevent the development of varicose veins and improve muscle tone.
To avoid varicose veins, it is necessary to follow preventive measures. You should try to minimize hot baths, saunas and steam rooms, as well as prolonged exposure to the sun. This will help reduce venous tone, which leads to blood stagnation in the legs.
To prevent varicose veins in your legs, avoid wearing tight-fitting items such as stockings or stockings with tight elastic bands, as they put too much pressure on the veins and can cause poor circulation and dilation. High heels are excluded; shoes for every day should not be higher than 4 cm. Shoes with heels can be worn for festive events.