Varicose veins of the lower extremities are a chronic systemic pathology that develops against the background of dysfunction of the valves that control blood flow.
This leads to the accumulation of excessive volume of fluid in the vessels, which gradually stretch, losing their elasticity and strength.Varicose veins are characterized by the formation of large nodes under the skin of the legs, but this is not the only symptom of the disease.Patients complain of pain and heaviness in the legs, burning and itching, dryness and irritation of the skin.In advanced cases, non-healing purulent ulcers form on the skin, which are very difficult to heal due to the irreversible necrotic processes progressing there.For the treatment of varicose veins on the legs to be effective and help prevent relapses, you must first know the causes.
Causes of varicose veins on the legs
The tendency to develop such serious vascular disease is often hereditary, and in most cases this pathology is inherited by women.Therefore, if there are cases of varicose veins in your family, girls and women will be at risk.
Other common causes of the disease:
- Poor diet.If the diet is dominated by fatty and heavy foods, rich in animal fats, the risk of developing varicose veins of the lower extremities increases significantly.
- Intense physical activity.Certain types of work, for example, a cook, a waiter, a surgeon, an office worker, a hairdresser, create conditions for a gradual increase in pressure in the veins.With regular stress, blood vessels and valves become deformed;due to constant high pressure, the walls of the veins become thinner, brittle and varicose veins develop.
- Wearing uncomfortable high heels.Such shoes reduce the amplitude of muscle contraction and compress blood vessels, which in turn contributes to impaired blood flow and the development of varicose veins.
- Sedentary lifestyle.In the absence of at least minimal load on the muscles, blood begins to stagnate in the venous bed, since the walls of the veins do not contract on their own.Gradually, the vessels stretch, the function of the valves is disrupted and thickenings and varicose nodes are formed.
- Excess weight.The more excess weight a person has, the greater the load on the lower extremities and, accordingly, on the blood vessels.In addition, obese people move very little and generally eat poorly, which doubles the risk of developing varicose veins in the legs.
- Pregnancy.As the fetus grows, the volume of blood in the expectant mother's body increases, which creates additional stress on the veins.Additionally, the uterus and growing fetus compress the pelvic vessels, which prevents normal venous outflow.During pregnancy, the hormone progesterone is produced in excess, which relaxes the walls of blood vessels, thus promoting the development of varicose veins.In most cases, varicose veins during pregnancy are reversible, so after childbirth a woman can completely get rid of the problem.
- Age.As the body ages, the walls of the veins and valves stop performing their full functions and become weaker.Elasticity and strength are lost, causing the vessels to stretch.
The mechanism of development of varicose veins of the lower limbs
Varicose veins of the lower limbs develop according to a complex mechanism:
- At the initial stage, in the presence of a hereditary predisposition and provoking exogenous and endogenous factors, a slowdown in venous blood flow occurs.A long-term stagnation process causes the development of inflammatory processes in the walls and valves of the vein.
- When the valves are incompetent and the walls of the venous vessels are weak, blood begins to flow through the veins in both directions.This leads to an increase in intravenous pressure, which leads to excessive stretching and deformation of the vessel walls.
- Further stagnation of blood and progression of the inflammatory process contribute to the spread of pathology, the development of ischemia and the formation of trophic ulcers.
Gradually, the function of the affected veins is impaired.Varicose veins cause stagnation of blood in the vessels, which leads to local toxic damage, as well as increased pressure.In advanced stages, the vessels are no longer able to withstand excessive pressure, resulting in ruptures, which lead to heavy bleeding.
Symptoms
The disease is insidious in that it is virtually asymptomatic in the early stages.The first sign indicating the development of varicose veins is leg fatigue, which is often ignored by patients and does not become a reason to seek advice from a specialist.However, as the pathology progresses, leg fatigue is felt more often, particularly in the evening, after a day of work.Other symptoms of vascular disease:
- Pain, feeling of compression.Such signs begin to appear from the second stage, when the pathological process begins to progress.The pain mainly occurs in the evening after a day of work, and disappears in the morning.If a person ignores the discomfort and there is no treatment, the pain syndrome becomes chronic and constantly worries.
- Swollen veins and vascular network.At first, the affected veins are stronger than usual, but later they begin to swell, swell, forming knots.The vascular network is most often located in the thighs and legs.
- Cramps.A characteristic sign of varicose veins, the cause of which is stagnation of blood in the veins.Stagnant processes lead to an increase in pressure in the vessels, as a result of which the muscles begin to contract spontaneously.
In addition, vascular diseases are accompanied by pronounced external changes.With the development of ischemia, patients complain of constant itching.Excessive stretching and thinning of the veins leads to the formation of hematomas and bruises.In advanced stages, when atrophic processes develop, the following external symptoms appear:
- red spots on the skin;
- peeling;
- formation of dark pigmented spots;
- disappearance of hair.
If a patient develops trophic ulcers accompanied by blackening of the extremities, this indicates the progression of irreversible necrotic processes.
Complications of varicose veins of the legs
If there is no treatment for varicose veins of the lower limbs, serious complications appear as the disease progresses, such as:
- Venous thrombosis.With this complication, pathological processes affect the deep veins.The pathology is accompanied by blockage of a vessel by a blood clot - a thrombus.The main cause of venous thrombosis is slow blood flow in the lower extremities.
- Pulmonary embolism.Condition in which a blood clot broken off from the wall of a vessel, along with the blood flow, enters the pulmonary artery, blocking its lumen.If the blood clot is large, death occurs instantly.Smaller clots do not lead to death, but cause complex respiratory and circulatory disorders.
- Thrombophlebitis.It is characterized by inflammation of the walls of the superficial vessel, accompanied by the formation of a blood clot.The disease is manifested by hyperemia, swelling along the inflamed and blocked vein, pain of varying intensity.Acute thrombophlebitis is accompanied by fever and chills, which complement the above symptoms.
- Trophic ulcers.An inevitable complication of untreated varicose veins of the lower extremities, which develops in the absence of timely treatment.Violation of tissue nutrition and progression of the inflammatory process contribute to compaction of the subcutaneous tissue, thinning, darkening of the skin, followed by the formation of a non-healing trophic ulcer.
- Varicose eczema.It manifests itself by local redness of the skin, peeling and unbearable itching.If left untreated, the complication spreads quickly and leads to a deterioration in the patient's condition.
- Bleeding from varicose veins.A dangerous complication that develops against the background of rupture of varicose nodes.
Bleeding may occur due to mechanical injury, as the walls of the affected veins are very fragile and thinned.Therefore, even slight friction can cause heavy venous bleeding.
Diagnosis of varicose veins of the lower limbs
If you have symptoms indicating the development of varicose veins of the lower extremities, you should make an appointment with a phlebologist who will diagnose, treat and prevent this vascular pathology.
The doctor will be able to make a preliminary diagnosis during the initial examination, during which a dense vascular network, swollen veins protruding above the surface of the skin and venous nodes are discovered on the limbs.To confirm the diagnosis, a referral is given for additional examination, including the following procedures:
- Doppler ultrasound;
- duplex ultrasound angiography;
- radionuclide and radiopaque phleboscintigraphy;
- phlebomanometry;
- plethysmography;
- photoplethysmography.
Treatment of varicose veins of the legs
If the disease is diagnosed at an early stage, when there are no serious complications, conservative treatment is prescribed, the main goals of which are:
- eliminate stagnant processes;
- normalize pressure in the veins;
- restore blood circulation;
- eliminate pathological symptoms.
For these purposes, drugs from the following groups are used:
- Venotonics and phlebotonics.Helps improve blood vessel health, normalize blood circulation and improve lymphatic flow.
- Anticoagulants.Used to reduce blood viscosity and prevent the formation of blood clots.
- Non-steroidal anti-inflammatory drugs.They have a pronounced anti-inflammatory effect and relieve pain.
- Antiplatelet agents.Reduce the risk of thrombosis and improve tissue trophism.
If drug treatment proves ineffective and the disease progresses, the doctor discusses surgical treatment options with the patient.Surgical methods of treating varicose veins include:
- Sclerotherapy.Introduction into the lumen of the affected vein of a sclerosing drug which sticks the vessel, causing it to resolve on its own and be replaced by connective tissue.
- Laser coagulation.Indicated in cases where the diameter of the affected veins does not exceed 10 mm.The laser beams create a sclerosis effect in the vessel, as a result of which it resolves on its own.
- Phlebectomy.Surgical procedure in which the surgeon excises deformed areas of blood vessels, carrying out all the necessary manipulations by means of microscopic punctures in the skin.
Contraindications
For varicose veins of the legs, any actions contributing to the development of stagnation in the vessels of the lower extremities are contraindicated:
- long stay in static positions;
- strenuous physical activity, lifting heavy weights;
- sitting with legs folded or crossed;
- wear tight, uncomfortable shoes.
It is also necessary to get rid of bad habits like smoking and alcohol abuse.Tobacco smoke and alcohol negatively affect the health of the whole body, making veins fragile, thinned and inelastic, which quickly leads to the development of varicose veins and other cardiovascular diseases.
Cost of treatment for varicose veins of the lower limbs
The cost of treatment for varicose veins of the legs is influenced by the following factors:
- the stage at which the disease was diagnosed;
- associated complications;
- individually selected method of therapy - conservative or surgical;
- the need for additional therapeutic techniques, such as physiotherapy.