Every second person suffers from varicose veins. Some do not even suspect that they are sick. And others, and these are the majority, put off visiting a doctor until the last minute, preferring to treat themselves with the help of various gels and creams, advertising of which promises "healthy veins forever. "Meanwhile, many simply do not know that today medicine has made great progress in 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 the lot of people "who are over 40. "In fact, no one is immune from the disease. The main cause of varicose veins of the lower extremities 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 at a computer all day, and salespeople, hairdressers, teachers or, for example, the same surgeons are forced to spend their working day "on their feet. "
The risk group also includes:
- pregnant women (varicose veins of the lower extremities in women are intermittent and after childbirth the condition returns to normal);
- people whose work involves heavy physical labor and heavy lifting;
- persons interested in strength training;
- everyone who is overweight.
Phlebologists have this joke: "Any person will live to see his varicose veins, unless, of course, he dies from something else! "Cynically? But there is some 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 there is something wrong with their veins, attributing everything to fatigue or age-related changes. Let's take, for example, the notorious "spider veins" - damage to small (reticular) vessels of the venous system.
Modern phlebology does not separately consider reticular varicose veins of the lower extremities. Rather, it is a cosmetic defect that occurs in women due to hormonal imbalance, which 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 as if your legs are "filled with lead" and noticeably swell. By the way, the gold standard is now considered to be a situation where a phlebologist himself performs an ultrasound examination to determine the severity of the disease and decide on further treatment tactics for the patient.
Stages of varicose veins of the lower extremities
According to the international classification according to CEAP, 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 discomfort in the legs at the end of the day, there are no visible changes.
- First stage.Single networks of small veins are visible through the skin.
- Second stage.The expansion 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 areas above the expansion of deep veins, the skin begins to itch constantly and over time becomes dark brown.
- Fifth stage.An indicator of an advanced state of the disease: trophic ulcers appear in places where damaged veins are scratched, which take a long time to heal.
- Sixth stage.Trophic ulcers no longer heal, ooze, and constantly become infected.
Depending on the degree of varicose veins of the lower extremities, the doctor chooses one or another treatment tactic.
Surgery for varicose veins of the lower extremities
It is worth clearly understanding that treatment of varicose veins of the lower extremities does not always involve surgical intervention. Often on the Internet, patients search 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 surgery can be done without surgery.
In the initial stages of varicose veins, it is enough to adjust your lifestyle and take medications from the rutoside class, which strengthen the vascular walls. Only a doctor can prescribe their dosage and duration of use.
Radical methods of treating 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
It is the surgical removal of a damaged vein fragment under general or spinal anesthesia. There are several varieties of its implementation (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 regards this method of treatment as an extreme measure, used when, for various reasons, it is impossible to use others.
- Endovenous laser coagulation
Belongs to the category of modern thermo-ablative treatment methods. An electric current is applied to the affected vein, causing 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 surgery 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 operation is similar to endovenous laser coagulation, only in this case the role of the electrode is played by a light guide through which the pathologically altered vein is exposed to radiofrequency radiation. The operation is also performed using local anesthesia and has a short recovery period.
- Echosclerotherapy
This mechanochemical method is today considered even more innovative than laser treatment, since it uses not a physical, but a chemical agent. 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 basic compulsory medical insurance program.
* Please note that the decision to choose one or another treatment method 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. Firstly, since drug therapy in this case is aimed at relieving symptoms and not the cause, it is prescribed only if there are signs of venous insufficiency, which we have already discussed above. Secondly, they are prescribed only by the attending physician.
As for all kinds of gels, creams and ointments for varicose veins of the lower extremities, their effectiveness is extremely negligible for the simple reason that the active substance reaches the walls of the veins in minimal concentration. The relief that many patients experience after rubbing such drugs into problem areas of their legs can be explained by the placebo effect. If you use any 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. at stages 1–3 of the disease.
Massage and physical activity for varicose veins
The comprehensive treatment program for varicose veins includes massage and exercise therapy. Need I say that both the first and second must be agreed upon 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 at home on your own include:
- A ride on the bicycle.
Lying on your back, imitate pedaling a bicycle.
- Alternate walking.
Walk in place first on your toes and then on your heels.
- "Scissors".
While lying on your back, make crossing swings with your legs straightened 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 excess weight with varicose veins
Nutrition for varicose veins of the lower extremities is a special topic. The main wish of doctors comes 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, because any internal pressure leads to dilation of the veins.
There is no special diet for varicose veins of the lower extremities, but it is advisable 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, which contain a lot of vitamin C. And it’s 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. Firstly, trophic ulcers in varicose veins of the lower extremities are an integral part of the disease in the final stages. Besides the fact that they look very unsightly, they also itch and hurt.
Secondly, 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-blood clotting drugs, doctors will no longer be able to offer laser surgery as a treatment: while taking acetylsalicylic acid and similar drugs, ablation, the purpose of which is to cause the formation of a blood clot, will simply be useless.
When they 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’re unlikely to like such a life! "Firstly, trophic changes in the veins lead to ulcers, which will certainly become infected and leak. Secondly, 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 could be 100% guaranteed to protect us from the possibility of getting sick once and for all. Moreover, even when using radical treatment methods, the probability of relapse, according to statistics, is 30%.
Does this mean that you should give up on everything and not limit yourself to anything? Of course not. To prevent varicose veins of the lower extremities, doctors strongly recommend adhering to a healthy lifestyle: watch your weight, move more, engage in non-strength sports (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 stockings or tights on an individual basis, depending on the severity of the disease.