Every second person suffers from varicose veins. Some do not even suspect that they are sick. And others, and they are the majority, postpone a visit to the 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 medicine today 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 part of people "who are older than 40 years". In fact, no one is immune from disease. The main cause of varicose veins of the lower extremities is the accumulation of blood in the veins during long-term 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 just that from us: all office workers sit at the 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 occasional and after childbirth the condition returns to normal);
- people whose work involves heavy manual labor and heavy lifting;
- persons interested in strength training;
- to everyone who is overweight.
Phlebologists have this joke: "Everyone will experience their varicose veins, unless, of course, they die of something else! "Cynical? But there is truth in every joke. 90% of the world's population today suffers from this disease.
Which symptoms of varicose veins of the lower extremities should alert the patient and signal that it is time to visit the doctor? Everything is not 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 changes. Take, for example, the infamous "spider veins" - damage to the 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 hormonal imbalance, which does not necessarily lead to varicose veins. The main signs of varicose veins of the lower extremities 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 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 situation in which the phlebologist himself performs an ultrasound examination in order to determine the severity of the disease and decide on the further tactics of the patient's treatment is now considered the gold standard.
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 the discomfort in the legs at the end of the day, there are no visible changes.
- The first stage.Individual networks of small veins are visible through the skin.
- The second stage.The expansion of saphenous veins is clearly visible through the skin of the legs.
- The third phase.A feeling of heaviness in the legs is accompanied by swelling, and above the surface of the skin, venous "bulges" appear.
- The fourth stage.In the areas above the deep vein dilation, the skin starts to itch constantly and turns dark brown over time.
- The 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.
- The sixth stage.Trophic ulcers no longer heal, do not leak and are constantly 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 surgery can be performed without surgery.
In the initial stages of varicose veins, it is enough to adjust your lifestyle and take drugs from the rutoside class that 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 variants 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 an extreme measure, which is 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 causes the formation of a blood clot, which is eventually replaced by connective tissue, and the problematic 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 of varicose veins of the lower extremities. The principle of operation is similar to endovenous laser coagulation, except that 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 under local anesthesia and has a short recovery period.
- Echosclerotherapy
Today, this mechanochemical method is considered even more innovative than laser treatment, because it does not use a physical, but a chemical agent. A sclerosant is injected into the lumen of the vein - a special medicinal substance that "blinds" it. The procedure is painless for the patient and is performed on an outpatient basis. Most effective for superficial varicose veins. However, it is not included in the basic mandatory health 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 alleviating the symptoms and not the cause, it is prescribed only if there are signs of venous insufficiency, which we have already discussed. Second, they are prescribed only by a doctor.
As for all types 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 the 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. in stages 1-3 of the disease.
Massage and physical activity for varicose veins
A comprehensive treatment program for varicose veins includes massage and exercise therapy. Should it be said that both the first and second must be agreed with the attending physician? A 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:
- Riding a bicycle.
Lying on your back, imitate pedaling 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.
As for yoga and stretching for varicose veins of the lower extremities, everything is individual. The possibility of performing these exercises depends on factors such as the stage of the disease, the presence of accompanying 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 wish of the doctor boils down to one thing: it is necessary to control body weight. Excess weight not only "hits" the joints and damages the functioning of the cardiovascular system, but also serves as a provoking factor for the appearance of varicose veins, because 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 advisable to exclude spicy and salty food 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 if you want to prolong the health of blood vessels for a long time. time.
Consequences of varicose veins
The consequences of neglected varicose veins are always extremely serious. First, trophic ulcers in varicose veins of the lower extremities are an integral part of the disease in the final stage. Apart from looking 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 occurrence, acetylsalicylic acid is also prescribed, but for varicose veins of the lower extremities it 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: while taking acetylsalicylic acid and similar drugs, ablation, the purpose of which is to create 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 it? "", I honestly answer: "You can live. But it is unlikely that you will 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 poses 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 would be 100% guaranteed to protect us from the possibility of getting sick once and for all. Moreover, even when radical methods of treatment are used, the probability of recurrence, according to statistics, is 30%.
Does this mean that you should give up everything and limit yourself to nothing? Of course not. In order to prevent varicose veins of the lower extremities, doctors strongly recommend following 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: the phlebologist will help you choose class 1 or 2 for socks or tights on an individual basis, depending on the severity of the disease.