Varicose veins of the lower limbs, according to information communicated to medical institutions, are found in one in five men and 28% of women of working age.
If we consider the entire population, half of adults will present with 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 who are engaged in manual labor, taking long walks.
Why are the veins of the legs loaded?
The anatomical structure of the venous wall is characterized by a strengthened muscular skeleton and a valve apparatus. The opportunity lies in the need not only to keep the blood flow in a person's upright position, but also to organize its rise against gravity in the direction of the heart.
The valves block the return to prevent overflows at the points farthest from the body. This "uncomfortable" place is that of the legs and feet.
The mechanism of formation of varicose veins of the legs
At 40 years of age, the human body begins to synthesize in a limited way plastics, the main one of which is collagen protein. It is essential for good venous valve tone. Absence results in loss of tone, sagging, and an inability to delay reverse blood flow and the overlying mass.
The venous network of the legs consists of superficial vessels located 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 manifests itself in areas with thin dilated veins, visible to the eye as a fine mesh.
The further development of the pathology leads to retention of blood at the periphery and causes tissue edema (flow of fluid through the walls of the veins), malnutrition (the flow of toxins is reduced, oxygen and nutrients are retained. through compressed arteries).
How Complications Join
The stagnation of venous blood in the legs causes a slowing of blood flow through the vessels, which creates favorable conditions for the aggregation (adhesion) of platelets. Blood clots complicate an already compromised blood supply.
The risk of the embolus rupturing and its movement through the large vessels to the heart increases. If a person has defects associated with the communication of the right and left chambers, it is possible that an embolus enters 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 venous wall, followed by the development of phlebitis or thrombophlebitis.
Causes of the disease
For varicose veins of the lower extremities, there is only one reason independent of a person - a genetic deficiency in the structure of collagen. It manifests itself not only in varicose veins, but also in the relatively early signs of skin aging (dryness, deep wrinkles).
Other reasons are related to the activities and behavior of people.
- Reduced physical activity or, on the contrary, heavy physical labor leads to a violation of the tone of the veins of the legs.
- Prolonged forced standing, sitting during working hours causes stagnation of blood in the legs and impaired discharge.
- Pregnancy puts increased pressure on the pelvic organs and large veins, preventing drainage from the lower veins.
- Doctors in Asian countries associate the growth of varicose veins in the legs in patients with an addiction to the European habit of sitting in a chair or chair instead of bending the knees.
- A high and comfortable toilet requires increased tension of the muscles of the abdominal wall during a bowel movement, the exertion contributes to the stagnation of the legs. While squatting, the act of defecation 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 shoes cause inappropriate stress on the muscles of the legs and disrupt the tone of the veins.
- Common pills, hormonal contraceptives, treatment with hormonal drugs for menopause, osteoporosis lead to impaired 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
Considering the listed reasons for the development of venous pathology, the group of people with an increased likelihood of developing varicose veins of the legs should include:
- people professionally associated with an extended stay in a standing or sitting position (salespeople, teachers, hairdressers, drivers, office workers);
- women who prefer skinny jeans, shapely underwear and high-heeled shoes;
- people involved in weight lifting and bodybuilding;
- people 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;
Preventive measures are necessary for these populations.
The first symptoms of varicose veins in the legs are noticeable at a young age. At the initial stage, they appear with increased stress on the legs:
- at the end of the shift, pain appears in the feet and legs, muscle fatigue;
- when changing shoes, swelling of the feet is noted due to the tightness of the shoes;
- in the evening the feet "burn", you want to soak 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 calf cramps, walking cramps are possible;
- brown 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, an increase in body temperature, you need to think about thrombophlebitis.
In diagnosis, it is customary to distinguish between true (primary) varicose veins, depending on the lesion of the valve apparatus, and secondary varicose veins, resulting from trauma and tumors.
Polyclinic surgeons, vascular surgeons, phlebologists participate in the examination. The doctor sees subcutaneous venous nodes, vascular networks, skin pigmentation, early 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 will show the appearance of inflammation (leukocytosis, accelerated SV), a tendency for thrombus formation according to a coagulogram.
Vascular ultrasound allows you to monitor blood flow, the function of venous valves, and detect blood clots.
Doppler examination makes it possible to check the structure of the veins, to make a diagnosis at the initial stage of the disease.
The spiral computed tomography method is performed in case of diagnostic difficulties. It makes it possible 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 of the legs at the initial stage. To do this, you will need to think about the necessary changes in habits, nutrition, and movement.
In order not to swell the legs at the end of the working day, "sedentary professionals" and "standing" people are advised to take breaks from physical culture or warm-ups with massage of the feet in an elevated position. Drivers and office workers must walk around during breaks.
The simplest exercises can be done at work:
- barefoot on the floor, standing alternately on toes and heels;
- sitting on a chair, raise your legs and make circles with your feet in one direction, then in the other.
Morning exercises should include exercises while lying down: alternate leg lifts, "bicycles", shaking the raised legs. Exercises with squats with bent knees are not suitable.
Bodybuilding enthusiasts should refuse them. The most illustrated are swimming, biking and hiking.
Selection of a balanced diet
Limit all foods that increase weight, promote fluid retention, and increase blood viscosity.
Fatty meat and dairy products, spicy and salty foods, canned foods, sweets, baked goods, 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 indicated instead of butter, nuts.
Venous support methods
Wearing compression or golf stockings is recommended to promote blood circulation. They are sized to be worn lying on your back.
Silicon-filled treads are touted as a remedy that creates an electrical charge on the surface of the foot.
Specialists pay attention to the possible impact of these aids only at the initial stage of the disease. In the presence of superficial lymph nodes and edema on the legs, their use is completely unnecessary.
The use of medication
Drug treatment consists of taking drugs from the group of "venotonics" orally at a therapeutic dose chosen by the doctor. They help relieve fatigue, discomfort in the feet, but they do not eliminate the disease.
Surgeons attribute drugs for varicose veins to the conservative background treatment, 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 only in 5% of patients.
Regarding minimally traumatic operations
The minimally traumatic methods of treating varicose veins allow you to avoid surgery, rightly number one in terms of effectiveness. They do not require a skin incision, can be performed in a polyclinic and are practically painless. The patient is not limited 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 vein and a circular laser beam is turned on during the reverse movement.
Method of action: the beam causes a pronounced burning of the inner wall of the vein, further hardening. The duration of the operation is approximately two hours. The method is applicable in the treatment of veins of any size.
A substance is injected into the affected vein which can cause the walls to collapse with subsequent scarring. Especially recommended are foam preparations, which quickly and safely fill the lumen of the diseased vein. The method is applicable when the diameter of the vessel reaches 1 cm. After the introduction, it is necessary to walk for an hour. Phlebologists recommend wearing compression socks for another month.
Under local anesthesia, an incision is made in the skin of several mm, through which a diseased vein is grasped by a hook, brought to the surface of the skin and excised. The method is suitable for venous lymph nodes of any size and diameter. A small scar will remain at the incision site. You must wear socks or compression stockings for 10 days.
Radiofrequency ablation method
It is performed similarly to 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 rehabilitation is considered complete. You can play sports.
In which cases is the operation indicated?
With unsuccessful treatment by conservative methods and the inability to use 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 out and pulled out. Sutures are applied to the incisions. The patient is treated in a hospital for a week. Medicines that reduce blood clotting are used. The stitches are removed after at least 7 days.
Phlebectomy is not performed:
- in the old age of the patient;
- with massive damage to the 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.
The prevention of varicose veins in the legs is above all necessary for people with risk factors in the profession.
Walking more is recommended. There is a massage and strengthening of the walls of the veins.
During breaks, vendors and hairdressers have their feet and shins massaged. It is done with slow and fluid movements in the direction of the fingers towards the knee and along the thigh. The knuckles of the fist are massaged in a circular motion to the central fossa of the foot.
Drivers must get out of the car, walk around, stretch their legs. Exercises for the legs are shown.
Fashionistas should think about the consequences before putting on high heels and wearing tight clothes.
At home, you can do contrast baths or foot showers. Apply a compress to 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.