Lower limb relapses occur in one in five men and 28% of women of working age, according to appeal information submitted to medical institutions.
If we consider the entire population, half of the adults will have characteristic symptoms.
This disease is characterized by growth from comfortable living conditions. Studies in Asian countries have shown a lower prevalence among the poor who do physical work and take long walks.
Why are the veins in the legs loaded?
The anatomical structure of the venous wall is characterized by a reinforced muscle skeleton and valve equipment. The expediency lies in not only keeping the flow of blood in a vertical position, but also organizing its rise against gravity towards the heart.
The valves block the return flow to prevent overcharging at the farthest points of the body. This is an "uncomfortable" place for your feet and legs.
Mechanism of varicose veins in the legs
At age 40, the human body begins to synthesize limited amounts of plastics, the major part of which is collagen protein. This is essential for good venous valve sound. Deficiency leads to loss of tone, sagging, and an inability to delay reverse blood flow and covering mass.
The venous network of the legs consists of superficial blood vessels that lie just below the skin and deep veins that are located in the thickness of the muscle layer.
Varicose veins in the lower extremities are characterized by an initial change in the valves of the superficial veins. Congestion is manifested in areas with dilated fine veins, visible to the eye in the form of a fine mesh.
Further development of the pathology leads to blood retention in the periphery and causes tissue edema (fluid escape through the walls of the veins), malnutrition (decreased outflow of toxins, retention of oxygen and nutrients by compressed arteries).
How the complications relate
Stagnation of venous blood in the legs slows down blood flow in the blood vessels, creating favorable conditions for platelet aggregation (adhesion). Blood clots complicate an already endangered blood supply.
There is an increased risk of the embolism rupturing and moving through the large vessels toward the heart. If a person has defects related to right and left ventricular communication, it is possible that the embolism enters the arterial blood and necrotic lesions develop in the organs.
The most common concomitant complication is the addition of a local infection to the affected area of the venous wall, followed by the development of phlebitis or thrombophlebitis.
Causes of the disease
There is only one cause of lower limb varicose vein that is independent of humans - a genetic lack of collagen structure. 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 people’s activities and behavior.
- Decreased physical activity, or on the contrary, heavy physical work leads to violation of the sound of the veins in the leg.
- Prolonged forced standing, sitting during working hours causes blood to stagnate in the legs and damages the outflow.
- Pregnancy puts increased pressure on the pelvic organs and large veins, preventing the lower veins from draining.
- Doctors in Asian countries associate the increase in varicose veins in the legs with the European habit of patients sitting in a chair or chair instead of bent knees.
- Comfortable high toilets require increased tension in the abdominal wall muscles during bowel movements, the exertion contributes to the stagnation of the legs. During squats, defecation is more physiological.
- A fast food habit, a decrease in the proportion of raw vegetables and fruits in the diet leads to constipation and persistent stress.
- Smokers expose the whole body to the effects of nicotine, acting as a paralyzing poison on the veins.
- Fashionable high-heeled footwear leads to inappropriate stress on the leg muscles and disturbs the tone of the blood vessels.
- Common pills, hormonal contraceptives, treatment with hormonal drugs during menopause, osteoporosis lead to impaired collagen synthesis.
- Due to the advertised slimming underwear and tight jeans, the blood stagnates in the parts of the body.
Who should be classified in the risk group
Taking into account the listed causes of venous pathology, the group of persons more likely to develop varicose veins in the legs should include:
- people who are professionally related to a long-standing or sitting position (salespeople, teachers, hairdressers, drivers, office workers);
- women who prefer skinny jeans, shaping underwear and high heels;
- weightlifting and bodybuilding people;
- people accustomed to sitting "side by side";
- women with frequent pregnancies and births and taking hormonal contraceptives;
- smokers, lovers of strong coffee and alcohol;
- constipation.
Preventive measures are needed for these populations.
Symptoms
The first symptoms of leg varicose veins are noticeable at a young age. In the initial stage, they appear with an increased load on the legs:
- by the end of the shift, pain appears in the legs and feet, muscle fatigue;
- when changing shoes, there is swelling of the feet due to the tightness of the shoes;
- in the evening the legs "burn", you want to dip them in cold water;
- "spiders" are formed on the skin of the thighs and legs.
In the next stage, an image of chronic venous insufficiency develops and symptoms of the internal vein appear:
- disturbed by the night cramps of calves, cramps while walking;
- dark spots, dryness, peeling appear on the skin of the feet and legs;
- appearance of trophic ulcers, very painful, with loose edges, difficult to treat.
If you need to think about thrombophlebitis due to local pain, swelling, redness, fever.
Diagnostics
In diagnostics, it is customary to distinguish between real (primary) varicose veins, depending on the change in the valve system, and due to secondary, trauma, and tumors.
Surgeons, vascular surgeons and phlebologists participate in the study. The doctor sees subcutaneous venous nodes, vascular networks, skin pigmentation, initial ulcers, dermatitis.
On palpation, the tension of the superficial veins, the density of the wall, the size of the local changes, the presence of a thrombus, and the temperature of the skin above the nodes (signs of thrombophlebitis) are evaluated.
A general blood test shows the development of inflammation (leukocytosis, accelerated ESR), a tendency to form thrombi according to the coagulogram.
Vascular ultrasound allows blood flow to be monitored, venous valves to function, and blood clots to be detected.
The Doppler examination makes it possible to check the structure of the veins and to make a diagnosis in the early stages of the disease.
The method of spiral computed tomography is performed in case of diagnostic difficulties. It allows a three-dimensional image of the anatomical region to be obtained and helps in the selection of surgical treatment.
Treatment of varicose veins of the legs
It is better to start the treatment of leg varicose veins in the initial stage. To do this, you need to rethink the necessary changes in habits, diet and exercise.
Mode
In order to keep the legs from swelling by the end of the work day, people in the "sitting" and "standing professions" are advised to lift exercise breaks or warm-ups with a foot massage. Drivers, office workers have to walk during the breaks.
The simplest exercises can be done in the workplace:
- stand barefoot on the floor alternately on toes and heels;
- sitting in a chair, lift your legs and make circles with your legs in one direction and then the other.
Morning exercises should include exercises in a supine position: alternating leg raises, "bikes", shaking raised legs. Squats, bent knee exercises are not suitable.
Lovers of strength training should deny them. Most can be seen swimming, cycling and hiking.
Choosing a balanced diet
It limits all foods that increase weight, promote fluid retention, and increase blood viscosity.
Not recommended for fatty meat and dairy products, spicy and salty foods, canned food, sweets, baked goods, carbonated drinks.
In the daily diet should use more vegetables and fruits, berries, onions, garlic, fermented dairy products, cereals, vegetable oil and nuts instead of butter.
Venous support methods
It is recommended to wear compression stockings or golf to support blood flow. They are sized to be worn lying on your back.
Silicon-filled treads are referred to as a cure that creates an electric charge on the surface of the foot.
Specialists only pay attention to the possible effects of these aids in the early stages of the disease. In the presence of superficial nodules and edema, their use on the legs is completely useless.
Use of drugs
Medication consists of taking medications orally from the group of "venotonics" at a therapeutic dose selected by the physician. They help relieve fatigue, discomfort in the legs, but do not eliminate the disease.
Surgeons attribute varicose veins to background conservative treatment, but the main one is a less traumatic way to affect the affected veins. Efficacy was demonstrated in 95% of patients. More serious interventions are used in only 5% of patients.
What applies to low traumatic operations
Low traumatic methods of treating varicose veins allow you to avoid surgery, rightly in the first place in terms of effectiveness. They do not require skin incisions, they can be performed in an outpatient clinic, they are practically painless. The patient is not restricted in terms of work, movement. There is no need for a long recovery period after surgery.
Laser ablation method
Performed under local anesthesia. A light guide is placed in the varicose vein and a circular laser beam is turned on during the reverse motion.
Method: the jet causes marked burning of the inner lining of the vein, further hardening. The duration of the intervention is about two hours. The method can be used to treat veins of any size.
Sclerotherapy technique
A substance is injected into the affected vein that can cause the walls to collapse and then scar. It is especially recommended for foam formulations that quickly and safely fill the lumen of a patient's vein. The method is applicable if the diameter of the vessel does not exceed 1 cm. Phlebologists recommend wearing compression socks for another month.
Method of micleblebectomy
Under local anesthesia, an incision of several mm is made in the skin, through which a hook grabs the patient’s vein, brings it to the surface of the skin, and cuts it out. The method is suitable for venous nodes of any size and diameter. A small scar remains at the incision site. You should wear compression socks or stockings for 10 days.
Radiofrequency ablation method
It happens similarly to a laser, but differs from the effects of microwave radio frequencies. This method does not cause tissue burns and is therefore less traumatic than a laser. After 30 minutes of exposure to microwaves, 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?
Phlebectomy surgery is prescribed if conservative treatment fails and minimally invasive techniques are impossible. It allows the removal of large areas of varicose veins and bundles.
The patient is taken to hospital. Surgery is performed under general anesthesia. Two incisions are usually made: in the lumbar region and below the knee. The vein is ligated on both sides, pulled outwards and removed. Sutures are applied to the incisions. The patient is treated in a hospital for a week. They use drugs that reduce blood clotting. The stitches are removed after at least 7 days.
Phlebectomy should not be performed:
- in the elderly of the patient;
- with severe damage to deep and superficial veins;
- during pregnancy;
- atherosclerosis of the vessels of the legs, diabetes;
- if there are skin conditions at the site of the planned surgery.
Prevention methods
Prevention of leg varicose veins is primarily needed by people with risk factors in the profession.
More walking is recommended. There is a massage and strengthening the walls of the blood vessels.
During breaks, vendors and hairdressers present foot and leg massages. It is done in slow, smooth movements from the fingers to the knees and along the thighs. The fists of the fist are massaged in a circular motion into the middle fossa of the foot.
Drivers need to get out of the car, walk around, stretch their legs. Exercises for the legs are shown.
Fashioners need to think about the consequences before getting into high-heeled shoes and wearing tight clothes.
You can make a contrast bath or foot shower at home. Apply a compress on tired legs with chamomile, chestnut, wormwood, burdock decoctions.
A timely visit by a surgeon will allow you to get rid of painful problems, restore activity and movement.