At least half of adults have some type of problem with dilated veins. This common condition is a familiar problem for many people. Women are at least twice as likely to develop varicose veins as men. In both sexes it affects 25% to 60% of adults, depending on age.
Dilated veins do not always appear as convex bluish filaments; Varicose veins sometimes appear as a thin vascular network that runs just beneath the surface of the skin. It almost always affects the legs and feet. The visible swollen, tortuous veins — sometimes surrounded by patches of congested capillaries, resembling a spider web or spider veins — are superficial varicose veins. Although they are often painful and disfiguring, in most cases they are harmless. When inflammation develops, these veins become dense to the touch and can impede blood circulation to the point of causing swelling of the ankles, itching and pain in the affected limb.
In addition to the superficial venous network, the legs have an internal, or deep, venous network. In rare cases, the deep veins of the legs are also affected by varicose veins. These deep varicose veins are usually not visible, but they can cause swelling or pain throughout the leg and, even more dangerous, can be the site of blood clots.
To help circulate oxygenated blood from the lungs to all parts of the body, arteries have a thick muscular lining. For the reverse flow of blood through the venous system, the surrounding muscles are used, the muscle layer on the venous wall is thin and weak, but the veins are equipped with internal valves that allow blood to pass in only one direction: towards the heart, valves are necessary to prevent the reverse flow of blood.
With varicose veins, the valves don't work properly, causing blood to pool in the vein and making 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 damaging the valves, causing the vein to bulge and become tortuous. 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 lead to the appearance of 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 lifting heavy loads. Chronic constipation, prostatic adenoma that requires straining during bowel movements and urination, and in rare cases, tumors can also cause varicose veins. A sedentary lifestyle contributes to the development of varicose veins, since muscles that do not work do not pump blood well.
The likelihood of varicose veins increases with age as muscles and veins weaken. Previous trauma to the leg 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 an existing condition.
Is it possible to prevent varicose veins?
Although genetics play a role in the risk of developing varicose veins, there are things you can do to prevent them:
- Do physical activity regularly because staying in good physical shape is the best way to keep your leg muscles toned, improve blood circulation and control your weight. It is believed that of all types of fitness, swimming and water aerobics 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, since normal weight prevents excessive pressure on the leg veins;
- Avoid tight clothing. Tight clothing can restrict blood flow in the thighs, groin, and legs;
- Avoid frequent and prolonged use of high-heeled shoes, as they can hinder blood circulation. Shoes with completely flat soles are also undesirable; it is better to choose shoes with a low, stable heel or elastic soles, as they promote blood circulation and also improve the tone of the calf muscles.
- Movement! Avoid sitting or standing for prolonged periods to stimulate blood circulation. If your daily routine requires a lot of standing, consider wearing a daily support shirt. Stretch your legs and exercise as often as possible to improve circulation and reduce venous pressure.
- Fight against smoking. Research shows that smoking can contribute to the development of varicose veins.
- During pregnancy you should sleep on your left side and not on your back. This will reduce the pressure of the uterus on the veins in the pelvic area and also improve the blood supply to the fetus;
- If you have risk factors for developing varicose veins, ask your doctor to choose compression stockings for you - these could be special socks, stockings or pantyhose.
Varicose veins and varicose veins
As we age, many of us find bumpy, bluish stars under our skin or swollen cords stretching down our thighs and calves. These deformed blood vessels occur in 60 percent of adults after age 50.
What are spider veins?
Spider veins are small, twisty blood vessels that show 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, swelled and acquired a tortuous course due to changes in the venous wall. Such veins appear bluish and raised above the surface of the skin. Varicose veins can appear anywhere, but most commonly develop on the legs, thighs, and feet.
What causes varicose 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 in the desired direction from superficial veins to 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 the backflow of blood. However, problems with the valves, muscles, or blood pressure can cause blood to pool within the vein. When blood builds up in a vein, pressure increases and the vein wall weakens. As a result, the vein becomes swollen and tortuous. As a result, depending on the caliber of the blood vessel and the degree of swelling, a network of varicose veins or varicose veins is formed.
Who is at risk for varicose veins?
Varicose veins or varicose veins of large veins can appear in any person, but women are susceptible to this problem twice as often as men. This problem is also familiar to those whose jobs require constant standing, 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 symptoms are accompanied by varicose veins?
Often capillaries and/or varicose veins are not just an unpleasant aesthetic defect. Varicose veins are a disease that can cause unpleasant symptoms and dangerous complications, especially pain or cramps in the legs, feeling of heaviness, throbbing or tingling. Severely inflamed veins become hard to the touch and reduce circulation, causing itchy, swollen ankles. Additionally, over time, trophic changes develop in the skin and subcutaneous tissue, such as thickening, pigmentation, and ulceration.
Complications of varicose veins
Although varicose veins and varicose veins ruin the appearance of the legs and cause uncomfortable symptoms, they rarely pose a serious health hazard. However, in some cases, complications can develop that require a visit to the doctor and even hospitalization.
The most common complications of varicose veins are trophic ulcers against the background of long-term venous insufficiency, such ulcers are most often formed in the ankle area and heal very poorly; The second frequent and most 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 requiring hospitalization and intensive treatment. If thrombosis has developed in the deep venous system, there is a danger of migration of the blood clot, the so-called thromboembolism, and as a result of thrombophlebitis, a chronic post-thrombophlebitis disease may develop, which significantly affects the quality of the patient. life and performance.
Diagnosis of varicose veins of the lower extremities
It is easy to diagnose varicose veins and varicose veins of the superficial veins - a visual examination is enough. However, the primary diagnostic complex always includes an ultrasound examination of the deep venous system, since superficial dilated veins may indicate insufficiency 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 swelling of the ankles, the symmetry of the swelling, if any, compaction of the venous wall and subcutaneous tissue, changes in skin color, pigmentation, pain and the presence of trophic ulcers.
Most cases of varicose 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 in 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 therapeutic method can be made by a phlebologist based on the 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 thorough examination, an 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. The 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 that deals with the study and treatment of diseases and malformations of the venous system. A phlebologist surgeon must be skilled 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 their development and preventing complications. It usually consists of recommendations for lifestyle changes (weight loss, proper physical activity, elimination of static loads that contribute to the progression of the disease), choice of compression stockings, prescription of drugs that tone the walls of venous vessels and prescription ofa course of physiotherapy.
Compression shirt: socks, hold-ups and support tights
The easiest way to prevent the progression of varicose veins is to wear elastic 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 need to normalize your weight and introduce physical activity into your life, such as walking or swimming; exclude frequent use of high heels, static loads and a sedentary lifestyle.
Pharmacological 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 influence the speed of progression of varicose veins, slowing down their development. However, their action can only be effective in combination with other preventive measures.
Physiotherapy – for varicose veins, both in the initial stages and in advanced forms of the disease, pressotherapy is often used - a course of physiotherapy with compression - sequential compression of the veins with specialized circular pads, the pressure in which spreads from the feet to the hips, improving blood flow, stimulating the vascular wall and normalizing the functioning of venous valves. This treatment is prescribed 2-4 times a year in courses of 10-12 procedures. It is also recommended to perform it after sessions of sclerotic and laser therapy for varicose veins. Such physiotherapy can be performed independently or in combination with specialized electrical stimulation of the leg muscles, with the expectation of mutually enhancing the therapeutic effect.
Other situations in which physiotherapy gives good results are trophic alterations of the skin caused by advanced stages of varicose veins, in these cases it is appropriate to remember laser therapy, magnetotherapy, phono- and electrophoresis (→ and other methods); which is 100% contraindicated for physiotherapy for varicose veins is concomitant thrombosis or thrombophlebitis, therefore, before conducting a course of physiotherapeutic procedures, it is necessary to undergo an ultrasound examination of the veins of the lower extremities.
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 beautiful half of humanity, come to the phlebologist because of the external side of the disease: they are bothered by unsightly spots and cords on the legs. Treatment of varicose veins in this situation most often involves the elimination of cosmetic defects. For this purpose, minimally invasive methods are used for the treatment of varicose veins: sclerotherapy and endovenous laser coagulation (EVLC).
The term "minimally invasive" in relation to medical procedures means "minimally traumatic" and "gentle. " Indeed, such treatment is carried out on an outpatient basis, causes minimal pain, comparable to a regular injection, and allows you to achieve excellent results. This treatment consists in destroying the internal wall of the vein with a drug (sclerosant) or a laser, which leads to the adhesion of the vessel lumen and the disappearance of the aesthetic defect.
In any case, the decision on the method of treatment is made by the doctor based on the examination and examination. In case of complicated varicose veins, surgical treatment is used, which is carried out in a hospital setting.