One in two people suffers from varicose veins. Some do not even suspect that they are sick. And others, and these are the majority, postpone visiting the 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 various minimally invasive and painless methods.
varicose veins
There is an opinion that the diagnosis of "varicose veins of the lower extremities" corresponds to people "over 40 years old. "In fact, no one is immune to 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 of the most in-demand professions demand 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 workday "on their feet. "
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 work involves heavy physical labor and heavy lifting;
- people interested in strength training;
- all those who are overweight.
Phlebologists have this joke: "Anyone will live to see his varicose veins, unless, of course, he dies from something else! " Cynically? But there is some truth in every joke. Today 90% of the world's population suffers from this disease.
What symptoms of varicose veins of the lower extremities should alert the patient and indicate that it is time to see a doctor? Not everything is so simple here. As a rule, the disease develops gradually and many simply do not realize that something is wrong with their veins, attributing everything to fatigue or age-related changes. Take, for example, the notorious "spider veins" - damage to the small vessels (reticular) 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 a hormonal imbalance, which does not necessarily lead to the appearance of varicose veins. The main signs of varicose veins of the lower extremities include: swelling, a feeling of heaviness in the legs at the end of the workday, 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 "full of lead" and they swell noticeably. By the way, the gold standard is now considered to be a situation when the phlebologist himself conducts an ultrasound examination to determine the severity of the disease and decide on other treatment tactics for the patient.
Stages of varicose veins of the lower extremities.
According to the international CEAP classification, which is used in phlebology, the development of varicose veins of the deep veins of the lower extremities is divided into 6 stages.
- Stage zero.Apart from the discomfort in my 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 stage.The expansion of the saphenous veins is clearly visible through the skin of the legs.
- Third stage.The feeling of heaviness in the legs is accompanied by swelling, and venous "bumps" appear on the surface of the skin.
- Fourth stage.In the areas above the expansion of the deep veins, the skin begins to constantly itch and over time turns dark brown.
- 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.
- Sixth stage.Trophic ulcers no longer heal, they constantly ooze and become infected.
Depending on the degree of varicose veins of the lower extremities, the doctor chooses one or another treatment tactic.
Surgery for 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 are looking for the 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 the lifestyle and take drugs from the rutoside class, which strengthen the vascular walls. Only a doctor can prescribe its dosage and duration of use.
Radical methods for treating varicose veins of the lower extremities include: phlebectomy, laser surgery and various mechanochemical methods*. Let's take a closer look.
- Standard phlebectomy
It is 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 injury and the diameter of the damaged vein. In any case, modern phlebology considers this method of treatment as an extreme measure, used when, for various reasons, it is impossible to use others.
- Intravenous laser coagulation
It belongs to the category of modern thermoablative treatment methods. An electrical current is applied to the affected vein, causing the formation of a blood clot, 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 surgery is performed under local anesthesia, once completed, the patient gets up and literally goes home.
- radiofrequency ablation
This is another method of laser treatment for varicose veins of the lower extremities. The principle of operation is similar to endovenous laser coagulation, only 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.
- Ecosclerotherapy
This mechanochemical method is considered today even more innovative than laser treatment, since it does not use a physical agent, but a chemical one. 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 compulsory health insurance program.
* Please note that the decision to choose one or another treatment method is made by doctors, depending on the individual indications and contraindications of a particular patient.
Ointments and gels for varicose veins.
Is any medication used to treat varicose veins in the lower extremities? They are applied, but with two serious reservations. First of all, since drug therapy in this case is aimed at relieving the symptoms, and not the cause, it is prescribed only if there are signs of venous insufficiency, which we have already talked about above. Secondly, they are prescribed only by the treating doctor.
As for all types of gels, creams and ointments for varicose veins of the lower extremities, their effectiveness is extremely insignificant for the simple reason that the active substance reaches the walls of the veins in a minimal concentration. The relief that many patients experience after rubbing these medications on problem areas of the legs can be explained by the placebo effect. If you use any external products, 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 to 3 of the disease.
Massage and physical activity for varicose veins.
The comprehensive varicose vein treatment program includes massage and exercise therapy. Should I say that both the first and the second must be agreed with the treating doctor? 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 the outflow of lymph. Exercises you can do at home on your own include:
- A bike ride.
Lying on your back, imitate pedaling a bicycle.
- Alternate walk.
Walk in place first on your toes and then on your heels.
- "Scissors".
While lying on your back, make cross movements with your legs stretched at the knees.
As for 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 fitness instructor.
The danger of excess weight with varicose veins.
Nutrition for varicose veins of the lower extremities is a special topic. The main desire of doctors comes down to one: it is necessary to control body weight. Excess weight not only "hits" the joints and is detrimental to the functioning of the cardiovascular system, but also serves as a provoking factor in the development of varicose veins, since any internal pressure causes 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 infusions. The diet should be rich in fiber, vegetables and fresh 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 vessels for a long time. time.
Consequences of varicose veins
The consequences of neglected varicose veins are always extremely serious. First of all, trophic ulcers in the varicose veins of the lower extremities are an integral part of the disease in the final stages. In addition to looking very unpleasant, 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 its 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: while taking aspirin and similar medications, ablation, which aims to cause a blood clot to form, will simply be useless.
When I am asked: "Doctor, is it possible to live with varicose veins and do nothing about it? ", I sincerely answer: "You can live. But you are unlikely to like such a life! First of all, trophic changes in The veins cause ulcers, which are sure to become infected and leak. Second, varicose veins in the superficial veins can cause 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 can be 100% guaranteed to protect us from the possibility of getting sick once and for all. Moreover, even when using radical treatment methods, the probability of relapse, according to statistics, 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 following a healthy lifestyle: controlling weight, moving more, playing non-strength sports (for example, going to the pool).
A good prevention of varicose veins of the lower extremities is the regular use of elastic compression: a phlebologist will help you choose classes 1 or 2 for stockings or pantyhose individually, depending on the severity of the disease.