Varicose veins of the legs (varicose veins - common name) - externally visible dilation of the subcutaneous veins, which develops as a result of varicose veins or postthrombotic syndrome and is accompanied by a sharp violation of venous outflow in the lower extremities.
Modern methods allow radical treatment of varicose veins without incisions and pain.
Complaints of varicose veins
For many people, varicose veins and spider veins are just a cosmetic problem. In others, varicose veins cause painful pain and discomfort. Sometimes varicose veins lead to more serious problems and complications - thrombophlebitis or trophic ulcers. Treatment consists of removing or closing deformed veins, which is the job of a phlebologist.
Varicose veins is a complete degeneration of the venous wall associated with the weakness of its connective tissue (varicose veins of the lower extremities) or developing with a sharp violation of venous outflow due to blockage or overflow of the veins.
Causes of varicose veins of the lower extremities
Varicose veins of the lower extremities
The disease, as a cause of varicose veins of the legs, occurs in 20-40% of the population of developed countries around the world. For a long time, varicose veins were just a cosmetic defect, but the progression of the disease leads to pain, swelling of the feet and legs, and in the advanced stage to darkening of the skin of the legs, inflammatory changes and dilated trophic ulcers.
Hereditary predisposition is the main cause of primary varicose veins, but the disease develops when the veins are overloaded. The mechanism for triggering varicose veins of the lower extremities is a sharp physical strain, pregnancy and childbirth. In this case there is a sharp increase in pressure in the veins of the lower extremities and damage to the valvular apparatus, which triggers the mechanism for the development of the disease.
Postthrombophlebitic disease
Secondary varicose veins develop after venous thrombosis or as a result of congenital diseases (arteriovenous fistulas, congenital venous dysplasia). Postthrombotic disease is a complex progressive pathological process in the venous system of the lower extremities. Due to valve insufficiency or obstruction of the deep veins, the subcutaneous veins dilate as they overflow with blood. Another reason may be congenital or acquired arteriovenous fistulas. Sometimes congenital obstruction of the deep veins occurs, leading to secondary varicose veins (Klipel-Trenaunay syndrome).
Complications of varicose veins
More than 40% of women and 20% of men have swollen varicose veins. In 20% of cases, varicose veins lead to trophic ulcers, more than 25% of patients suffer from thrombophlebitis of varicose veins. These complications often require serious treatment and pose a major health threat.
Chronic venous insufficiency
Obstruction of the venous outflow causes a pathological condition called chronic venous insufficiency. At the very beginning of the disease, single nodules of varicose veins can be noted, which do not cause much anxiety, although they can sometimes hurt. Subsequently, there is an increase in the number of varicose veins. The disease progresses slowly but steadily. If the first varicose veins appeared below the knee, then the rate of disease development is much higher. If the disease is not stopped, the third stage of venous insufficiency gradually develops. The swelling becomes permanent, dark skin color appears in the ankle area, the heaviness in the legs is constantly disturbing, which can continue even after a night's rest. Thrombophlebitis of varicose veins and skin inflammations, eczema and dermatitis often develop. The last stage in the development of varicose veins is the appearance of trophic ulcers.
Thrombophlebitis of varicose veins
Thrombophlebitis is the most common complication of varicose veins. Thrombophlebitis is an inflammation of the venous wall that causes blood clots to form in the lumen of the vein. Thrombophlebitis occurs in superficial and deep veins. In varicose veins, thrombophlebitis occurs in 25% of patients and is usually superficial. The cause of thrombophlebitis in varicose veins is very slow blood flow, especially in large nodes. Under these conditions, any factors that increase blood clotting (pregnancy, overheating, trauma, sprains, hypothermia and scratches, acute respiratory infections) can cause blood clots in varicose veins and inflammation. Thrombophlebitis occurs in 25% of patientswith varicose veins of the lower extremities. The cause of thrombophlebitis is a slowing of blood flow in varicose veins. Thrombophlebitis can progress and lead to deep vein thrombosis. Chronic venous insufficiency is a painful condition of venous outflow with varicose veins. It is characterized by swelling, darkening of the skin, the appearance of trophic ulcers and varicose dermatitis.
Varicose trophic ulcer
Trophic ulcer is a sign of extreme chronic venous insufficiency. This is a long-term non-healing wound that occurs with severe impairment of venous outflow through the deep and superficial veins. It occurs in 1% of the general population and in 20% of patients with venous disease. Every fifth patient with varicose veins who is not treated sooner or later gets a trophic ulcer. It can develop in both varicose veins and secondary varicose veins. Without elimination of pathological venous secretions, varicose trophic ulcer is not treated or is constantly recurring. Trophic ulcers with varicose veins occur in most patients and cause severe suffering. Modern minimally invasive methods allow you to reliably remove varicose trophic ulcers without incisions and pain.
Venous thrombosis and thromboembolism
Pulmonary embolism is a severe complication of venous thrombosis. Varicose veins are an important risk factor for thrombophlebitis and deep vein thrombosis. Thromboembolism leads to the development of severe heart and respiratory failure, with a mortality rate of over 50%.
Prevention of varicose veins of the lower extremities
Every modern person must understand what varicose veins of the legs are, how to treat and prevent its occurrence. In case of hereditary predisposition, factors contributing to varicose veins should be avoided. The use of venotones, the wearing of compression stockings during training, periodic examinations by a phlebologist and ultrasound of the veins are shown.
When working in conditions of concomitant factors it is necessary to use compression socks from the 1st class of compression at work, therapeutic exercises, outdoor activities, daily walks of at least 1 hour in medical socks, foot massage and swimming. Refusal to use oral contraceptives with complex inheritance of varicose veins. It is better to follow these simple rules than to treat varicose veins in the legs.
Avoid producing factors during heavy physical work. This requires compression stockings, especially if you are prone to varicose veins. The medical leotard is indicated for all pregnant women, and in case of predisposition to varicose veins and thrombophlebitis, special compression stockings are worn at birth. It is recommended that all pregnant women visit a phlebologist and have an ultrasound of the veins in the last weeks of pregnancy. This will help reduce the risk of venous problems.
How to treat varicose veins of the legs
In the last 10 years, "barbaric" methods of treating varicose veins have become a thing of the past, thanks to the emergence of more gentle and effective methods that are used successfully in clinics.
Sclerotherapy of veins for varicose veins
Sclerotherapy is the introduction into the lumen of varicose veins of a drug that causes the walls to "stick" along with the disappearance of the veins. A number of chemicals are used for sclerotherapy, there are attempts to treat with ozone. At one time, the advent of foam sclerotherapy revolutionized phlebology. For the first time, an effective method of treating varicose veins without major surgery has emerged. Foam sclerotherapy is currently used to remove varicose veins of medium diameter after laser obliteration of pathological venous secretions. Sclerotherapy is indispensable in the treatment of spider veins and reticular varicose veins, where there are no real competitors.
Laser treatment of varicose veins
Laser treatment of varicose veins of the lower extremities (EVLT) is the most modern, radical and inexpensive method of treatment that allows you to treat varicose veins of the legs and eliminate the causes of trophic ulcers. The meaning of laser treatment lies in the thermal heating of the venous wall from the inside and the subsequent resorption of varicose veins. The latest achievement in EVLT is the 1470 nm laser and radial light guide, which were introduced into medical practice by phlebologists. The postoperative period after this technique is completely painless, and the result surpasses other treatment options - the radicality of laser intervention is at least 98%.
Surgery to remove varicose veins
Surgical treatment of varicose veins with removal of the main venous trunks is a thing of the past. The risk of complications in the removal of stem veins forced phlebologists to look for other approaches, which led to the development of laser techniques and other methods for thermal obliteration of veins. However, the modification of classical phlebectomy into microphlebectomy according to Mueller and Varadi allowed a great combination of laser treatment and removal of large varicose veins by punctures without incisions or sutures. Varadi's technique saves patients from painful sclerotherapy of large varicose veins. Miniphlebectomy allows you to both treat varicose veins in the legs and remove visible varicose veins all over the body.
Radiofrequency obliteration of varicose veins
Radiofrequency obliteration (RFO) of varicose veins of the legs is a modern and safe method of treatment. The method is based on the use of microwaves that heat a metal probe, which is already the wall of the vein and causes the destruction of the inner membrane. Due to its painlessness, the method corresponds to laser coagulation with lasers with a wavelength of 1470 nm, is easy to perform and has little postoperative pain. However, RFO is much lower than laser in terms of long-term treatment results. The effectiveness of RFO is 85% without recurrence. The method is not suitable for the treatment of perforating veins.
Massage and bath for varicose veins
Massage is a method for active treatment of varicose veins.
All types of modern massage are used, especially in the pathology of the lymphatic and venous systems. Among the exclusive methods is the technology of lymphatic drainage massage with a bandage, which very effectively relieves chronic venous insufficiency.
In chronic venous insufficiency, massage is used to eliminate venous hypertension in varicose veins and postthrombotic syndrome. The combination of this massage with a bandage allows you to effectively eliminate all clinical manifestations of the disease.
A bath with varicose veins, thrombophlebitis or post-thrombotic disease is very dangerous. Any thermal stress can provoke the formation of blood clots in the deep veins with all the ensuing consequences.
Unfortunately, it is impossible to achieve a complete cure of varicose veins without eliminating venous secretions and varicose veins. Although the reduction of symptoms associated with stagnation of venous blood in the legs is quite possible with the help of modern therapy. However, the spread of varicose veins and chronic venous insufficiency sometimes makes you want to speculate on this problem. Think about modern methods of treatment and deception.
Medicines for varicose veins
The goal of drug therapy for venous pathology is to reduce symptoms and prevent complications, but these goals are not easy to achieve. Today, the abundance of tools that can be applied has raised another problem: which one to choose? Unfortunately, most of the proposed drugs have a rather low effectiveness, despite the theoretically justified appropriateness of use. This is due to a number of reasons, the main of which is the low absorption of the medicinal substances of these drugs by the body. The ideal drug for the treatment of venous insufficiency should affect as many pathogenetic links of chronic venous insufficiency as possible, while having a minimal number of side effects and high absorption by the body. A large number of venotonic agents are presented on the modern pharmaceutical market. However, they have similar medicinal substances (plant flavonoids) and therefore the effectiveness of one or the other depends only on the concentration and digestibility of the active principle.
You should not expect the disappearance of varicose veins from these drugs, but there may be lightness in the legs, reduced swelling and the disappearance of night cramps.
Creams and gels for varicose veins
Despite the high effectiveness promoted by sellers and manufacturers, creams and gels do not bring relief from varicose veins and varicose veins do not disappear from them. In the initial stage of venous insufficiency, phlebologists do not object to the use of these funds, as their rubbing promotes venous outflow, as a light massage, and has a soothing effect on the skin. In advanced forms of venous insufficiency, these creams and ointments can cause dermatitis and allergies and are therefore very harmful. Some drugs are used in the development of acute thrombophlebitis and help to alleviate the inflammatory process, but varicose veins do not disappear from them. Thanks to proper advertising, shamanic products with leeches have become very popular among people, but they have nothing to do with drugs, even leeches, and it makes no sense to expect them.
Medicines for blood clots in varicose veins
A common complication of varicose veins is thrombophlebitis, especially during pregnancy and the postpartum period. A proven drug to prevent blood clots is low molecular weight acid sulfur-containing glycosaminoglycan. To prevent thrombophlebitis after treatment of varicose veins, tablets are used in clinics. It is taken 7 days after laser or radiofrequency intervention.
Compression stockings for varicose veins
Compression stockings are undoubtedly one of the most effective means of treating venous edema and reducing the degree of chronic venous insufficiency. Invented more than 100 years ago, which gained immense popularity in the 20th and even more so in the 21st century, compression stockings and socks have become an integral part of phlebological treatment. This is due to the effects it has:
- improving venous and lymphatic outflow from the lower extremities,
- improving microcirculation,
- slowing the progression of the disease,
- prevention of complications of varicose veins (varicothrombophlebitis, trophic disorders),
- prevention of deep vein thrombosis.
How to use compression socks
So, if you have varicose veins and plan to treat it, then during the treatment you will undoubtedly use compression stockings for a period of several days or several months (separately). If your feet are swollen at the end of the day after work and you suffer from heavy foot syndrome, you can also use compression stockings during the day to avoid these symptoms in the evening. If you have complications from untreated varicose veins - trophic ulcers or thrombophlebitis - of course, you will also use compression to improve the condition of the legs and reduce unpleasant symptoms.
The fact is that by improving venous outflow, compression stockings work every second of wearing to improve the return of venous blood from the legs, which is undoubtedly not easy for veins compromised by disease and against the law of universal attraction. Compression knitwear can easily be called one of the ingenious inventions of mankind, but for it to work for you, several conditions must be met:
- The compression jersey is chosen individually (according to the standards). The main requirement is to observe the anatomical profile of the limb and therefore create the correct pressure gradient.
- The jersey is chosen by a doctor (phlebologist) individually. Medical devices are marked in mm Hg and are divided into compression classes 1, 2, 3, 4. Each compression class corresponds to a certain pressure. For different stages of varicose veins or chronic venous insufficiency, the appropriate compression class is used. Therefore, only a doctor has the right to prescribe and choose the right compression stockings - taking into account the nature of the pathology and according to individual standards.
- It should be medical, not weight loss jersey. Only proven brands with RAL certification.
When do you need knitwear for varicose veins?
- correction of the syndrome of "heavy legs": reducing weight, edema, improving quality of life;
- during treatment with a phlebologist: after surgery or for a period prescribed by a specialist;
- to slow the progression of varicose veins;
- for the treatment of varicose vein complications (varicothrombophlebitis).
A necessary component of any treatment for varicose veins and chronic venous insufficiency is medical elastic compression. Thanks to compression therapy it is possible to completely eliminate swelling, heaviness in the legs and create conditions for any kind of radical treatment of varicose veins. Modern medical knitwear has a high therapeutic effect and excellent aesthetic properties.
Elastic bandages |
Therapeutic tights |
|---|---|
The creation of the necessary pressure is determined by the technique and skills of bandaging the doctor or patient |
Processing profile and pressure level determined during production in accordance with the compression class |
The need for medical involvement in bandaging or patient education |
The doctor's involvement is limited to the choice of compression class and type of product |
Difficulty in providing compression and fixation on the thigh |
Provides effective compression and fixation on the thigh |
Used for non-standard shape of the limbs |
With a non-standard shape of the limb, customization is possible |
Daily washing leads to rapid wear of the bandages |
Daily washing is necessary to maintain the compression properties |
It needs to be changed after a few washes |
Guaranteed preservation of compression properties for 6 months |
Possible disturbances of the water and temperature balance of the skin |
Porous bonding ensures normal skin temperature and water balance |
Low aesthetic properties provide convenience and comfort |
High aesthetic properties, convenience and comfort in use |
Exercise and sports for varicose veins
Strength sports for varicose veins and athletics are possible after the elimination of varicose veins or in compression socks of 2-3 classes of compression. Modern treatment is able to return the legs with varicose veins to normal, which removes all restrictions.
We offer you a set of therapeutic and preventive exercises developed by leading experts. Regular use will help reduce the manifestations of venous insufficiency in the lower extremities, slow the progression of the disease and reduce the risk of life-threatening complications.
- Unloading the veins of the legs. Breathe deeply and evenly, lie down with your eyes closed, relax. At the same time put a few pillows under your feet so that they are raised at an angle of 15-20 °
- Exercise with a bicycle. Lie on your back and breathe evenly, imagine that you are pedaling a bicycle.
- The exercise consists of several parts, performed slowly and smoothly. Lie on your back with outstretched legs, take a deep breath. As you exhale, bend your right leg, bringing your knee closer to your chest. Inhale, straighten your legs vertically upwards. Exhale, lower it. Repeat this exercise sequentially for each leg.
- Lie on your back, arms around your body, lift your legs vertically up. Rotate both legs inward at the same time, then outward.
- Alternatively, bend and unfold the feet at the ankle joint back and forth.
- Alternatively, bend and unfold your toes.
- Stand in position: legs together, arms along the torso. After taking a deep breath, slowly rise to your toes, exhale, return to starting position.
- Walk on the spot without lifting your socks off the floor.
- Vertical scissors. Lie on your back, arms around your body, breathe evenly, cross your legs consistently, alternating them.
- Lying on your back, bend your knees without lifting your legs off the floor. Put your hands on your hips. Inhale slowly, lift your head and torso. At the same time, the hands slide to the knees. Exhale slowly, return to starting position.
- Lie on your back, arms along the body, legs at an angle of 15-20 °, hold a small pillow between the legs. Inhale slowly, bend at the waist, tearing your butt off the mattress. Exhale slowly, return to starting position.
- Lie on your back, arms around your body, bend your knees, keeping your feet on the floor. Exhale slowly, pull out your stomach. Inhale slowly, inflate the stomach.
- Lying on his back, legs raised at an angle of 15-20 °. Bend your right leg, bringing your knee close to your chest. At the same time, tighten the foot firmly with your hands. Slowly straighten your legs up. The arms, clasped tightly, slide along the calf to knee level. Slowly lower your legs as your hands slide down your thighs. The exercise is repeated for the other leg.
- Standing, legs together, arms around your body, inhale slowly, bring your shoulders back, exhale slowly, relax your shoulders and tilt your head forward.
- Contrasting foot shower. Alternation of solid jets of hot and cold water. 5-10 minutes for each leg.