Causes of varicose veins in legs
- Genetic predisposition (congenital weakness of blood vessel valves). If your parents have signs of weak vein walls in any of their blood vessels (legs, groin, esophagus, rectum), you are likely to develop symptoms of varicose veins.
- Poor blood circulation in the lower limbs during pregnancy and childbirth (the developing fetus presses on the abdominal veins, increased pressure in the veins of the legs, hormonal changes lead to a decrease in venous tone).
- Obstructed blood flow when standing for long periods of time (varicose veins in the lower limbs are more common among salespeople, teachers, waiters, surgeons) and sitting (managers, accountants, office workers, drivers, etc. )
- Heavy physical work, weight lifting related sports training (for athletes, loaders, construction workers, gym and health club regulars)
- Long-term use of birth control pills with high levels of female sex hormones.
- Hormonal changes in the body, accompanied by a decrease in venous vascular tone (puberty, pregnancy, menopausal disorders in old age).
- Factors such as being overweight, chronic coughing, constipation, and the habit of wearing tight clothes and shoes can disrupt venous outflow, often leading to varicose veins.
Why do varicose veins occur during pregnancy?
- Hormonal changes in a woman's body during pregnancy promote the appearance of varicose veins, causing the vein walls to lose elasticity, stretch and transform into varicose nodules.
- Blood flow increases significantly in pregnant women. Increased venous pressure causes thinning of the vein walls and their localized dilation (varicose veins).
- The growth of the fetus leads to a corresponding increase in the size of the uterus, which makes it difficult for blood to flow out of the lower limbs through the pelvic veins due to increased intra-abdominal pressure and mechanical compression of the veins.
- Maternal weight gain can also have a negative impact on venous outflow.
Varicose veins of lower limbs: symptoms
- In the first stage, the venous circulation is violated, with the appearance of individual "spider veins", the skin becomes thinner, through which, during physical activity, dilated veins in the form of twisted cords begin to appear (usually in the skin). Popliteal fossa) without any discomfort.
- In the second stage of varicose veins, the lower limbs will feel heavy and tired. At night and after walking for a long time, there will be a "pins and needles" sensation in the legs and night cramps. Calf muscles, upon closer inspection, there are several dilated veins in the calf and sometimes in the feet and thighs.
- The third stage of lower extremity varicose veins is characterized by obvious bulging of venous nodules, mainly concentrated on the inner surface of the calf. Dark brown or brown spots appear on the thin and easily injured skin of the calf, and develop into lower extremity varicose veins. Dermatitis is accompanied by itching and rash. The swelling in the legs becomes more severe, making it difficult to walk.
- The fourth stage of varicose veins is the appearance of varicose nodes on the feet, calves and thighs, the development of complications of the disease (chronic venous insufficiency with trophic ulcers, damage to the varicose nodes and bleeding, development of thrombophlebitis).
- Sometimes the fifth stage is also distinguished - having all the symptoms of the fourth stage of varicose veins, the course of which spreads to the inguinal area, buttocks, perineum, the presence of multiple trophic ulcers, the appearance of phenoderma, often exacerbation of thrombophlebitis and the occurrence of disability.
Complications of varicose veins
- Superficial vein thrombophlebitis.
- Bleeding occurs when varicose veins rupture.
- Dermatitis, eczema.
- Nutritional ulcer.
- Deep vein thrombosis (venous thrombosis) and post-thrombotic venous disease.
- Pulmonary embolism (PE).
- Lymphedema (elephaniasis).
Diagnosis of varicose veins
- Clinical examination (clarification of complaint, history, examination, palpation).
- Doppler ultrasound.
- Ultrasound vascular scan.
- Plethysmography.
- Ascending and descending venography.
- Radionuclide venography (radiovenography).
- Computed tomography and MRI (CT venography, MR venography).
- Intravascular ultrasonography.
- Thermal Imaging.
Treatment of varicose veins of lower limbs
At the same time, you should not be afraid of surgery, because modern technology can eliminate varicose veins in the lower limbs without requiring large incisions, without pain, and with almost no interference with people's normal lifestyle.
Main types of surgery for varicose veins
- Sclerotherapy. In the early stages of varicose veins, good cosmetic results can be achieved by introducing special drugs into the problem veins to gradually harden them and "glue" the pathologically expanded areas of the blood vessels. Medication (usually a sclerosing agent) is injected into the varicose veins through a special catheter or a very fine needle. To achieve a positive result, 3 to 10 injections are required.
- phlebectomy. This surgery has been performed for nearly a hundred years, but in modern conditions, large incisions have long been abandoned. Today, cosmetic surgery is performed through micro-incisions of 3-5 mm. The pathologically dilated veins are first ligated and intersected at the point where they flow into the deep veins, and then removed using a special probe. The procedure lasts about 1-2 hours, after which the patient stays in the hospital of a medical institution for 1-2 days.
- venous resection. The surgery is performed under local anesthesia without incisions, but the varicose veins are removed through a small puncture. This results in a good cosmetic result (usually without the need for sutures) and significantly shortens postoperative recovery time. In some cases, the entire vein may not be removed, but only the pathologically altered portion of it. This intervention is called a short peel.
- intravenous laser coagulation. The operation is performed under ultrasonic control. A special laser light guide is inserted into the pathologically dilated vein and burns out the saphenous vein and its tributaries. After a period of time, the veins become occluded and hardened, closing completely. If necessary, laser coagulation can be combined with venectomy. In this case, surgical treatment of varicose veins of the lower limbs will be most effective.
- Radio wave ablation of varicose veins. Modifying the occlusion ("gluing") of the vein lumen can be achieved by exposing a certain power of radio waves to the problem area of the vein through a special catheter. The process lasts approximately 20 minutes.
Under what circumstances is surgical treatment of varicose veins in the legs inappropriate?
- During pregnancy and the first two months after birth.
- In the early stages of varicose veins, when there is still no discomfort and there is a cosmetic problem ("spider veins" on the legs), you can first try to eliminate them with exercise therapy, compression stockings and traditional methods.
- The risk of possible complications increases significantly in old age and in the presence of severe disease and dysfunction of various organs and systems of the body.
- There are lymphatic drainage disorders, lower limb skin infectious lesions, thrombophlebitis, and arteriovenous fistulas.
Prevent varicose veins of lower limbs
system and diet
- Avoid wearing clothing that blocks venous blood flow.
- Avoid standing or sitting for long periods of time (take regular breaks and perform simple gymnastics exercises).
- Avoid strenuous physical activity.
- Maintain an active lifestyle (moderate dynamic load - daily walking, swimming, cycling).
- Drink at least 1. 5-2 liters of fluid per day; your daily diet should include vegetables and fruits, whole-grain breads and cereals.
- Avoid bathing, sauna, and hot baths.
- Take contrast showers (warm water - cold water) every day.
- Use comfortable, low-heeled shoes.
antiplatelet therapy
- Acetylsalicylic acid and modern medicines containing it;
- Venotonics of plant origin - more often extracts of plants such as horse chestnut, hazelnut, arnica etc. are used;
- Synthetic intravenous injection. By the way, intravenous injection not only reduces the formation of blood clots, but also improves blood circulation in the veins, strengthens the walls of blood vessels and prevents the appearance of dilated areas.
compression jersey
gymnastics
- Lie on your back with your legs on pillows on a raised platform. Relax and stay in this position for a few minutes.
- "Bicycle" - Lie on your back with your legs raised and knees bent. Perform pedaling movements that simulate riding a bicycle;
- "Scissors" - lie on your back, raise your legs and cross them, and change the position of your legs (up and down) for 1 minute;
- Lift your legs and bend them at the knees. Bend and straighten your feet to imitate walking;
- Lie on your back, bend your left leg and bring your knee toward your chest. Place your hands around the ankle joints of your legs, gradually straighten your legs, and massage the calf muscles. Repeat the exercise with the right leg;
- Stand with your feet together. Stand on tiptoes and lower your body (if there are no complications, you can perform the exercise sharply - with your heels touching the floor).