One in two people suffer from varicose veins. Some people don’t even suspect they are sick. And others, and they are the majority, postpone consulting a doctor until the last minute, preferring to treat themselves with various gels and creams whose advertising 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 reserved for people "over 40 years old". In fact, no one is safe 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 remains 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 "standing".
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 jobs involve heavy physical labor and heavy lifting;
- people interested in strength training;
- everyone who is overweight.
Phlebologists have this joke: "Anyone will live long enough to see their varicose veins, unless, of course, they die of something else! "Cynically? But there is 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 consult a doctor? Everything is not so simple here. As a rule, the disease develops gradually and many simply do not notice that there is a problem with their veins, attributing everything to fatigue or age-related changes. Take, for example, the famous "spider veins" - damage to small (reticular) vessels of the venous system.
Modern phlebology does not consider reticular varicose veins of the lower limbs separately. Rather, it is an aesthetic defect that occurs in women due to a hormonal imbalance, which does not necessarily lead to varicose veins. The main signs of varicose veins of the lower limbs are: 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 it be done? If at the end of the working day you feel that your legs are "filled with lead" and noticeably swell. By the way, the situation in which a phlebologist himself conducts an ultrasound scan to determine the severity of the disease and decide on further treatment tactics for the patient is now considered the gold standard.
Stages of varicose veins of the lower limbs
According to the international CEAP classification, used in phlebology, the development of varicose veins of the deep veins of the lower limbs is divided into 6 stages.
- Step zero.Apart from some discomfort in the legs at the end of the day, no visible change.
- First stage.Unique networks of small veins are visible through the skin.
- Second step.The expansion of the saphenous veins is clearly visible through the skin of the legs.
- Third step.The feeling of heaviness in the legs is accompanied by swelling and venous "bumps" appear above the surface of the skin.
- Fourth step.In areas above the expansion of deep veins, the skin begins to itch constantly and over time becomes dark brown.
- Fifth step.Indicator of an advanced state of the disease: trophic ulcers appear in places where damaged veins are scraped, which take a long time to heal.
- Sixth step.Trophic ulcers no longer heal, no longer ooze and become constantly infected.
Depending on the degree of varicose veins of the lower extremities, the doctor chooses one or another therapeutic tactic.
Surgery for varicose veins of the lower limbs
It should be clearly understood that the treatment of varicose veins of the lower extremities does not always involve surgical intervention. Often on the Internet, patients are looking 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 performed without surgical intervention.
In the early stages of varicose veins, it is enough to adjust your lifestyle and take drugs 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
This involves 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 depending on the severity of the lesion and the diameter of the damaged vein. Be that as it may, modern phlebology considers this method of treatment an extreme measure, used when, for various reasons, it is impossible to use others.
- Endovenous laser coagulation
Belongs to the category of modern methods of thermo-ablative treatment. An electric current is applied to the affected vein, causing a blood clot to form, 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 carried out under local anesthesia; once finished, the patient gets up and literally goes home.
- Radiofrequency ablation
This is another laser treatment method for varicose veins of the lower extremities. The principle of operation is similar to laser endovenous coagulation, except that in this case the role of the electrode is played by a light guide through which the pathologically damaged vein is exposed to radiofrequency 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, since it uses not a physical agent, 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 on an outpatient basis. More effective for superficial varicose veins. However, it is not included in the basic program of compulsory health insurance.
* Please note that the decision to choose one or another method of treatment is made by doctors, based on the individual indications and contraindications of a particular patient.
Ointments and gels for varicose veins
Are there medications to treat varicose veins of the lower limbs? They apply, but with two serious reservations. Firstly, since drug treatment in this case is aimed at relieving the symptoms, and not the cause, it is prescribed only in case of signs of venous insufficiency, which we have already talked about above. Secondly, they are prescribed only by the attending physician.
As with 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 applying such drugs to problem areas of their 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, that is, at stages 1-3 of the disease.
Massage and physical activity for varicose veins
The comprehensive treatment program for varicose veins includes massage and therapeutic exercises. Should I specify that the first and second must be agreed with the attending physician? Light massage of varicose veins of the lower extremities is aimed at improving blood circulation and is carried out by a specialist only in the absence of trophic ulcers.
Gymnastics for varicose veins of the lower extremities prevents the formation of edema, promoting the flow of lymph. Exercises you can do yourself at home include:
- A bike ride.
Lying on your back, imitate pedaling a bicycle.
- Alternate walking.
Walk in place first on your toes, then on your heels.
- "Scissors".
While lying on your back, perform crossed movements 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 physical trainer.
The danger of excess weight with varicose veins
Nutrition for varicose veins of the lower limbs is a special subject. 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 harms the functioning of the cardiovascular system, but also serves as a provoking factor in the development of varicose veins, since 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 is better to say goodbye to bad habits such as alcohol and nicotine consumption if you want to prolong the health of your blood vesselsfor a long time.
Consequences of varicose veins
The consequences of neglected varicose veins are always extremely serious. First, trophic ulcers of 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 anticoagulant medications, doctors will no longer be able to offer laser surgery as a treatment: when taking acetylsalicylic acid and similar medications, ablation, the aim of which is to cause the formation of a clotblood, will simply be useless.
When someone asks me: "Doctor, is it possible to live with varicose veins without doing anything? ", I answer honestly: "You can live. But you are unlikely to like such a life! First, trophic changes in the veins lead to ulcers that will certainly become infected and leak. Second, varicose veins of superficial veins can lead to deep vein thrombosis of the lower extremities, which poses a risk of pulmonary embolism and, in some cases, death.
Is prevention possible?
It is easier to prevent a 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 once and for all from the possibility of getting sick. Moreover, even using radical treatment methods, the probability of relapse, according to statistics, is 30%.
Does this mean you have to give up everything and limit yourself to nothing? 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-force sports (for example, going to the swimming pool).
A good prevention of varicose veins of the lower extremities is the regular use of elastic compression: a phlebologist will help you individually choose class 1 or 2 for stockings or tights, depending on the severity of the disease.