At least half of adults have some type of problem with varicose veins. This common condition is a family problem for many people. Women have at least twice as many varicose veins as men. It affects 25%-60% of adults in both sexes, depending on age.
Dilated veins do not always look like bulging bluish threads; It almost always affects the legs and feet. Visible swollen and tortuous veins—sometimes surrounded by patches of occluded capillaries that look like spider webs or spider veins—are superficial varicose veins. Although they are often painful and disfiguring, they are mostly harmless. When inflammation develops, such vessels become tight to the touch and can obstruct blood circulation to such an extent that ankle swelling, itching, and pain develop in the affected area.
In addition to the superficial network of veins, there is an internal or deep venous network of the legs. In rare cases, the deep veins of the legs are also affected by varicose veins. These deep varicose veins are usually invisible, but they can cause swelling or pain throughout the leg and, most dangerously, can be the site of a blood clot.
Arteries have a thick muscular lining to help carry oxygen-rich blood from the lungs to all parts of the body. The surrounding muscles are used to reverse the flow of blood from the venous system, the muscle layer on the venous wall is thin and weak, but the veins are equipped with internal valves that ensure that blood flows in only one direction - towards the heart. , valves are needed to prevent reverse blood flow.
In varicose veins, the valves do not work properly, blood accumulates in the vein and makes it difficult for the muscles to push the blood "up". Instead of flowing from one valve to another, blood continues to pool in the vein, increasing venous pressure and further weakening the valves, causing the vein to bulge and curve. Because superficial veins have less muscle support than deep veins, they are more prone to varicose veins.
What contributes to the development of varicose veins?
Any condition that involves excessive strain and pressure on the legs or abdomen can cause varicose veins. The most common factors that cause intra-abdominal pressure are pregnancy, obesity, and work that requires prolonged standing or heavy lifting. Chronic constipation, prostate adenoma and rarely tumors that require straining during bowel movements and urination can also cause varicose veins. A sedentary lifestyle contributes to the development of varicose veins, because inactive muscles do not pump blood well.
Varicose veins are more likely to develop with age as the muscles and veins weaken. Previous leg trauma can damage venous valves and contribute to the development of varicose veins. Genetics also play a role, so if other family members have varicose veins, you are more likely to have them too. Contrary to popular belief, sitting cross-legged does not cause varicose veins, although it can aggravate the existing condition.
Can you prevent varicose veins?
Although genetics plays a role in the risk of developing varicose veins, there are things you can do to prevent them:
- Exercising regularly is the best way to stay in good physical shape, keep leg muscles toned, improve blood circulation and manage weight. Among all types of fitness, swimming and aqua aerobics are believed to have the greatest preventive effect;
- Healthy weight support; if you are overweight or even obese, losing weight will reduce the risk of developing varicose veins, because a normal weight prevents excessive pressure on the veins of the legs;
- Avoid tight clothing. Tight clothing can restrict blood flow to the thighs, groin, and legs;
- Avoid wearing high heels frequently and for long periods of time, as they can restrict blood circulation. Shoes with completely flat heels are also undesirable, it is better to choose shoes with a low and stable heel or elastic soles, because they are better for blood circulation and improve the tone of the calf muscles.
- Movement! Avoid sitting or standing for long periods of time to stimulate blood circulation. If your day job requires you to be on your feet a lot, consider wearing a daily support jersey. Stretch your legs and exercise as often as possible to improve blood circulation and reduce venous pressure.
- Fight smoking. Research shows that smoking can contribute to the development of varicose veins.
- During pregnancy, you should sleep on your left side, not on your back. This will reduce the pressure of the uterus on the vessels in the pelvic region and even improve the blood supply to the fetus;
- If you have risk factors for the development of varicose veins, then ask your doctor to choose compression stockings for you - these can be special stockings, socks or tights.
Spider veins and varicose veins
As we age, many of us notice bumpy, bluish stars under our skin or swollen cords that spread across our thighs and calves. These deformed blood vessels occur in 60% of adults after age 50.
What are spider veins?
Spider veins are small, tortuous blood vessels visible through the skin. They can be red, purple or blue and most often appear on the legs or face.
What are varicose veins?
These are larger blood vessels that have lost their elasticity, are swollen and have acquired a curved course due to changes in the venous wall. Such veins appear blue and rise above the surface of the skin. Varicose veins can appear anywhere, but they are more common in the legs, thighs, and feet.
What causes spider veins and varicose veins?
Healthy veins collect blood from the capillary network and transport it from the periphery to the heart through a system of one-way valves. These valves direct blood flow from the superficial veins to the deeper veins and the heart. The vessels are surrounded by muscles that contract and help pump blood to the heart. Normally, healthy venous valves prevent backflow of blood. However, problems with the valves, muscles, or blood pressure can cause blood to pool in the vein. When blood accumulates in a vein, the pressure increases and the vessel wall weakens. As a result, the vein becomes bulging and curved. As a result, depending on the caliber of the blood vessel and the degree of swelling, a network of spider veins or varicose veins is formed.
Who is at risk for varicose veins?
Spider veins or varicose veins of large veins can appear in any person, but women are twice as susceptible to this problem than men. This problem is also familiar to those whose work requires constant standing, including nurses, hairdressers, teachers and educators. Other factors that trigger the development of varicose veins are aging, obesity, pregnancy, leg injury or surgery, and a family history of varicose veins.
What are the symptoms of varicose veins?
Often, spider veins and / or varicose veins are not just an unpleasant cosmetic defect. Varicose veins are a disease that can cause unpleasant symptoms and dangerous complications, especially pain or cramps in the legs, a feeling of heaviness, throbbing or tingling. Severely inflamed veins become difficult to touch and reduce blood circulation, which leads to itching and swollen ankles. Also, over time, trophic changes such as thickening, pigmentation and ulcers develop in the skin and subcutaneous tissue.
Complications of varicose veins
Although spider veins and varicose veins spoil the appearance of the legs and cause uncomfortable symptoms, they rarely pose a serious health threat. However, in some cases, complications may develop that require a visit to the doctor and even hospitalization.
The most common complications of varicose veins are trophic ulcers on the background of long-term venous insufficiency, such wounds are most often formed in the ankle area and heal very poorly. The second frequent and more dangerous complication of varicose veins is thrombophlebitis - thickening and inflammation of the venous wall, which in turn can lead to venous thrombosis - a dangerous complication that requires hospitalization and intensive treatment. If thrombosis has occurred in the deep vascular system, then there is a danger of blood clot migration, which is called thromboembolism, and chronic post-thrombophlebitis may develop as a result of thrombophlebitis, which significantly affects the quality of the patient. life and performance.
Diagnosis of varicose veins of the lower extremities
Spider veins and superficial varicose veins are easy to diagnose - a visual examination is enough. However, the initial diagnostic complex always includes an ultrasound examination of the deep vascular system, because superficially dilated veins may indicate a deficiency of the valves of the deep veins of the lower extremities, which requires a serious approach to treatment. During the examination, the doctor always pays attention to the swelling of the ankles, the symmetry of the swelling, if any, the density of the venous wall and subcutaneous tissue, changes in skin color, pigmentation, pain, and the presence of trophic ulcers.
Most spider veins and varicose veins, unless accompanied by venous insufficiency, do not require surgical treatment, but can be removed for cosmetic purposes. If varicose veins are accompanied by complaints such as heaviness in the legs, pain, muscle fatigue or cramps, swelling of the ankles, then there are treatment recommendations that will reduce the symptoms and slow down the progression of the disease.
Treatment of varicose veins
Therapeutic approaches to varicose veins can be conservative and surgical. The choice of therapy method can be made by a phlebologist based on examination and examination. The purpose of the examination for varicose veins is to determine the stage of the disease and the risk of developing possible complications. Such an examination, which includes a comprehensive examination, ultrasound examination of the veins of the lower extremities, and in some cases laboratory tests.
Who treats varicose veins?
A phlebologist treats diseases of the veins of the lower extremities. A phlebologist is a physician with a surgical specialty based on training first in general surgery and then in cardiovascular surgery. Phlebology is a branch of vascular surgery that deals with the study and treatment of diseases and malformations of the venous system. A phlebologist surgeon must be experienced in a wide range of techniques used in the treatment of venous diseases.
Conservative treatment of varicose veins
Conservative therapy for varicose veins is aimed at slowing down its development and preventing complications. Usually, this consists of lifestyle changes (weight loss, proper physical activity, elimination of static loads that contribute to the progression of the disease), choosing compression stockings, prescribing drugs that tone the walls of venous vessels, and a prescription. physiotherapy course.
Compression jacket – support socks, stockings and tights
The easiest way to prevent the development of varicose veins is to wear supportive stockings. Also called compression stockings, they improve blood circulation and relieve pain and discomfort in the legs. They can be found in pharmacies and specialty medical supply stores. Such socks are especially necessary during pregnancy and during long flights.
Lifestyle change it can also help prevent the rapid development of varicose veins. First of all, you should normalize your weight and include physical activity such as walking or swimming in your life; exclude frequent wearing of high-heeled shoes, static loads and a sedentary lifestyle.
Drug treatment - there are many drugs, both in the form of gels and creams, and in the form of tablets, which have a venotonic effect and affect the speed of development of varicose veins, slowing down their development. However, their activity can be effective only in combination with other preventive measures.
Physiotherapy – For varicose veins, both in the early stages and in advanced forms of the disease, pressotherapy is most often used - a course of physiotherapy using compression - continuous compression of the veins with special circular pads, the pressure is spread from the legs. hips, improves blood flow, stimulates the vascular wall and normalizes the work of venous valves. This treatment is prescribed 2-4 times a year in courses of 10-12 procedures. It is also recommended after sclero- and laser therapy sessions for varicose veins. Such physiotherapy can be performed either independently or together with special electrical stimulation of the leg muscles with the expectation of mutually increasing the therapeutic effect.
Other conditions in which physiotherapy gives good results are trophic changes in the skin caused by the advanced stages of varicose veins, in these cases laser therapy, magnetic therapy, phono- and electrophoresis (→ and other methods) can be prescribed Physiotherapy for varicose veins is 100% contraindicated, thrombosis andor thrombophlebitis, therefore, before conducting a course of physiotherapeutic procedures, undergo an ultrasound examination of the veins of the lower extremities.
Surgical and minimally invasive treatment of varicose veins and its complications
Patients, most of whom are women and girls, come to consult a phlebologist because of the external side of the disease, since varicose veins most often affect the fair half of humanity - they are bothered by unsightly spots and cords on their legs. In this case, the treatment of varicose veins involves the removal of most cosmetic defects. For this purpose, minimally invasive methods of treating varicose veins are used - sclerotherapy and endovenous laser coagulation (EVLC).
When it comes to medical procedures, the term "minimally invasive" means "less traumatic" and "gentle. " Indeed, this type of treatment is performed on an outpatient basis, causes minimal pain comparable to a regular injection, and allows for excellent results. This treatment consists in destruction of the inner wall of the vessel with medicine (sclerosant) or laser, which leads to the adhesion of the lumen of the vessel and the disappearance of the cosmetic defect.
In each case, the doctor makes the decision on the method of treatment based on examination and examination. In case of complex varicose veins, surgical treatment performed in hospital conditions is used.