One in two people suffers from varicose veins. Some don't even suspect they are sick. And others, and these are the majority, postpone the visit to the doctor until the last minute, preferring to treat themselves with the help of various gels and creams, the advertising of which 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 several minimally invasive and painless methods.
Varicose veins
There is an opinion that the diagnosis of "varicose veins of the lower extremities" is reserved for people "who are over 40 years old. "In reality, 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 remains in the same position for a long time: standing or sitting. The modern world is structured in such a way that most of the in-demand professions require exactly this from us: all office workers sit at the computer all day, and sellers, hairdressers, teachers or, for example, surgeons themselves are forced to spend their "standing" working day.
The risk group also includes:
- pregnant women (varicose veins of the lower extremities in women are intermittent and after giving birth the condition returns to normal);
- people whose jobs involve heavy physical labor and heavy lifting;
- people interested in strength training;
- all those who are overweight.
Phlebologists say this joke: "Every person will live to see his varicose veins, unless, of course, he dies from something else! "Cynically? But there is 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 signal that it is time to consult a doctor? Not everything is so simple here. As a rule, the disease develops gradually, and many simply do not notice that there is something wrong with their veins, attributing everything to fatigue or age-related changes. Take, for example, the infamous "spider veins": damage to the 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, which does not necessarily lead to varicose veins. The main signs of varicose veins of the lower extremities include: swelling, feeling of heaviness in the legs at the end of the working day and sometimes cramps.
Today, ultrasound of the veins of the lower extremities is the most informative method of 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 swell noticeably. By the way, the gold standard is now considered a situation where the phlebologist himself performs an ultrasound examination to determine the severity of the disease and decide on further treatment tactics for the patient.
Stages of varicose veins of the lower extremities
According to the international CEAP classification, used in phlebology, the development of varicose veins of the deep veins of the lower extremities is divided into 6 phases.
- 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 phase.The expansion of the saphenous veins is clearly visible through the skin of the legs.
- Third phase.The feeling of heaviness in the legs is accompanied by swelling, and venous "bumps" appear on the surface of the skin.
- Fourth phase.In the areas above the expansion of the deep veins, the skin begins to itch constantly 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 limbs
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 an 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 surgical intervention can be performed without surgery.
In the initial stages of varicose veins, it is sufficient to adapt your 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 the treatment of varicose veins of the lower extremities include: phlebectomy, laser surgery and various mechanochemical methods*. Let's take a closer look at them.
- Standard phlebectomy
It is the surgical removal of a fragment of damaged vein 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, based 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.
- Endovenous laser coagulation
It belongs to the category of modern thermoablative treatment methods. An electric 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; at the end, 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 today considered even more innovative than laser treatment, since it uses not a physical, but a chemical agent. A sclerosant, a special medicinal substance that "glues" it, is injected into the lumen of the vein. 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 medical insurance program.
* Please note that the decision to choose 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 there any medications used to treat varicose veins of the lower extremities? They apply, but with two serious reservations. Firstly, since drug therapy in this case is aimed at alleviating the symptoms and not the cause, it is prescribed only if there are signs of venous insufficiency, which we have already talked about previously. Secondly, they are prescribed only by the attending physician.
As for 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 walls of the veins in minimal concentration. The relief that many patients feel after smearing such drugs on problem areas of the legs can be explained by the placebo effect. If you use 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 1-3 of the disease.
Massage and physical activity for varicose veins
The comprehensive varicose vein treatment program includes massage and physical therapy. Should I say that both the first and second must be agreed with the attending 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 limbs prevents the formation of edema, promoting the outflow of lymph. Exercises you can do at home on your own include:
- A bicycle ride.
Lying on your back, imitate pedaling a bicycle.
- Alternate walking.
Walk in place first on the balls of your feet and then on your heels.
- "Scissors".
While lying on your back, perform cross-swings with your legs extended 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 being overweight with varicose veins
Nutrition for varicose veins of the lower extremities is a special topic. The main desire of doctors boils down to one thing: it is necessary to control body weight. Excess weight not only "affects" the joints and is harmful to the functioning of the cardiovascular system, but also serves as a provoking factor for the development of varicose veins, because any internal pressure leads to dilation of the veins.
There is no special diet for varicose veins of the lower limbs, 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 fruits and vegetables, which contain a lot of vitamin C. And it is better to say goodbye to bad habits such as drinking alcohol and nicotine if you want to prolong the health of your blood vessels for a long time.
Consequences of varicose veins
The consequences of neglected varicose veins are always extremely serious. Firstly, trophic ulcers in the varicose veins of the lower extremities are an integral part of the disease in the final stages. In addition to having a very unpleasant appearance, they also cause itching and pain.
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 their 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 drugs, doctors will no longer be able to offer laser surgery as a treatment: while taking acetylsalicylic acid and similar drugs, ablation, the purpose of which is to cause the formation of a blood clot, will be simply useless .
When they ask me: "Doctor, is it possible to live with varicose veins and do nothing? ", I honestly answer: "You can live. But you will hardly like such a life! "First, trophic changes in the veins lead to appearance of ulcers, which will certainly become infected and leak. Second, varicose veins of the superficial veins can lead to deep vein thrombosis of the lower extremities, with the 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 treating it. Unfortunately, varicose veins are a chronic disease. There are no particular 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? Obviously not. To prevent varicose veins of the lower extremities, doctors strongly recommend adhering to a healthy lifestyle: watching your weight, moving more, doing 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 individually choose class 1 or 2 for stockings or tights, depending on the severity of the disease.