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 an acute violation of venous outflow in the lower extremities.
Modern methods allow to treat varicose veins radically without incisions and pain.
Complaints with varicose veins.
For many people, varicose veins and spider veins are just a cosmetic problem. In others, varicose veins cause pain and discomfort. Sometimes varicose veins lead to more serious problems and complications - thrombophlebitis or the appearance of trophic ulcers. Treatment consists of 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 an acute violation of venous outflow, due to obstruction or overflow of the veins .
Causes of varicose veins of the lower extremities
Varicose veins of the lower extremities
The disease, as a cause of varicose veins of the legs, occurs in 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 and ulcers. varicose trophic.
Hereditary predisposition is the main cause of primary varicose veins, however, the disease develops with excessive stress on the veins. The triggering mechanism for varicose veins in the lower extremities is strong physical overexertion, 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 for 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 may be congenital or acquired arteriovenous fistulas. Occasionally, 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
Venous outflow obstruction causes a pathological condition called chronic venous insufficiency. At the beginning of the disease, the appearance of single nodules of dilated veins may be noted, which do not cause much concern, although they can sometimes 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, then the rate of development of the disease is much higher. If the disease is not stopped, the third stage of venous insufficiency gradually develops. The edema becomes permanent, a dark color of the skin appears in the ankle area, the heaviness in the legs is constant and can persist even after a night's rest. They 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 vein thrombophlebitis
Thrombophlebitis is the most common complication of varicose veins. Thrombophlebitis is an inflammation of the venous 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 the large nodes. In these conditions, any factor that increases blood coagulation (pregnancy, overheating, trauma, sprains, hypothermia and scratches, acute respiratory infections) can cause 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 extremities. The cause of thrombophlebitis is decreased blood flow in varicose veins. Thrombophlebitis can progress and lead to deep vein thrombosis. Chronic venous insufficiency is a painful venous outflow condition with varicose veins. It is characterized by edema, darkening of the skin, 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 the 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 removal of pathological venous discharges, a varicose trophic ulcer does not heal or constantly recurs. Trophic ulcers with varicose veins occur in most patients and cause serious suffering. Modern minimally invasive methods allow you to reliably remove varicose trophic ulcers without incisions and pain.
Venous thrombosis and thromboembolism
Pulmonary embolism is a serious complication of venous thrombosis. Varicose veins are a major risk factor for thrombophlebitis and deep vein thrombosis. Thromboembolism leads to the development of severe heart and respiratory failure, with a mortality rate of over 50%.
Prevention of varicose veins of the lower extremities
Any modern person should understand what varicose veins on the legs are, how to treat and prevent them. With a hereditary predisposition, factors that contribute to varicose veins should be avoided. The use of venotonic drugs, the use of compression stockings during exercise, periodic examinations by a phlebologist, and ultrasound of the veins are shown.
When working in conditions of concomitant factors, it is necessary to wear compression stockings of the first compression class at work, therapeutic exercises, outdoor activities, daily walks for at least 1 hour in medical stockings, 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 factor production during heavy physical work. For this, compression stockings are necessary, especially with a predisposition to varicose veins. Medical knitwear is indicated for all pregnant women, and in cases of predisposition to varicose veins and thrombophlebitis, special compression stockings are used for childbirth. It is recommended that all pregnant women see 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 becoming a thing of the past, thanks to the appearance 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 walls to "stick together" along with the disappearance of the veins. For sclerotherapy, a number of chemicals are used, there have been attempts to treat with ozone. At one point, the advent 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 remove medium-diameter varicose veins after laser obliteration of pathologic venous discharges. Sclerotherapy is indispensable in the treatment of spider veins and reticular varicose veins, where it has no real competitors.
Laser treatment of varicose veins
Laser treatment for varicose veins of the lower extremities (EVLT) is the most modern, radical and inexpensive method of treatment that allows you to 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 1470nm laser and radial light guide, which were 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 radical nature of the 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 stripping stem veins 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 classic phlebectomy to microphlebectomy according to Müller and Varadi allowed a wonderful combination of laser treatment and removal of large varices through punctures without incisions or sutures. Varadi's technique saved patients from painful sclerotherapy of large varicose veins. Miniphlebectomy allows you to treat varicose veins in the legs and remove visible varicose veins anywhere on the body.
Radiofrequency obliteration of varicose veins
Radiofrequency obliteration (RFO) of varicose veins in 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 forms the wall of the vein and causes the destruction of the internal membrane. As for its painlessness, the method corresponds to laser coagulation with lasers with a wavelength of 1470 nm, it is easy to perform and the postoperative period is not very painful. 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 an active treatment method for 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 lymphatic drainage massage technology with bandage, 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 bandages allows you to effectively eliminate all clinical manifestations of the disease.
Bathing with varicose veins, thrombophlebitis or post-thrombotic disease is very dangerous. Any thermal stress can cause the formation of blood clots in deep veins with all the consequences that this entails.
Unfortunately, it is impossible to achieve a complete cure for 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 gives rise to the desire to speculate on this problem. Consider the 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. Nowadays, the abundance of means that can be applied has given rise to another problem: which one to choose? Unfortunately, most of the proposed drugs have rather low efficiency, despite the theoretically justified convenience of use. This is due to a number of reasons, the main of which is the low absorption of the medicinal substances of these drugs by the body. An ideal drug for the treatment of venous insufficiency should affect as many pathogenic 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 depends solely on the concentration and digestibility of the active ingredient.
You should not expect the disappearance of varicose veins from these drugs, however, the lightness in the legs, the 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 go away. At the initial stage of venous insufficiency, phlebologists are not opposed to the use of these agents, since their rubbing promotes venous outflow, like a light massage, and has a calming effect on the skin. With advanced forms of venous insufficiency, these creams and ointments can cause dermatitis and allergy, and therefore are very harmful. Some drugs are used in the development of acute thrombophlebitis and help slow down the inflammatory process, but varicose veins do not go away from them. Thanks to proper advertising, shamanic products with leeches have gained wide popularity among the people, but they have no attitude towards medicines, and even leeches, and it makes no sense to expect from them.
Medicines for blood clots in varicose veins
A frequent complication of varicose veins is thrombophlebitis, especially during pregnancy and the puerperium. A proven drug for the prevention of blood clots is a low molecular weight acidic glycosaminoglycan containing sulfur. 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 means of treating venous edema and reducing the degree of chronic venous insufficiency. Invented over 100 years ago, having gained immense popularity in the 20th century 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 the venous and lymphatic outflow of the lower extremities,
- improvement of microcirculation,
- slow the progression of the disease,
- prevention of complications of varicose veins (varicothrombophlebitis, trophic disorders),
- prevention of deep vein thrombosis.
How to wear compression stockings
So, if you have varicose veins and plan to treat them, then during treatment you will certainly wear compression stockings for a period of several days or several months (individually). If your feet are swollen towards the end of the day after work and you suffer from heavy legs syndrome, you can also wear compression stockings during the day to prevent these symptoms at night. If you have complications from untreated varicose veins (trophic ulcers or thrombophlebitis), you will of course also use compression to improve the condition of your legs and reduce unpleasant symptoms.
The fact is that by improving venous flow, compression stockings work every second of use to improve the return of venous blood from the legs, which is certainly not easy for veins compromised by disease and against the law of universal gravitation. Compression knitwear can be safely considered one of the ingenious inventions of mankind, but in order for it to work for you, several conditions must be met:
- Compression knitwear is selected individually (according to standards). The main requirement is compliance with the anatomical profile of the limb and thus the creation of the correct pressure gradient.
- Knitwear is selected by a doctor (phlebologist) individually. 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 appropriate compression stockings, taking into account the nature of the pathology and in accordance with individual standards.
- It must be a doctor, not slimming knitwear. Only tested brands with RAL certificate.
When do you need knitwear for varicose veins?
- correction of "heavy legs" syndrome: reduction of severity, edema, improvement of quality of life;
- during treatment with a phlebologist: after surgery or for a period prescribed by a specialist;
- to slow the progression of varicose veins;
- for the treatment of complications of varicose veins (varicothrombophlebitis).
A necessary component of any treatment for 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 conditions for any kind of radical treatment of varicose veins. Modern medical knitwear has a high therapeutic effect and excellent aesthetic properties.
elastic bandages |
therapeutic leotard |
|---|---|
The creation of the necessary pressure is determined by the technique and the skills of bandaging the doctor or the patient. |
Treatment profile and pressure level specified during manufacture according to compression class |
The need for medical participation in the imposition of a bandage or in the education of the patient |
Physician involvement is limited to selection of compression class and product type. |
Difficulties in providing compression and fixation in the thigh. |
Provides effective compression and fixation on the thigh. |
Used for non-standard limb shapes |
With a non-standard shape of the limb, customization is possible |
Daily washing causes bandages to wear out quickly |
Daily washing is necessary to maintain compression properties. |
It needs to be replaced after several washes. |
Guaranteed preservation of compression properties for 6 months |
Possible violations of water balance and skin temperature. |
The porous bond provides a normal temperature and water balance of the skin. |
Low aesthetic properties, provide convenience and comfort. |
High aesthetic properties, convenience and comfort of use. |
Exercises and sports for varicose veins
Strength 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 can 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 in the lower extremities, slow down the progression of the disease and reduce the risk of life-threatening complications.
- Discharge from the veins of the legs. Breathing deeply and evenly, lie down with your eyes closed, relax. At the same time, put some pillows under your feet so that they rise at an angle of 15-20 °
- Bicycle exercise. Lying on your back and breathing evenly, imagine that you are pedaling a bicycle.
- The exercise consists of several parts, it is performed slowly and smoothly. Lying on your back with your legs extended, take a deep breath. Exhaling, bend your right leg, bringing your knee to your chest. Inhaling, stretch the leg vertically up. Exhaling, lower it. Repeat this exercise alternately for each leg.
- Lying on your back, with your arms along your body, lift your legs vertically up. Simultaneously turn both feet in and then out.
- Alternately bend and unbend your feet at the ankle joint forwards and backwards.
- Alternately bend and unbend your toes.
- Stand in one position: legs together, arms along the torso. After taking a deep breath, slowly rise up on 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 the body, breathing evenly, 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. Inhaling slowly, raise your head and torso. At the same time, the hands slide down to the knees. Exhaling slowly, return to the starting position.
- Lying on your back, arms along the body, legs at an angle of 15-20 °, hold a small pillow between your feet. Inhaling slowly, bend at the waist, ripping your buttocks off the mattress. Exhaling slowly, return to the starting position.
- Lying on your back, with your arms alongside your body, bend your knees, keeping your feet on the ground. Breathing out slowly, contract your stomach. Breathing in slowly, inflate your stomach.
- Lying on your back, legs raised at an angle of 15-20 °. Bend your right leg, bringing your knee to your chest. At the same time, firmly hold the foot with your hands. Slowly stretch your leg up. 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.
- Stand with your feet together, arms alongside your body, inhale slowly, roll your shoulders back, exhale slowly, relax your shoulders, and tilt your head forward.
- Contrast shower on the legs. Alternate hard jets of warm and cold water. 5-10 minutes for each leg.