Varicose veins of the lower extremities, according to information calling for medical facilities, 1 in 5 men and 28% of women of working age.
If we consider the entire population, then half of the adults will have characteristic symptoms.
The peculiarity of this disease is that it develops from comfortable living conditions. Studies in Asian countries show that the proportion of poor people who do manual labor and go hiking is lower.
Why are the veins of the legs loaded?
The anatomical structure of the venous wall is characterized by a reinforced skeleton of muscles and a valve apparatus. The effectiveness lies in not only keeping the blood flow in one's vertical position, but also organizing its rise against gravity in the direction of the heart.
Backflow stop valves to prevent overfilling at the furthest points of the body. This "uncomfortable" place is the legs and feet.
Mechanism of formation of varicose veins of the legs.
When entering the age of 40, the human body begins to limit the synthesis of plastic substances, mainly collagen protein. It is essential for good venous valve tone. The absence leads to loss of tone, sagging, and an inability to delay the backflow of blood and the mass above.
The network of veins in the legs consists of superficial vessels located just below the skin and deep veins located within 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. Obstruction manifests in areas with dilated small veins, visible to the eye as a fine mesh.
Further development of the pathology leads to peripheral blood retention and tissue edema (fluid escapes through the venous wall), malnutrition (reduced release of toxins, and oxygen and nutrients trapped bycompressed arteries).
How Complications Join
Stagnation of venous blood in the legs causes blood flow in the vessels to slow down and this facilitates the agglomeration (sticking) of platelets. Blood clots further complicate an already compromised blood supply.
The risk of embolism rupture and its migration through the great vessels to the heart is increased. If a person has defects related to the communication of the right and left chambers, occlusion of the arterial blood flow and the development of necrotic changes in the organs can occur.
The most common concomitant complication is local infection of the affected area of the venous wall, followed by the development of phlebitis or thrombophlebitis.
Cause of 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 not only in varicose veins but also in relatively early signs of skin aging (dryness, deep wrinkles).
Other reasons relate to human activities and behaviour.
- Reduced physical activity or, conversely, strenuous physical labor leads to a violation of the tone of the veins in the legs.
- Being forced to stand and sit for a long time during working hours causes blood to stagnate in the legs and decrease menstrual blood flow out.
- Pregnancy puts increased pressure on the pelvic organs and large veins, preventing drainage from the veins below.
- Doctors from Asian countries associate the development of varicose veins of the legs in patients who are addicted to the habit of sitting on a chair or in a chair instead of a bent knee.
- Comfortable high toilets require increased abdominal wall muscle tension during bowel movements, stress that contributes to stagnant legs. While squatting, the act of defecation is more physiological.
- The habit of eating quickly, reducing the proportion of raw vegetables and fruits in the diet leads to constipation and prolonged stress.
- Smokers expose their entire body to the effects of nicotine, which acts on the veins like a paralyzing poison.
- Fashionable heels lead to improper stress on the leg muscles and disrupt the tone of the veins.
- Conventional pills, hormonal contraceptives, hormone therapy for menopause, osteoporosis leading to impaired collagen synthesis.
- Wearing advertised slimming underwear and tight jeans causes blood to pool in the lower parts of the body.
Who should be included in the risk group?
Considering the reasons listed for the development of varicose veins, the group of people who are more likely to develop varicose veins of the legs should include:
- professional people associated with a long time in a standing or sitting position (salesman, teacher, hairdresser, driver, office worker);
- women like tight jeans, shapewear and high heels;
- those involved in weightlifting and bodybuilding;
- people who are used to sitting "side to side";
- women who are regularly pregnant and giving birth, as well as taking hormonal contraceptives;
- a smoker, a lover of coffee and spirits;
- have constipation.
Precautionary measures are needed for these populations.
Symptom
The first symptoms of varicose veins in the legs are noticeable at a young age. In the early stages, they present with increased stress in the legs:
- At the end of the working shift, there was pain in the feet, muscle fatigue;
- when changing shoes see swelling feet due to shoes too tight;
- evening feet "burnt" want to dip in cold water;
- "Spiders" are formed 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:
- disorders caused by night cramps in the calves, possible cramps when walking;
- on the skin of the feet, the skin of the feet appears black spots, dry, peeling;
- Genital ulcers appear, very painful, with jagged edges, difficult to treat.
If you experience local pain, swelling, redness, and increased body temperature, you need to think of thrombophlebitis.
Diagnose
In diagnosis, it is common to distinguish between true (primary) varicose veins, depending on the damage of the valve apparatus, and secondary, due to trauma and tumors.
General clinic surgeons, vascular and venous surgeons all participate in the examination. The doctor sees subcutaneous venous nodes, vascular network, skin pigmentation, ulceration begins, dermatitis.
On palpation, assess the tension of the superficial veins, the density of the walls, the size of the local changes, the presence of thrombus, the temperature of the skin over the nodes (signs of thrombophlebitis). circuit).
A general blood test will show the onset of inflammation (leukocytosis, increased ESR rate), propensity to thrombus formation according to the coagulation pattern.
Vascular ultrasound allows you to monitor blood flow, venous valve function, and detect blood clots.
Doppler examination allows you to examine the structure of the veins, to make a diagnosis at an early stage of the disease.
Spiral computed tomography is performed in difficult-to-diagnose cases. It helps to get a three-dimensional image of the anatomical area and helps in the selection of surgical treatments.
Treatment of varicose veins
It is better to start the treatment of varicose veins in the legs at an early stage. To do this, you will have to think about the necessary changes in habits, nutrition and exercise.
Regime
In order to avoid foot swelling at the end of the working day, people who are "sedentary" and "standing work" are recommended to take breaks or warm up physical culture with foot massage in the lying position. high. Drivers and office workers should travel during breaks.
The simplest exercises that can be done at work:
- walk barefoot on the floor alternately on tiptoes and heels;
- Sit in a chair, raise your legs and make a circle with your feet in one direction, then the other.
Morning exercises should include exercises in the lying position: alternating leg raises, "cycling", elevated leg swings. Squats, knee flexion exercises are not suitable.
Those who love strength training should refuse them. Most of the programs are swimming, cycling and hiking.
Choose a balanced diet
Limit all foods that increase weight, promote water retention and increase blood viscosity.
Avoid fatty meats and dairy products, spicy and salty foods, canned foods, sweets, baked goods, and carbonated drinks.
In your daily diet, you should use more vegetables and fruits, berries, onions, garlic, fermented dairy products, cereals, vegetable oils in place of butter, walnuts.
Venous support method
Compression stockings or golf are recommended to aid blood flow. They are the right size to wear when you are lying on your back.
Silicone-filled insoles advertised as a remedy create an electrical charge on the surface of the foot.
Specialists pay attention only to the possible impact of these aids in the early stages of the disease. With the presence of superficial nodes and edema on the legs, their use is completely useless.
The use of drugs
Drug therapy consists in the use of oral drugs from the group of "venotonics" in therapeutic doses selected by the doctor. They help relieve fatigue and discomfort in the feet but do not eliminate this disease.
Surgeons consider varicose veins medication to be a conservative treatment, but the mainstay is one of the less traumatic to the affected veins. Efficacy confirmed in 95% of patients. More severe interventions were used in only 5% of patients.
What is involved in low-injury activities?
Low-cost treatments for varicose veins that allow you to go without surgery, are ranked first in terms of effectiveness. They don't require a skin incision, can be done in a general clinic, and are practically painless. Patients are not limited in terms of work and movement. There is no need for a long recovery period 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.
Method of action: the beam causes a pronounced burn of the inner lining of the vein, further hardening. The intervention time is about two hours. The method can be applied in the treatment of veins of any size.
Sclerotherapy Techniques
A substance injected into the affected vein can cause the walls to collapse with subsequent scarring. Foam preparations are especially recommended, which quickly and safely fill the diseased vein. This method is applicable when the diameter of the vessel is up to 1 cm, after insertion it is necessary to walk for an hour. Vein researchers recommend wearing compression stockings for another month.
Microflebectomy
Under local anesthesia, an incision is made in the skin several millimeters, through which a diseased vein is clamped with a hook, brought to the surface of the skin, and excised. 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 stockings 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 burn tissue, so it is less traumatic than laser methods. After 30 minutes of microwave exposure, the vessel lumen was sealed. After 7 days, rehabilitation is considered complete. You can play sports.
What instances of operations are specified?
When treatment is unsuccessful with conservative methods and minimally invasive techniques cannot be used, surgical venectomy is indicated. It allows you to remove large areas of varicose veins, bundles.
Patient hospitalized. Surgical treatment is performed under general anesthesia. Usually two incisions: in the groin area and below the knee. Veins were constricted on both sides, pulled out and excised. Sutures are applied to the incisions. The patient was treated in the hospital for a week. Drugs that reduce blood clotting are used. The stitches are removed after at least 7 days.
Vein ablation is not performed:
- in the old age of the patient;
- with extensive damage to the deep and superficial veins;
- during pregnancy;
- with atherosclerosis of the vessels of the legs, diabetes mellitus;
- if there is a skin disease at the proposed surgery site.
Prevention methods
Prevention of varicose veins of the legs is first and foremost essential for those with occupational risk factors.
More walking is recommended. There is a massage and strengthening of the walls of the veins.
During breaks, shopkeepers and hairdressers get foot and shin massages. It is done with slow, smooth movements in the direction from the fingers to the knees and along the thighs. The knuckles of the fist are massaged in a circular motion to the central part of the foot.
The driver needs to get out of the car, go around, straighten his legs. Exercises for the legs are shown.
Fashionistas should think about the consequences before wearing high heels and tight clothes.
At home, you can soak in a contrast bath or foot bath. Apply to tired feet with decoction of chamomile, chestnut, wormwood, burdock.
Timely visit to the surgeon allows you to get rid of painful problems and restore activity and mobility.