Causes, symptoms and treatment of varicose veins

varicose veins in the legs

Varicose veins are divided into subtypes, each of which has its own characteristics. Treatment depends on the degree of the disease, the causes that caused it, the accompanying pathologies and other factors.

Description of the disease

In short, everything about varicose veins is a disease in which the outflow of blood is disturbed, its stagnation appears. This leads to swelling of the veins and their tortuosity. The disease is quite common, occurring in approximately a quarter of the population.

In adolescence, venous expansion develops with equal frequency in both sexes. In adulthood, women are twice as likely to be at risk. Vein problems are caused by serious hormonal changes that occur during the menstrual cycle or during pregnancy.

As a result, the tone of the blood vessels is greatly weakened, they begin to dilate, and the flow of venous blood is disturbed. The diagnosis of vbvnc (otherwise - varicose veins of the lower extremities) is made.

Development mechanism

The veins of the legs form a network with many branches, which are connected by perforators. The outflow from the epidermis and its tissue takes place through the superficial blood veins, through the deep ones - from other tissues. Perforating vessels equalize venous pressure. In the normal state, the blood flow moves only towards the deep ones. From the periphery to the middle - due to residual blood pressure and tendon pressure.

When this process is disrupted, the peripheral veins swell, become blue and twisted. At the same time, varicose nodes appear, the valve circuit is destroyed and varicose veins appear. The outflow of blood cannot follow the usual pattern. This is accompanied by venous reflux. Spider veins appear. Closed valves in the veins do not let the blood flow. Blood stagnation occurs, the pressure in the arteries increases.

As it grows, blood begins to flow. Its excess stretches the venous walls and blood vessels, creating intradermal varicose veins. The edges of the capillaries strongly rest on the dermis and shine through it, forming vascular networks. Such places are very faint, their color becoming more and more noticeable. The nodules on the legs become clearly visible (what varicose veins look like is shown in the photo). High blood pressure contributes to atrophy of muscle fibers, nerves involved in venous tone die.

Classification of diseases

The disease can manifest in different areas. Veins on the hips and legs are more common. The disease has several classifications. This is due to the many course variants and places of damage.

Stages of varicose veins:

  1. Compensation A. The patient does not complain of anything, but a visual examination reveals the presence of swollen veins in the legs. These are the first signs of the disease.
  2. Subcompensation B. The blood veins in the legs are greatly dilated. Patients complain of swollen limbs, night cramps. In the evening, there is a slight swelling of the veins in the feet, legs and ankles. These symptoms disappear in the morning.
  3. In addition to decompensation, eczema, dermatitis and itching in the epidermis are added to the above symptoms. The skin begins to shine, becomes dry and thick. Small hemorrhages are visible below the surface.

This classification reflects the levels of venous insufficiency, the form of venous swelling and some complications.

Classification by shape

The disease is divided into several types:

  • segmental varicose veins;
  • main (with two subspecies - in a small or large vein);
  • perforation;
  • reticular.

International classification

According to the international classification, varicose veins of the lower extremities are divided into six classes, due to certain characteristics:

  • zero - there are no other symptoms of the disease, except for heaviness in the legs;
  • first - the venous network and asterisks are visually visible, at night the person is twisted in muscle cramps;
  • others - some veins begin to dilate;
  • third - there is swelling of the legs, which does not disappear even after a short rest;
  • fourth - there is hyperpigmentation of the legs, dermatitis;
  • fifth - ulcers form;

The sixth class of varicose veins on the legs is diagnosed when skin lesions develop into trophic and become permanent.

Causes

The causes of varicose veins are very diverse - from improper lifestyle and diet to congenital pathologies. Varicose veins are caused by a violation of the circulatory system.

Its causes:

  1. Hereditary predisposition. Children whose parents had varicose veins can get this disease in 70 percent of cases. At the same time, signs of varicose veins often appear at an early age.
  2. Disorders of the endocrine and hormonal systems. The risk group is mainly women, due to the anatomy of the body. Women have an insufficient amount of estrogen, and corpus luteum hormones predominate. They have a relaxing effect on the muscles, reduce the elasticity of the vein walls. The most dangerous varicose veins on the legs in women during childbirth, breastfeeding, menopause. The risk zone for both sexes is the maturation period.
  3. Stress, depression, nervous disorders reduce the tone of the veins. Their elasticity is regulated by nerve endings.
  4. Pelvic inflammation damages small blood veins.
  5. Why do varicose veins appear with insufficient mobility, work in the office? When a person sits, his veins are very tight. As a result, blood circulation is disturbed and the tone of the canal walls is reduced. Fluid begins to stagnate in it, leading to varicose veins.
  6. Increased physical activity that includes weight lifting, prolonged leg work, obesity, pregnancy. In the background of the above, the pressure in the veins increases greatly.
  7. Various neoplasms, blood clots that interfere with blood flow.
  8. Flat feet.
  9. Diseases and injuries.
  10. Constipation, in which the pressure in the abdomen increases.
  11. Arterial-venous "crossroads" where arterial blood cells can overflow.
  12. Heels too high. The risk of varicose veins increases significantly if you walk on them for a long time.
  13. Chronic liver diseases - cirrhosis, all types of hepatitis, etc.
  14. Body structure. People above average height are more likely to suffer from varicose veins.

Another cause of varicose veins of the lower extremities is upright posture. A great burden falls on a person's feet. The blood column extends from the lower extremities to the heart muscle, so those who spend a lot of time in a standing position are at the highest risk.

Symptoms of varicose veins

The symptoms of varicose veins begin with heaviness in the legs. Many people confuse this feeling with banal fatigue.

The disease begins to progress and new symptoms appear:

  • vein thickening occurs;
  • leg pain;
  • evening swelling of the legs;
  • veins pulsate;
  • burning sensation under the skin;
  • nocturnal muscle cramps;
  • redness of the affected areas;
  • veins begin to dilate;
  • the skin of the lower leg becomes dark, with seals;
  • numbness of the legs.

Sometimes the symptoms of varicose veins appear only in the popliteal region or behind the legs. These signs are less noticeable if the limbs have excessive hairiness or thick skin.

Varicose veins on the legs are easily determined by palpation. In this case, the curvature of the veins is felt. If the patient's legs are raised, the venous network disappears, in the upright position it thickens.

Blunt lobes, tingling and cramps often appear after prolonged standing. The feet swell mainly in the area of soft tissue - in the lower part of the lower leg, in the ankles. If varicose veins are not treated, the deformity affects and affects the skin. Take on a bluish hue, swell quickly. Additional symptoms appear:

  • induration;
  • severe muscle pain that becomes more intense when walking
  • varicose ulcer;
  • pigmentation;
  • veins respond to pain on palpation;
  • malnutrition of the epidermis.

When varicose veins of the lower extremities pass into a complicated phase, additional weakness and fever occur. In rare cases, bleeding occurs due to rupture of a vein. This phenomenon most often occurs at night.

Diagnosis

Only a vascular surgeon or phlebologist can pinpoint varicose veins. At the first signs of the disease you should consult a doctor. First, a visual examination of the patient is performed, palpation of the allegedly damaged areas. To clarify the diagnosis, additional diagnostics of varicose veins are performed:

  1. Ultrasound examination, during which not only the pathology is determined, but also the directions of blood flow, the presence of neoplasms and blood clots are noticed. The procedure allows you to assess the degree of vascular dilatation.
  2. Contrast venography is the most informative and accurate method. It allows you to assess the condition of the veins as accurately as possible. To do this, a blood-staining contrast agent is injected into the patient's body before the procedure.

The methods are interchangeable. However, ultrasound is less invasive, so this method is preferred. The severity of deformities and disorders is determined by X-ray and rheovasographic examination.

Treatment of diseases

For the treatment of varicose veins, a complex treatment is initially prescribed. It includes several directions. The main thing is drug treatment. In the initial phase, venotonics are prescribed in the form of ointments and gels. They protect the vascular walls, accelerate drainage and improve blood circulation.

the doctor examines the legs with varicose veins

Preparations for venous diseases are used in courses, reduce pain and swelling. However, ointments and gels do not have a strong effect, but are used in the early stages of the disease. Venotonics are also available in tablets. They are prescribed to remove deep varicose veins:

  1. Saponite.
  2. Diosmin-based.
  3. Rutosides eliminate inflammation.

Phlebectomy of the lower extremities is performed by injection or elastic bandage. The puncture method is used before, during and after surgery. Catheter view - only during surgery. Isolated sclerotherapy does not give stable results and will not stop the worsening of the disease. It is more often combined with surgical treatment. Treatment of phlebosclerosis has contraindications:

  • obliterating endarteritis;
  • acute thrombophlebitis of the extremities;
  • diabetic angiopathy;
  • blood clotting disorders;
  • pregnancy;
  • atherosclerosis with ischemic disease;
  • allergic reactions to drug ingredients.

Additionally, drugs that improve blood circulation are prescribed - low molecular weight dextrans. They reduce the viscosity of the blood, increase the elasticity of blood vessels and participate in the breakdown of platelets. It improves microcirculation and tissue oxidation.

Also, direct and indirect anticoagulants are prescribed for venous diseases. They reduce the risk of blood clots.

External decongestants are used at the same time. They reduce inflammation and prevent blood clots from forming. Nonsteroidal tablets for varicose veins relieve pain and inflammation, prevent their spread.

Physiotherapy

Treatment of varicose veins on the legs is possible by the method of puncture. It can be classified as physiotherapy, because it is often performed in a surgeon's office. Large veins are blocked first, then smaller ones. Before introducing the drug, the patient lies on the couch. For a long vein or several located along the circumference of the leg, more than one therapy session is performed.

varicose veins on the legs ultrasound diagnosis

Physiotherapy of varicose veins includes a new direction of treatment - obliteration of veins by radiofrequency radiation. This method does not cause major blood vessel trauma, has mild pain and prevents possible complications. The efficiency of the method is high. Radiation destroys the affected walls of blood vessels, while healthy ones remain intact. Venous voids disappear.

Pneumatic massage can be prescribed with a small device. Tissue trophism and blood circulation improve during the session. Some of the symptoms of varicose veins are significantly reduced.

Surgical operations

The decision on lower extremity vein surgery is made by a vascular surgeon or phlebologist. They give other recommendations for varicose veins. For example, for pregnant women, if the disease is not dangerous, it is suggested to postpone the operation until the baby is born.

During gestation, varicose veins in women progress and the results achieved by surgery may disappear. Then re-intervention will be needed. Surgical treatment can be performed in several ways:

  1. Combined phlebectomy is the most common method. It is used for severe varicose veins. The operation is performed under general anesthesia. Minimal incisions are made through which a special probe with a phleboextractor is inserted. A vein is then removed and excised from the groin to the middle of the lower leg. Small blood veins and ducts are removed through punctures. This operation is called a miniphlebectomy.
  2. Endovasal electrocoagulation was followed by current removal of the veins. The method is more dangerous than conventional surgery or obliteration.
  3. Cryotherapy is used to remove blood veins at low temperatures. The method is safe, but it can be difficult to determine the required depth of freezing so as not to damage nearby tissues, so the treatment of varicose veins in this way is used extremely rarely.
  4. Vein sclerobliteration is performed by inserting a catheter under the skin. Before that, the necessary veins and parts are marked. The anastomosis is then exposed to a large blood vessel, and the tributaries are connected. Perforating veins are pinched from the incisions. A catheter is inserted into the incised vein. Then the vein is sutured and the wound is bandaged. The gauze roller is placed along the entire vein and pressed against the leg. When the catheter is removed, a venosclerosant is injected.
  5. Endoscopic dissection of the perforating veins allows the affected veins to be ligated, thus excluding them from the general circulation. Special probes are used for this. Another similar method is transillumination phlebectomy.

Laser coagulation is performed using special equipment. The affected blood vein is sealed from the inside with a laser beam. As a result, the vein is excluded from the general circulation.

Home treatment

It is necessary to consult a doctor before treating varicose veins on the legs. He can prescribe systemic drugs, leech therapy. Latent internal varicose veins can be diagnosed. It is impossible to cure it at home. Apple cider vinegar and cabbage leaves are usually used for mild diseases.

elastic bandage of legs with varicose veins

To cure varicose veins, you need to wear compression underwear, make an elastic bandage. However, any treatment at home will be ineffective in the advanced stage of the disease. Leeches are an unconventional method of therapy. Home treatment with chiropractic can be used only under the supervision of a specialist. You cannot perform the procedure yourself.

Complications of varicose veins

If varicose veins are not treated in time, the disease can cause serious complications. This includes:

  • dermatitis;
  • eczema;
  • acute thrombophlebitis of superficial blood veins;
  • phlebothrombosis;
  • hypoxia;
  • varicose veins;
  • trophic ulcers.

With the progression of varicose veins on the legs, varicothrombophlebitis appears, followed by lebotrombosis. It affects the deep veins, the pulmonary embolism begins. If the varicose veins do not stop at this stage, vascular occlusion develops, and after stopping the swelling of the blood, gangrene. This is accomplished at least by limb amputation.

Prophylaxis

It is necessary to consult a doctor before treating varicose veins. There may be enough light venotonics and adherence to preventive measures to keep the disease from progressing. It is necessary to reduce excessive physical activity, you can not stand for long - it is better to move, sitting position is occasionally replaced by lying down. If this is not possible, at least make circular movements with your feet.

After a hard day, you need to keep your tired legs in an elevated position. Try to avoid putting one foot on the other for a long time. It is necessary to maintain optimal weight, with obesity - go on a diet. Avoid wearing things that crush you on your groin, legs and waist.

It is recommended to walk in the fresh air every day, actively engage in swimming or cycling. It is recommended to do exercises every morning and evening. It is important to quit bad habits - smoking, consuming alcohol. It is useful to take a contrast shower.

Varicose veins in the early stages can be treated with ointments and gels, light medications. However, progressive disease requires cardinal surgical methods combined with compression and sclerotherapy.