Varicose veins in the legs (varicose veins - common name) - externally visible enlargement of the saphenous veins, which develops as a result of varicose veins or post-thrombotic syndrome and is accompanied by a sharp violation of venous outflow in the lower extremities.
Modern methods make it possible to radically treat varicose veins without incisions and pain.
Complaints of varicose veins
For many people, varicose veins and spider veins are just a cosmetic problem. In others, varicose veins cause aching pain and discomfort. Sometimes varicose veins lead to more serious problems and complications - thrombophlebitis or the appearance of trophic ulcers. Treatment involves removing or closing the deformed veins, which is the job of a phlebologist.
Varicose veins are a complete degeneration of the venous wall, associated with the weakness of its connective tissue (varicose veins of the lower extremities), or developing with a sharp violation of venous outflow, due to blockage or overflowveins.
Causes of varicose veins of the lower limbs
Varicose veins of the lower limbs
The disease, as the cause of varicose veins of the legs, affects 20-40% of the population of the developed countries of the world. For a long time, varicose veins are only a cosmetic defect, but the progression of the disease leads to pain, swelling of the feet and legs and, in advanced stages, darkening of the skin of the legs, inflammatory changes andvaricose trophic ulcers.
Hereditary predisposition is the main cause of primary varicose veins, however, the disease develops with excessive stress on the veins. The trigger mechanism of varicose veins of the lower limbs is acute physical overstrain, pregnancy and childbirth. In this case, there is a sharp increase in pressure in the veins of the lower extremities and damage to the valvular apparatus, which triggers the mechanism of the development of the disease.
Post-thrombophlebitic disease
Secondary varicose veins develop after venous thrombosis or as a result of congenital diseases (arteriovenous fistulas, congenital venous dysplasia). Post-thrombotic disease is a complex progressive pathological process in the venous system of the lower extremities. Due to valvular insufficiency or blockage of the deep veins, the saphenous veins dilate as they overflow with blood. Another cause can be a congenital or acquired arteriovenous fistula. Sometimes a congenital obstruction of the deep veins occurs, leading to secondary varicose veins (Klippel-Trenaunay syndrome).
Complications of varicose veins
More than 40% of women and 20% of men have dilated and swollen varicose veins. In 20% of cases, varicose veins lead to the appearance of a trophic ulcer, more than 25% of patients suffer from thrombophlebitis of varicose veins. These complications often require serious treatment and pose a great threat to health.
Chronic venous insufficiency
Obstruction of venous outflow causes a medical condition called chronic venous insufficiency. At the very beginning of the disease, the appearance of single nodules of dilated veins can be noted, which do not cause much concern, although sometimes they can hurt. Subsequently, there is an increase in the number of varicose veins. The disease progresses slowly but steadily. If the first varicose veins appeared below the knee, the rate of development of the disease is much higher. If the disease is not stopped, the third stage of venous insufficiency gradually develops. Edema becomes permanent, a dark color of the skin appears in the ankle area, heaviness in the legs is constantly worried, which can persist even after a night's rest. Often develop thrombophlebitis of varicose veins and inflammation of the skin, eczema and dermatitis. The final stage in the development of varicose veins is the appearance of trophic ulcers.
Varicose thrombophlebitis
Thrombophlebitis is the most common complication of varicose veins. Thrombophlebitis is an inflammation of the vein wall, with the formation of blood clots in the lumen of the vein. Thrombophlebitis occurs in superficial and deep veins. With varicose veins, thrombophlebitis occurs in 25% of patients and is usually superficial. The cause of thrombophlebitis in varicose veins is very slow blood flow, especially in large nodes. In these conditions, any factor that increases blood clotting (pregnancy, heating, trauma, sprain, hypothermia and scratches, acute respiratory infections) can lead to the formation of a blood clot in the varicose vein and its inflammation. Thrombophlebitis occurs in 25% of patients with varicose veins of the lower limbs. The cause of thrombophlebitis is the slowing of blood flow in the varicose veins. Thrombophlebitis can progress and lead to deep vein thrombosis. Chronic venous insufficiency is a painful condition of venous flow with varicose veins. It is characterized by edema, darkening of the skin, the appearance of trophic ulcers and varicose dermatitis.
Varicose trophic ulcer
A trophic ulcer is a sign of an extreme degree of chronic venous insufficiency. This is a long-term non-healing wound that occurs with a severe violation of venous outflow through the deep and superficial veins. It occurs in 1% of the general population and in 20% of patients with venous disease. Every fifth patient with varicose veins who does not receive treatment sooner or later develops a trophic ulcer. It can develop both with varicose veins and with secondary varicose veins. Without the elimination of pathological venous discharges, a varicose trophic ulcer does not heal or constantly reappears. Trophic ulcers with varicose veins occur in most patients and cause severe suffering. Modern minimally invasive methods allow you to reliably remove trophic varicose ulcers without incisions and pain.
Venous thrombosis and thromboembolism
Pulmonary embolism is a serious complication of venous thrombosis. Varicose veins are an important risk factor for thrombophlebitis and deep vein thrombosis. Thromboembolism leads to the development of severe cardiac and respiratory failure, with a mortality rate of over 50%.
Prevention of varicose veins of the lower limbs
Every modern person should understand what varicose veins in the legs are, how to treat and prevent their occurrence. With a hereditary predisposition, factors contributing to varicose veins should be avoided. The use of venotonic drugs, wearing compression stockings during exercise, periodic examinations by a phlebologist and ultrasound of the veins are shown.
When working under conditions of concomitant factors, it is necessary to use compression stockings of the 1st class of compression at work, therapeutic exercises, outdoor activities, daily walks of at least 1 hour in stockingsmedical, a foot massage and swimming. Refusal to use oral contraceptives with complicated inheritance of varicose veins. It is better to adhere to these simple rules than to treat varicose veins on the legs.
Avoid producing factors during intense physical labor. For this, compression stockings are necessary, especially with a predisposition to varicose veins. Medical knitwear is indicated for all pregnant women, and in case of a predisposition to varicose veins and thrombophlebitis, special compression stockings are worn for childbirth. All pregnant women are advised to consult a phlebologist and perform an ultrasound of the veins in the last weeks of pregnancy. This will help reduce the risk of problems with the venous system.
How to treat varicose veins in the legs
In the past 10 years, "barbaric" methods of treating varicose veins are a thing of the past, thanks to the emergence of more gentle and effective methods that are successfully used in clinics.
Venous sclerotherapy for varicose veins
Sclerotherapy is the introduction into the lumen of a varicose vein of a drug that causes the "sticking" of the walls with the disappearance of the veins. For sclerotherapy, a number of chemicals are used, there have been attempts at treatment with ozone. At one time, the appearance of foam sclerotherapy revolutionized phlebology. For the first time, an effective method of treating varicose veins without major surgery has appeared. Currently, foam sclerotherapy is used to eliminate varicose veins of medium diameter after laser obliteration of pathological venous discharges. Sclerotherapy is indispensable in the treatment of spider veins and reticular varices, where it has no real competitors.
Treatment of varicose veins with a laser
Laser treatment of varicose veins of the lower extremities (EVLT) is the most modern, radical and inexpensive method of treatment that allows you to both treat varicose veins on the legs and eliminate the causes of trophic ulcers. The meaning of laser treatment lies in the thermal heating of the vein wall from the inside and the subsequent resorption of the varicose vein. The latest achievement in EVLT is a 1470 nm laser and a radial light guide, which have been introduced into medical practice by phlebologists. The postoperative period after this technique is completely painless, and the result is superior to other treatment options - the radicality of laser intervention is at least 98%.
Surgery to remove varicose veins
Surgical treatment of varicose veins with removal of the main venous trunks is a thing of the past. The risk of complications from stem vein removal has forced phlebologists to seek other approaches, leading to the development of laser techniques and other methods of thermal vein obliteration. However, the modification of the classical phlebectomy into a microphlebectomy according to Müller and Varadi allowed a marvelous combination of laser treatment and removal of large varicose veins by punctures without incisions or sutures. Varadi's technique has saved patients from painful sclerotherapy of large varicose veins. Miniphlebectomy allows you to both treat varicose veins in the legs and eliminate visible varicose veins anywhere on the body.
Radiofrequency obliteration of varicose veins
Radiofrequency obliteration (RFO) of varicose veins of the legs is a modern and safe method of treatment. The method is based on the use of microwaves that heat a metal probe, which already constitutes the wall of the vein and causes the destruction of the internal membrane. In terms of painlessness, the method corresponds to laser coagulation with lasers at a wavelength of 1470 nm, it is easy to perform and painless postoperatively. However, RFO is far inferior to laser in terms of long-term treatment results. The effectiveness of RFO is 85% without recurrence. The method is not suitable for the treatment of perforating veins.
Massage and bath for varicose veins
Massage is a method of active treatment of varicose veins.
All types of modern massage are used, especially in the pathology of the lymphatic and venous systems. Among the exclusive methods is the technology of lymphatic drainage massage with bandages, which very effectively relieves chronic venous insufficiency.
In chronic venous insufficiency, massage is used to eliminate venous hypertension in varicose veins and post-thrombotic syndrome. The combination of this massage with a bandage allows you to effectively eliminate all clinical manifestations of the disease.
Bathing with varicose veins, thrombophlebitis or post-thrombotic disease is very dangerous. Any heat stress can cause blood clots to form in the deep veins with all the ensuing consequences.
Unfortunately, it is impossible to achieve complete healing of varicose veins without eliminating venous discharge and varicose veins. Although the reduction of symptoms associated with stagnation of venous blood in the legs is quite possible with the help of modern therapy. However, the prevalence of varicose veins and chronic venous insufficiency sometimes makes one want to speculate on this problem. Consider modern methods of treatment and deception.
Medicines for varicose veins
The goal of drug therapy for venous pathology is to reduce symptoms and prevent complications, but these goals are not easy to achieve. Today, the profusion of means that can be implemented poses another problem: which one to choose? Unfortunately, most of the proposed drugs have rather low effectiveness, despite the theoretically justified expediency of use. This is due to a number of reasons, the main of which is the low absorption of medicinal substances from these drugs by the body. An ideal drug for the treatment of venous insufficiency should affect as many pathogenetic links of chronic venous insufficiency as possible, while having a minimum number of side effects and high absorption by the body. A fairly large number of venotonic agents are represented on the modern pharmaceutical market. However, they have similar medicinal substances (plant flavonoids) and therefore the effectiveness of one or the other only depends on the concentration and digestibility of the active ingredient.
The disappearance of varicose veins from these drugs should not be expected, however, lightness in the legs, a decrease in edema and the disappearance of night cramps can be.
Creams and gels for varicose veins
Despite the high efficiency promoted by sellers and manufacturers, creams and gels do not relieve varicose veins, and varicose veins do not disappear from them. At the initial stage of venous insufficiency, phlebologists do not object to the use of these agents, since rubbing them promotes venous outflow, like a light massage, and has a calming effect on the skin. In advanced forms of venous insufficiency, these creams and ointments can cause dermatitis and allergization, and are therefore very harmful. Some drugs are used in the development of acute thrombophlebitis and help calm the inflammatory process, but varicose veins do not disappear from them. Thanks to the good publicity, shamanic products from leeches have gained great popularity among people, but they have no attitude towards medicines, and even leeches, and there is no point in expecting from them.
Medicines for blood clots in varicose veins
A common complication of varicose veins is thrombophlebitis, especially during pregnancy and the postpartum period. A proven drug for the prevention of blood clots is a low molecular weight acid sulfur glycosaminoglycan. To prevent thrombophlebitis after treatment of varicose veins, tablets are used in clinics. They are taken 7 days after the laser or radiofrequency intervention.
Compression stockings for varicose veins
Compression stockings are undoubtedly one of the most effective ways to treat venous edema and reduce the degree of chronic venous insufficiency. Invented over 100 years ago, gaining immense popularity in the 20th and even more so in the 21st century, compression stockings and stockings have become an integral part of treatment by a phlebologist. This is due to the effects it has:
- improvement of venous and lymphatic outflow of the lower limbs,
- improvement of microcirculation,
- slow down the progression of the disease,
- prevention of complications of varicose veins (varicothrombophlebitis, trophic disorders),
- prevention of deep vein thrombosis.
How to use compression stockings
So, if you have varicose veins and are planning to treat them, then during treatment you will undoubtedly use compression stockings for a period of several days or several months (individually). If your feet are swollen at the end of the day after work and you suffer from heavy leg syndrome, you can also use compression stockings during the day to avoid these symptoms in the evening. If you have complications from untreated varicose veins - trophic ulcers or thrombophlebitis - you will of course also use compression to improve the condition of the legs and reduce unpleasant symptoms.
The fact is, by improving venous outflow, compression stockings work every second of wear to improve venous blood return from the legs, which is arguably not easy for veins compromised by disease and againstlaw of universal gravitation. Compression knitwear can safely be called an ingenious invention of mankind, but for it to work for you, several conditions must be met:
- Compression knits are selected individually (according to standards). The main requirement is compliance with the anatomical profile of the limb and, therefore, the creation of the correct pressure gradient.
- Knitwear is selected individually by a doctor (phlebologist). Medical products are marked in mm Hg and are divided into compression classes 1, 2, 3, 4. Each compression class corresponds to a certain pressure. At different stages of varicose veins or chronic venous insufficiency, the appropriate compression class is used. That is why only a doctor has the right to prescribe and choose the right compression stockings - taking into account the nature of the pathology and according to individual standards.
- It must be medical and not slimming. Only proven brands with RAL certificate.
When do you need knitwear for varicose veins?
- correction of the "heavy legs" syndrome: reduction in severity, edema, improvement in quality of life;
- during treatment by a phlebologist: after surgery or for a period prescribed by a specialist;
- slow the progression of varicose veins;
- for the treatment of complications of varicose veins (varicothrombophlebitis).
A necessary component of any treatment of varicose veins and chronic venous insufficiency is medical elastic compression. Thanks to compression therapy, it is possible to completely eliminate swelling, heaviness in the legs and create the conditions for any kind of radical treatment of varicose veins. Modern medical knitwear has a high therapeutic effect and excellent aesthetic properties.
Exercises and sports for varicose veins
Power sports for varicose veins and athletics are possible after the elimination of varicose syndrome, or in compression stockings of 2-3 compression classes. Modern treatment is able to return legs with varicose veins to normal, which removes all restrictions.
We bring to your attention a complex of therapeutic and preventive exercises developed by leading experts. Its regular implementation will help reduce the manifestations of venous insufficiency of the lower extremities, slow the progression of the disease and reduce the risk of life-threatening complications.
- Discharge from the veins of the legs. Breathe deeply and regularly, lie down with your eyes closed, relax. At the same time, place a few pillows under your feet so that they are raised at an angle of 15-20°
- Cycling exercise. Lying on your back and breathing steadily, imagine that you are pedaling a bicycle.
- The exercise consists of several parts, is performed slowly and smoothly. Lying on your back, legs extended, take a deep breath. As you exhale, bend your right leg bringing your knee towards your chest. Inhaling, straighten the leg vertically upwards. As you exhale, lower it. Repeat this exercise alternately for each leg.
- Lying on your back, arms along your body, raise your legs vertically upwards. Rotate both feet simultaneously inward, then outward.
- Alternately bend and unbend the feet at the ankle joint forwards and backwards.
- Alternately bend and unbend your toes.
- Standing in one position: legs together, arms along the torso. After inhaling deeply, slowly raise your toes, exhale, return to the starting position.
- Walk in place without lifting your socks off the ground.
- Vertical scissors. Lying on your back, arms along your body, breathing regularly, alternately cross your legs, alternating them.
- Lying on your back, bend your knees without lifting your feet off the ground. Put your hands on your hips. Inhale slowly, raise your head and torso. At the same time, the hands slide down to the knees. Slowly exhaling, return to the starting position.
- Lying on your back, arms along your body, legs at a 15-20° angle, hold a small pillow between your feet. Inhale slowly, bend at the waist, tearing the buttocks off the mattress. Slowly exhaling, return to the starting position.
- Lying on your back, arms along your body, bend your knees keeping your feet on the ground. Slowly exhale, pull in your belly. Inhaling slowly, inflate the belly.
- Lying on your back, legs raised at an angle of 15-20°. Bend your right leg, bringing your knee towards your chest. At the same time, firmly clasp the foot with your hands. Slowly straighten your leg. Hands, tightly squeezing the leg, slide along the calf to the level of the knee. Slowly lower your leg, hands sliding over your thigh. The exercise is repeated for the other leg.
- Standing, feet together, arms along the body, inhale slowly, bring your shoulders back, exhale slowly, relax your shoulders and tilt your head forward.
- Contrast shower on the legs. Alternating hard jets of hot and cold water. 5-10 minutes for each leg.