Varicose veins of the lower extremities are a chronic systemic pathology that develops against the background of dysfunction of the valves that control blood flow.
This leads to the accumulation of an excessive volume of liquid in the vessels, which gradually stretch, losing elasticity and strength.Varicose veins are characterized by the formation of bulky nodules under the skin of the legs, but this is not the only symptom of the disease.Patients complain of pain and heaviness in the legs, burning and itching, dryness and irritation of the skin.In advanced cases, non-healing purulent ulcers form on the skin, which are very difficult to treat due to the irreversible necrotic processes occurring in them.In order for the treatment of varicose veins in the legs to be effective and to help prevent recurrence, it is necessary to first establish the causes.
Causes of varicose veins on the legs
The tendency to develop such a serious vascular disease is often inherited, and in most cases this pathology is inherited by women.Therefore, if there are cases of varicose veins in your family, girls and women will be at risk.
Other common causes of the disease:
- Bad nutrition.If the diet is dominated by fatty, heavy foods rich in animal fat, the risk of developing varicose veins of the lower extremities increases significantly.
- Heavy physical activity.Certain types of work, for example, cook, waiter, surgeon, office worker, hairdresser, create conditions for a gradual increase in pressure in the veins.With regular stress, blood vessels and valves are deformed;due to the constant high pressure, the walls of the veins thin, become fragile and varicose veins develop.
- Wearing uncomfortable high heels.Such shoes reduce the amplitude of muscle contraction and compress blood vessels, which in turn contributes to impaired blood flow and the development of varicose veins.
- A sedentary lifestyle.In the absence of at least a minimal load on the muscles, blood begins to stagnate in the venous bed, since the walls of the veins do not contract on their own.Gradually, the vessels are stretched, the function of the valves is disturbed, varicose thickenings and knots are formed.
- Overweight.The more overweight a person is, the greater the load on the lower limbs and, accordingly, on the blood vessels.In addition, fat people move very little and mostly eat poorly, which doubles the chances of getting varicose veins in the legs.
- Pregnancy As the fetus grows, the volume of blood in the body of the expectant mother increases, which creates additional stress on the veins.In addition, the growing uterus and fetus compress the pelvic vessels, which prevents normal venous outflow.During pregnancy, the hormone progesterone is produced in excess, which relaxes the walls of blood vessels, promoting the development of varicose veins.In most cases, varicose veins during pregnancy are reversible, so after giving birth, the woman can completely get rid of the problem.
- Age.As the body ages, the walls of the veins, as well as the valves, cease to fully perform their functions, become weak.Elasticity and strength are lost, which leads to stretching of the vessels.
The mechanism of development of varicose veins of the lower extremities
Varicose veins of the lower extremities develop according to a complex mechanism:
- In the initial stage, in the presence of a hereditary predisposition and provoking exogenous and endogenous factors, a delay in venous blood flow is observed.The long-term stagnant process causes the development of inflammatory processes in the walls and valves of the vein.
- When the valves are incompetent and the walls of the venous vessels are weak, blood begins to flow through the veins in both directions.This leads to an increase in venous pressure, which in turn leads to overstretching and deformation of the vascular walls.
- Further stagnation of blood and progression of the inflammatory process contribute to the spread of pathology, the development of ischemia and the formation of trophic ulcers.
Gradually, the function of the affected veins is disturbed.Varicose veins cause stagnation of blood in the vessels, which leads to local toxic lesions, as well as an increase in pressure.In an advanced stage, the vessels can no longer withstand excess pressure, which leads to ruptures, which lead to profuse bleeding.
Symptoms
The disease is insidious in that it is practically asymptomatic in the earliest stages.The first sign indicating the development of varicose veins is fatigue in the legs, which is often ignored by patients and does not become a reason for seeking advice from a specialist.However, as the pathology progresses, fatigue in the legs is felt more often, especially in the evening, after a working day.Other symptoms of vascular disease:
- Pain, feeling of pressure.Such signs begin to appear from the second stage, when the pathological process begins to progress.The pain appears mainly in the evening after a working day and disappears in the morning.If a person ignores the discomfort and there is no treatment, the pain syndrome becomes chronic and worries him constantly.
- Swollen veins and vascular network.At first, the affected veins are stronger than usual, but later they begin to bulge, bulge, forming knots.Most often, the vascular network is located on the thighs and legs.
- Cramps.A characteristic sign of varicose veins, the cause of which is the stagnation of blood in the veins.Stagnant processes lead to increased pressure in the vessels, as a result of which the muscles begin to contract spontaneously.
In addition, vascular diseases are accompanied by pronounced external changes.With the development of ischemia, patients complain of constant itching.Excessive stretching and thinning of the veins leads to the formation of hematomas and bruises.In advanced stages, when atrophic processes develop, the following external symptoms appear:
- red spots on the skin;
- peeling;
- formation of dark pigmented spots;
- hair loss.
If the patient develops trophic ulcers accompanied by blackening of the limbs, this indicates the progression of irreversible necrotic processes.
Complications of varicose veins of the legs
If there is no treatment for varicose veins of the lower extremities, as the disease progresses, serious complications develop, such as:
- Venous thrombosis.With this complication, the pathological processes affect the deep veins.The pathology is accompanied by blockage of a vessel with a blood clot - a thrombus.The main cause of venous thrombosis is the slowing down of blood flow in the lower extremities.
- Pulmonary embolism.A condition in which a blood clot separated from the vessel wall enters the pulmonary artery along with the blood flow, blocking its lumen.If the blood clot is large, death occurs instantly.Smaller clots do not lead to death, but cause complex disorders of breathing and blood circulation.
- thrombophlebitis.It is characterized by inflammation of the superficial vessel walls, accompanied by the formation of a blood clot.The disease is manifested by hyperemia, swelling along the inflamed and blocked vein, pain of varying intensity.Acute thrombophlebitis is accompanied by fever and chills, which complement the above symptoms.
- Trophic ulcers.An inevitable complication of untreated varicose veins of the lower extremities, which develops in the absence of timely treatment.Disruption of tissue nutrition and progression of the inflammatory process contribute to thickening of the subcutaneous tissue, thinning, darkening of the skin, followed by the formation of a non-healing trophic ulcer.
- Varicose eczema.It manifests itself as local reddening of the skin, peeling and unbearable itching.If left untreated, the complication quickly spreads and leads to deterioration of the patient's condition.
- Bleeding from varicose veins.A dangerous complication that develops against the background of rupture of enlarged nodes.
Bleeding can occur due to mechanical injury, since the walls of the affected veins are very fragile and thin.Therefore, even light friction can cause profuse venous bleeding.
Diagnosis of varicose veins of the lower limbs
If you have symptoms indicating the development of varicose veins of the lower extremities, you should make an appointment with a phlebologist who will diagnose, treat and prevent such vascular pathology.
The doctor will be able to make a preliminary diagnosis during the initial examination, during which a dense vascular network, swollen veins protruding above the surface of the skin and venous nodes of the extremities are detected.To confirm the diagnosis, a referral is given for an additional examination, including the following procedures:
- Doppler ultrasound;
- ultrasound duplex angioscanning;
- radionuclide and X-ray contrast phleboscintigraphy;
- phlebomanometry;
- plethysmography;
- photoplethysmography.
Treatment of varicose veins of the legs
If the disease is diagnosed in the earliest stages, when there are no serious complications, conservative therapy is prescribed, the main goals of which are:
- elimination of stagnant processes;
- normalization of pressure in the veins;
- restoration of blood circulation;
- elimination of pathological symptoms.
Medicines from the following groups are used for these purposes:
- Venotonics and phlebotonics.It helps to improve the health of blood vessels, normalize blood circulation and improve lymphatic drainage.
- Anticoagulants.It is used to reduce blood viscosity and prevent the formation of blood clots.
- Nonsteroidal anti-inflammatory drugs.They have a pronounced anti-inflammatory effect and relieve pain.
- Antiplatelet agents.Reducing the risk of thrombosis and improving tissue trophism.
If drug treatment is ineffective and the disease progresses, the doctor discusses with the patient the options for surgical treatment.Surgical methods for treating varicose veins include:
- Sclerotherapy.Introduction into the lumen of the affected vein of a sclerosing drug that sticks the vessel, as a result of which it dissolves on its own, being replaced by connective tissue.
- Laser coagulation.It is indicated in cases where the diameter of the affected veins does not exceed 10 mm.Laser rays create a sclerosis effect in the vessel, as a result of which it dissolves on its own.
- Phlebectomy.Surgical intervention in which the surgeon cuts out deformed sections of blood vessels, performing all the necessary manipulations through microscopic punctures in the skin.
Contraindications
With varicose veins of the legs, any actions that contribute to the development of stagnation in the vessels of the lower extremities are contraindicated:
- long stay in static positions;
- heavy physical exertion, lifting heavy weights;
- sitting with legs together or crossed;
- wearing tight, uncomfortable shoes.
It is also necessary to get rid of bad habits such as smoking and alcohol abuse.Tobacco smoke and alcohol adversely affect the health of the whole body, making the veins fragile, thin and inelastic, which soon leads to the development of varicose veins and other cardiovascular diseases.
The cost of treatment of varicose veins of the lower extremities
The cost of treating varicose veins in the legs is influenced by the following factors:
- the stage at which the disease was diagnosed;
- related complications;
- individually selected method of treatment - conservative or surgical;
- the need for additional therapeutic techniques, such as physiotherapy.