Every second person suffers from varicose veins. Some do not even suspect that they are sick. And others, and this is the majority, postpone visiting a doctor until the last moment, preferring to treat themselves with the help of various gels and creams, the advertising of which promises "healthy veins forever". Meanwhile, many simply do not know that today medicine has made great progressin the treatment of this disease and can offer several minimally invasive and painless methods.
Varicose veins
There is an opinion that the diagnosis of "varicose veins of the lower extremities" is many people "who are over 40 years old". In fact, no one is immune from the disease. The main cause of varicose veins of the lower limbs is the accumulation of blood in the veins during prolonged static loads, when a person is in one position for a long time - standing or sitting. The modern world is structured in such a way that most in-demand professions require exactly this from us: all office workers sit in front of the computer all day, and salespeople, hairdressers, teachers or, for example, the same surgeons are forced to spend a working day "on their feet".
The risk group also includes:
- pregnant women (dilated veins of the lower limbs in women are unstable and after childbirth the condition normalizes);
- people whose work involves heavy physical labor and heavy lifting;
- individuals interested in strength training;
- all overweight.
Phlebologists have this joke: "Every person will live to see their varicose veins, unless, of course, they die of something else! ""Cynical? But there is a dose of truth in every joke. 90% of the world's population today suffers from this disease.
What symptoms of varicose veins of the lower extremities should alert the patient and signal that it is time to see a doctor? Not everything is so simple here. As a rule, the disease develops gradually, and many simply do not notice that something is wrong with their veins, attributing everything to fatigue or age-related changes. Take, for example, the notorious "spider veins" - damage to small (reticular) vessels of the venous system.
Modern phlebology does not consider reticular varicose veins of the lower extremities separately. Rather, it is a cosmetic defect that occurs in women due to a hormonal imbalance that does not necessarily lead to varicose veins. The main signs of varicose veins of the lower extremities include: swelling, a feeling of heaviness in the legs at the end of the working day, and sometimes cramps.
Today, ultrasound of the veins of the lower extremities is the most informative method for diagnosing varicose veins. When should you do it? If at the end of the working day you feel that your legs are "full of lead" and noticeably swell. By the way, the gold standard is now considered a situation where the phlebologist himself performs an ultrasound examination to determine the severity of the disease and takedecision on further tactics to treat the patient.
Stages of varicose veins of the lower extremities
According to the CEAP international classification, which is used in phlebology, the development of varicose veins of the deep veins of the lower extremities is divided into 6 stages.
- Zero stage.Apart from the discomfort in the legs at the end of the day, there are no visible changes.
- First stage.Individual networks of small veins are visible through the skin.
- Second stage.The dilatation of the saphenous veins is clearly visible through the skin of the legs.
- Third stage.The feeling of heaviness in the legs is accompanied by swelling, and venous "bumps" appear above the surface of the skin.
- Fourth stage.In the areas above the expansion of the deep veins, the skin begins to itch constantly and over time turns dark brown.
- Fifth stage.An indicator of an advanced state of the disease: in the places where the damaged veins are scratched, trophic ulcers appear, which take a long time to heal.
- Sixth stage.Trophic ulcers are no longer treated, flow and constantly become infected.
Depending on the degree of varicose veins of the lower extremities, the doctor chooses one or another treatment tactic.
Surgery of varicose veins of the lower extremities
It is worth clearly understanding that the treatment of varicose veins of the lower extremities does not always involve surgical intervention. Often on the Internet, patients look for an answer to the question: "How to treat reticular varicose veins of the lower extremities? ""Despite the fact that in Western terminology such a diagnosis does not exist at all, this is exactly the case when the operation can be done without surgery.
In the initial stages of varicose veins, it is enough to adjust your lifestyle and take drugs from the class of rutosides, which strengthen the vascular walls. Only a doctor can prescribe their dosage and duration of use.
Radical methods for the treatment of varicose veins of the lower extremities include: phlebectomy, laser surgery, as well as various mechanochemical methods*. Let's take a closer look at them.
- Standard phlebectomy
This is the surgical removal of a damaged fragment of a vein under general or spinal anesthesia. There are several varieties of its application (according to Babcock, according to Varadi and others), the choice of which is determined by the doctor based on the severity of the lesion and the diameter of the damaged vein. In any case, modern phlebology considers this method of treatment as a last resort, used when, for various reasons, it is impossible to use others.
- Endovenous laser coagulation
It belongs to the category of modern thermoablative treatment methods. An electric current is applied to the affected vein, which leads to the formation of a blood clot, which over time is replaced by connective tissue and the problem vein simply disappears. The advantage of the method is that it is painless. The operation is performed under local anesthesia, after completion the patient gets up and literally goes home.
- Radiofrequency ablation
This is another method of laser treatment for varicose veins of the lower extremities. The principle of action is similar to endovenous laser coagulation, only in this case the role of an electrode is played by a light wire through which the pathologically changed vein is exposed to radio frequency radiation. The operation is also performed under local anesthesia and has a short recovery period.
- Echosclerotherapy
This mechanochemical method is today considered even more innovative than laser treatment, as it uses a chemical agent rather than a physical one. A sclerosant is injected into the lumen of the vein - a special medicinal substance that "glues" it together. The procedure is painless for the patient and is performed in an outpatient setting. Most effective for superficial varicose veins. However, it is not included in the main compulsory medical insurance program.
* Please note that the decision to choose one or another method of treatment is made by doctors depending on the individual indications and contraindications of a particular patient.
Ointments and gels for varicose veins
Are any medications used to treat varicose veins of the lower extremities? They apply, but with two serious reservations. First, since drug therapy in this case is aimed at relieving the symptoms, and not at the cause, it is prescribed only if there are signs of venous insufficiency, which we have already considered above. Secondly, they are prescribed only by the attending physician.
As for all types of gels, creams and ointments for varicose veins of the lower limbs, their effectiveness is extremely insignificant for the simple reason that the active substance reaches the walls of the veins in minimal concentration. The relief experienced by many patients after rubbing such drugs into the problem areas of the legs can be explained by the placebo effect. If you use external products, then you should take into account this important nuance: it is safe to apply them only in the absence of open skin lesions, i. e. in the 1-3 stage of the disease.
Massage and physical activity for varicose veins
A comprehensive treatment program for varicose veins includes massage and exercise therapy. Do I need to say that both the first and the second must be agreed with the attending physician? Light massage for varicose veins of the lower extremities is aimed at improving blood circulation and is performed by a specialist only if there are no trophic ulcers.
Gymnastics for varicose veins of the lower extremities prevents the formation of edema, promoting the outflow of lymph. Exercises you can do yourself at home include:
- A bike ride.
Lying on your back, imitate the pedals of a bicycle.
- Alternative walking.
Walk in place first on your toes and then on your heels.
- "Scissors".
While lying on your back, make criss-cross swings with your legs straight at the knees.
Regarding yoga and stretching for varicose veins of the lower extremities, everything is individual. The ability to perform these exercises depends on factors such as the stage of the disease, the presence of concomitant pathologies and the competence of the fitness instructor.
The danger of being overweight with varicose veins
Nutrition for varicose veins of the lower extremities is a special topic. The main desire of doctors boils down to one thing: it is necessary to control body weight. Excess weight not only "hits" the joints and is harmful to the functioning of the cardiovascular system, but also serves as a provoking factor for the development of varicose veins, since any internal pressure leads to the expansion of the veins.
There is no special diet for varicose veins of the lower extremities, but it is recommended to exclude spicy and salty foods from the daily menu and replace tea and coffee with herbal teas. The diet should be rich in fiber, fresh vegetables and fruits that contain a lot of vitamin C. And it is better to say goodbye to such bad habits as drinking alcohol and nicotine if you want to prolong the health of your blood vessels for a long time.
Consequences of varicose veins
The consequences of neglected varicose veins are always extremely serious. First, trophic ulcers in the varicose veins of the lower extremities are an integral part of the disease in the final stages. Apart from the fact that they look very unsightly, they also itch and hurt.
Second, all patients diagnosed with varicose veins are at risk of thrombophlebitis of the lower extremities - an inflammatory disease of the veins in which blood clots form in their lumen. To prevent their appearance, acetylsalicylic acid is also prescribed, but for varicose veins of the lower extremities, this is already a double-edged sword. For patients taking anti-clotting drugs, doctors will no longer be able to offer laser surgery as a treatment: as long as they are taking acetylsalicylic acid and similar drugs, ablation, which aims to induce the formation of a blood clot, will simply be useless.
When people ask me, "Doctor, is it possible to live with varicose veins and not do anything about them? "", I honestly answer: "You can live. But you will hardly like such a life! "First, trophic changes in the veins lead to ulcers, which will certainly become infected and leak. Second, varicose veins of the superficial veins can lead to deep vein thrombosis of the lower extremities, which is a risk of pulmonary embolism and in some cases death.
Is prevention possible?
It is easier to prevent any disease than to waste time and money on its treatment. Unfortunately, varicose veins are a chronic disease. There are no special preventive measures that with a 100% guarantee will protect us from the possibility of getting sick once and for all. In addition, even with the use of radical methods of treatment, the probability of relapse, according to statistics, is 30%.
Does this mean you have to give up everything and limit yourself in nothing? Of course not. To prevent varicose veins of the lower extremities, doctors strongly recommend that you adhere to a healthy lifestyle: monitor your weight, move more, do sports without force (for example, go to the pool).
A good prevention of varicose veins of the lower extremities is the regular use of elastic compression: a phlebologist will help you choose class 1 or 2 for socks or tights on an individual basis, depending on the severity of the disease.