Every second person suffers from varicose veins. Some don't even know they are sick. And others, and this is the majority, put off going to the doctor until the last minute and prefer to treat themselves with the help of various gels and creams that promise "healthy veins forever" with advertising. Meanwhile, many simply do not know that medicine todayhas made great strides 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 made in many people "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 of the professions in demand require exactly this from us: all office workers sit at the computer all day, and sellers, hairdressers, teachers or, for example, the same surgeons are forced to spend their working day "onthe legs".
The risk group also includes:
- pregnant women (varicose veins of the lower extremities occur sporadically in women and after childbirth the condition returns to normal);
- People whose work requires heavy physical labor and heavy lifting;
- People interested in strength training;
- anyone who is overweight.
Phlebologists have this joke: "Everyone will live to see their varicose veins, unless of course they die of something else! "Cynical? But there is some truth in every joke. 90% of the world's population suffers from this disease today.
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 people simply do not realize that there is something wrong with their veins, which is due to fatigue or age-related changes. Take, for example, the infamous "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 a hormonal imbalance and does not necessarily lead to varicose veins. The main symptoms of varicose veins of the lower extremities include swelling, a feeling of heaviness in the legs at the end of the work day and sometimes cramps.
Today, ultrasound examination 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 have the feeling that your legs are "filled with lead" and noticeably swell. By the way, the gold standard is now the situation where a phlebologist himself conducts an ultrasound examination to determine the severity of the disease and to decide on further treatment tacticsto decide 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 level.Apart from discomfort in the legs at the end of the day, there are no visible changes.
- First stage.Individual networks of small veins are visible through the skin.
- Second floor.The expansion of the saphenous veins is clearly visible through the skin of the legs.
- Third section.The feeling of heaviness in the legs is accompanied by swelling and venous "bumps" forming over the surface of the skin.
- Fourth stage.In areas above the enlargement of deep veins, the skin begins to itch constantly and over time turns dark brown.
- Fifth stage.An indicator of an advanced disease state: trophic ulcers appear in places where damaged veins are scratched and take a long time to heal.
- Sixth stage.Trophic ulcers no longer heal and constantly ooze and become infected.
Depending on the degree of varicose veins of the lower extremities, the doctor chooses one or another treatment tactics.
Surgery for varicose veins of the lower extremities
It is important to understand that treatment of varicose veins of the lower extremities does not always require surgical intervention. On the Internet, patients often search for an answer to the question: "How to treat reticular varicose veins of the lower extremities? ""Although in Western terminology there is no such diagnosis at all, this is exactly the case when an operation can be performed without surgery.
In the initial stages of varicose veins, it is enough to adjust the lifestyle and take drugs from the rutoside class, which strengthen the vascular walls. Only a doctor can prescribe the dosage and duration of use.
Radical methods for 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 ways of conducting it (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, the use of other methods is impossible.
- Endovenous laser coagulation
Belongs to the category of modern thermoablative treatment methods. An electrical 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 performed under local anesthesia, after its 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 functional principle is similar to endovenous laser coagulation, only here a light guide takes on the role of the electrode, through which the pathologically changed vein is exposed to high-frequency radiation. The operation is also performed under local anesthesia and has a short recovery period.
- Echosclerotherapy
This mechanochemical method is now considered even more innovative than laser treatment because it does not use a physical, but rather a chemical agent. A sclerosant is injected into the lumen of the vein - a special medicinal substance that "glues" the vein together. The procedure is painless for the patient and is carried out on an outpatient basis. Most effective for superficial varicose veins. However, it is not included in the basic compulsory health insurance policycontain.
* Please note that the decision to use 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 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 relieving the symptoms, and not at 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 with 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 ingredient reaches the vein walls in minimal concentration. The relief that many patients feel after rubbing such medications into problem areas of their legs can be explained by the placebo effect. When using external products, you should take into account this important nuance: you can safely use them only if there are no open skin lesions, i. e. H. in 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. Do I need to mention 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 and promotes lymphatic drainage. Exercises you can do yourself at home include:
- Ride a bike.
Lie on your back and imitate pedaling a bicycle.
- Alternate walking.
First walk on the spot on your toes and then on your heels.
- "Scissors".
Lying on your back, do cross swings with your legs straight at the knees.
With 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 comorbidities and the competence of the fitness trainer.
The danger of being overweight with varicose veins
A special topic is nutrition for varicose veins of the lower extremities. The main desire of doctors is that body weight must be controlled. Excess weight not only "hits" the joints and impairs the functioning of the cardiovascular system, but is also a provoking factor for 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 that contain a lot of vitamin C. And it is better to say goodbye to bad habits like alcohol and nicotine if you want to maintain the health of your blood vessels for a long time.
Consequences of varicose veins
The consequences of neglected varicose vein disease are always extremely serious. First, trophic ulcers in varicose veins of the lower extremities are an integral part of the end-stage disease. Aside from looking very unsightly, they are also itchy and painful.
Secondly, all patients diagnosed with varicose veins are at risk of developing 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 with varicose veins of the lower extremities this is already a double-edged sword. For patients taking anticoagulant drugs, doctors can no longer offer laser surgery as a treatment: when taking acetylsalicylic acid and similar drugs, only ablation occurs, the purpose of which is the formation of a blood clot is useless.
If they ask me: "Doctor, is it possible to live with varicose veins and do nothing about it? "", I answer honestly: "You can live. "But you probably won't like such a life! "First, trophic changes in the veins lead to ulcers, which are sure to become inflamed and leak. Second, varicose veins of the superficial veins can lead to deep vein thrombosis of the lower extremities, which carries the risk of pulmonary embolism and, in some cases, even death.
Is prevention possible?
It is easier to prevent an illness than to waste time and money treating it. Unfortunately, varicose veins are a chronic disease. There are no special precautionary measures that can protect us 100% from becoming ill. In addition, according to statistics, even with radical treatment methods, the probability of relapse is 30%.
Does this mean that you should give up everything and limit yourself to nothing? Of course not. To prevent varicose veins of the lower extremities, doctors strongly recommend maintaining a healthy lifestyle: watch your weight, move more, engage in low-impact 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.