At least half of adults have some type of problem with varicose veins. This common condition is a family problem for many people. Women are at least twice as likely to develop varicose veins as men. Among both sexes, it affects 25% to 60% of adults, depending on age.
Dilated veins do not always look like convex bluish strands; Sometimes varicose veins appear as thin vascular networks that run just below the surface of the skin. It almost always affects the legs and feet. Visibly swollen and tortuous veins - sometimes surrounded by patches of blocked capillaries, resembling spider webs or spider veins - are superficial varicose veins. Although they are often painful and disfiguring, they are usually harmless. As the inflammation progresses, the vein becomes dense to the touch and can block blood circulation to the point where ankle swelling, itching and pain in the affected limb develop.
In addition to the superficial venous network, the leg has an internal, or deep, venous network. In rare cases, veins in 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 become a site for blood clots.
To help distribute oxygenated blood from the lungs to all parts of the body, arteries have a thick layer of muscle. For the return flow of blood through the venous system, the surrounding muscles are used, the muscle layer on the vein walls is thin and weak, but the veins are equipped with internal valves that allow blood to flow in only one direction - towards the heart. , a valve is needed to prevent backflow of blood.
With varicose veins, the valves don't work properly, causing blood to pool in the veins and making it difficult for the muscles to push the blood "up. " Instead of flowing from one valve to the other, the blood continues to pool in the veins, increasing venous pressure and further affecting the valves. , causing the veins to bulge and twist. 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 tension 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 standing for long periods of time or heavy lifting. Chronic constipation, prostate adenoma that requires straining during defecation and urination and, in rare cases, tumors can also cause varicose veins. A sedentary lifestyle contributes to the development of varicose veins, because dysfunctional muscles do not pump blood well.
The possibility of varicose veins increases with age as the muscles and veins weaken. Previous leg trauma can damage the 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 worsen existing conditions.
Can you prevent varicose veins?
Although genetics plays a role in your risk of developing varicose veins, there are things you can do to prevent them:
- Exercising regularly because maintaining good physical shape is the best way to keep your leg muscles toned, improve blood circulation and control your weight. It is believed that among all types of fitness, swimming and aqua aerobics have the greatest preventive effect;
- Support healthy weight; if you are overweight or obese, then losing weight will reduce the risk of developing varicose veins, because a normal body weight prevents excessive pressure on the leg veins;
- Avoid tight clothing. Tight clothing can restrict blood flow in the thighs, groin, and legs;
- Avoid wearing high-heeled shoes frequently and for long periods of time, as they can restrict blood circulation. Shoes with completely flat soles are also undesirable; it is better to choose shoes with low and stable heels or elastic soles, because they are better for blood circulation and also increase the tone of the calf muscles.
- Movement! Prolonged sitting or standing should be avoided to stimulate blood circulation. If your daily routine requires you to stand a lot, consider wearing a daily support jersey. Stretch your legs and exercise as often as possible to improve circulation and reduce venous pressure.
- Against 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 veins in the pelvic area and also increase the blood supply to the fetus;
- If you have risk factors for developing varicose veins, then ask your doctor to choose compression stockings for you - this may be special stockings, stockings or tights.
Spider veins and varicose veins
As we age, many of us find bumpy, bluish stars under the skin or swollen cords that spread to the thighs and calves. These defective blood vessels occur in 60% of adults after the age of 50.
What are spider veins?
Spider veins are small tortuous blood vessels that are visible through the skin. They can be red, purple or blue in color and most often appear on the legs or face.
What are varicose veins?
These are larger blood vessels that have lost their elasticity, swell and acquire a tortuous course due to changes in the vein wall. Such veins appear bluish and appear on the surface of the skin. Varicose veins can appear anywhere, but most often they develop in the legs, thighs and feet.
What causes spider veins and varicose veins?
Healthy veins collect blood from the capillary network and bring it from the periphery to the heart through a system of one-way valves. These valves direct blood flow in the desired direction from superficial veins to deeper veins and to the heart. Blood 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 valves, muscles, or blood pressure can cause blood to pool in the veins. As blood pools in the veins, pressure increases and the vein walls weaken. As a result, the veins become bulging and tortuous. As a result, depending on the caliber of blood vessels 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 large varicose veins can appear in any person, but women are exposed to this problem twice as often as men. This problem is also common in those whose jobs require them to be on their feet all the time, including nurses, hairdressers, lecturers and teachers. Other factors that trigger the development of varicose veins include 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 unpleasant cosmetic blemishes. Varicose veins are a disease that can cause unpleasant symptoms and dangerous complications, in particular, pain or cramps in the legs, heaviness, throbbing or tingling. Severely inflamed veins become difficult to touch and reduce circulation, causing itchy and swollen ankles. Also, over time, trophic changes in the skin and subcutaneous tissue develop, such as thickening, pigmentation and ulcers.
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 threat to health. However, in some cases, complications may develop that require a visit to the doctor and even hospitalization.
The most common complication of varicose veins is a trophic ulcer against the background of long-term venous insufficiency. Such ulcers most often form 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 vein wall, which in turn can cause venous thrombosis - a dangerous complication that requires hospitalization and intensive care. If thrombosis has developed in the deep venous system, then there is a danger of blood clot migration, which is called thromboembolism, and as a result of thrombophlebitis, chronic post-thrombophlebitis disease can develop, which significantly affects the quality of the patient. life and performance.
Diagnosis of varicose veins on the lower leg
It is easy to diagnose spider veins and varicose veins from superficial veins - a visual examination is enough. However, the main diagnostic complex always includes an ultrasound examination of the deep venous system, because a superficial dilated vein may indicate insufficiency of the deep vein valve in the lower leg, which requires a serious approach to treatment. During the examination, the doctor always pays attention to the swelling of the ankle, the symmetry of the swelling, if any, the compaction of the vein wall and subcutaneous tissue, changes in skin color, pigmentation, pain, and the presence of trophic ulcers.
Most cases of 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, ankle swelling, then there are treatment recommendations that will reduce symptoms and slow down the progression of the disease.
Treatment of varicose veins
The therapeutic approach 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 lower leg veins, and in some cases, laboratory tests.
Who treats varicose veins?
A phlebologist treats vein disease on the lower leg. A phlebologist is a doctor with a surgical specialty, which is based on training first in general surgery and then in cardiovascular surgery. Phlebology is a branch of vascular surgery concerned with the study and treatment of diseases and defects of the venous system. Phlebologist surgeons must be skilled in the various techniques used in the treatment of venous diseases.
Conservative treatment of varicose veins
Conservative therapy for varicose veins aims to slow their progression and prevent complications. Usually it consists of recommendations for lifestyle changes (weight loss, proper physical activity, elimination of static loads that contribute to the development of the disease), the selection of compression stockings, the prescription of drugs that tonic the vein walls, and the prescription of a course of physiotherapy.
Compression jerseys – support socks, stockings and tights
The easiest way to prevent the development of varicose veins is to wear support stockings. Also called compression stockings, they improve blood circulation and relieve pain and discomfort in the legs. They are available at pharmacies and specialty medical supply stores. Such stockings are especially necessary during pregnancy and during long flights.
Lifestyle changes can also help prevent the rapid development of varicose veins. First of all, you need to normalize your weight and introduce physical activity into your life, such as walking or swimming; excluding the frequent use of high heels, 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 rate of development of varicose veins, slowing down their development. However, their actions can only be effective 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 - physiotherapy courses using compression - sequential compression of veins with special round pads, pressure where it spreads from the legs to the hips, increasing blood flow, stimulating the vascular walls andnormalizes the function of venous valves. This treatment is prescribed 2-4 times a year in a course of 10-12 procedures. It is also recommended to be carried out after sclero and laser therapy sessions for varicose veins. Such physiotherapy can be carried out either independently or combined with specific electrical stimulation of the leg muscles, with the expectation of increasing the joint therapeutic effect.
Another situation where physiotherapy gives good results is trophic changes in the skin caused by the advanced stage of varicose veins in this case, laser therapy, magnetic therapy, phono- and electrophoresis (→ and other methods) can be prescribed that it is 100% contraindicated forphysiotherapy for varicose veins is concomitant thrombosis or thrombophlebitis, therefore, before carrying out a course of physiotherapeutic procedures, you should undergo an ultrasound examination of the lower leg veins.
Surgical and minimally invasive treatment of varicose veins and their complications
Patients, most of whom are women and girls, since varicose veins most often affect the fair half of humanity, come to see a phlebologist because of the external side of the disease - they are bothered by unsightly spots and cords on their legs. Treatment of varicose veins in this situation most often involves the elimination of cosmetic defects. For this purpose, minimally invasive methods to treat varicose veins are used - sclerotherapy and endovenous laser coagulation (EVLC).
The term "minimally invasive" in relation to medical procedures means "low traumatic" and "gentle". Indeed, such treatment is carried out on an outpatient basis, causing minimal pain, comparable to regular injections, and allows you to achieve excellent results. This treatment consists of destroying the inner wall of the vein with a drug (sclerosant) or laser, which leads to the lumen of the vessel sticking together and the disappearance of the cosmetic defect.
In each case, the decision on the treatment method is made by the doctor based on examination and examination. In complicated cases of varicose veins, surgical treatment is used, which is carried out in hospital conditions.