Varicose veins in the legs (varicose veins - common name) - externally visible enlargement of the saphenous veins, which develops as a result of varicose veins or post-thrombotic syndrome and is accompanied by a sharp violation of the venous outflow in the lower limbs.
Modern methods allow you to treat varicose veins radically without incisions and pain.
Complaints with varicose veins
For many people, varicose veins and varicose veins are just a cosmetic problem. In others, varicose veins cause pain and discomfort. Sometimes varicose veins lead to more serious problems and complications - thrombophlebitis or the appearance of trophic ulcers. Treatment consists of removing or closing the deformed veins, which is the work of a phlebologist.
Varicose veins are a complete degeneration of the venous wall, associated with the weakness of its connective tissue (varicose veins of the lower extremities) or which develops with a sharp violation of venous outflow, due to blockage or overflow of the veins.
Causes of varicose veins of the lower limbs
Varicose veins of the lower limbs
The disease, as the cause of varicose veins of the legs, occurs in 20-40% of the population of the developed countries of the world. For a long time, varicose veins are just a cosmetic defect, but the progression of the disease leads to pain, swelling of the feet and legs and, in the advanced stages, darkening of the skin of the legs, inflammatory changes and varicose trophic ulcers.
Hereditary predisposition is the main cause of primary varicose veins, however the disease develops with excessive stress on the veins. The trigger mechanism of varicose veins of the lower extremities is a strong physical overload, 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). Post-thrombotic disease is a complex progressive pathological process in the venous system of the lower limbs. Due to valve insufficiency or deep vein blockage, the saphenous veins dilate as they overflow with blood. Another cause can be congenital or acquired arteriovenous fistulas. Congenital obstruction of the deep veins occasionally occurs, leading to secondary varicose veins (Klippel-Trenaunay syndrome).
Complications of varicose veins
More than 40% of women and 20% of men have swollen and dilated varicose veins. In 20% of cases, varicose veins lead to the appearance of a trophic ulcer, more than 25% of patients suffer from thrombophlebitis of varicose veins. These complications often require serious treatment and pose a serious health threat.
Chronic venous insufficiency
Obstruction of the venous outflow causes a pathological condition called chronic venous insufficiency. At the onset of the disease, the appearance of single nodules of dilated veins may be noted, which does not cause much concern, 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 development of the disease is much higher. If the disease is not stopped, the third stage of venous insufficiency gradually develops. Edema becomes permanent, a dark color of the skin appears in the ankle area, heaviness in the legs is constantly worried, which can persist even after a night's rest. Thrombophlebitis of varicose veins and skin inflammation, eczema and dermatitis often develop. The final 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 inflammation of the vein wall, with the formation of blood clots in the lumen of the vein. Thrombophlebitis occurs in the superficial and deep veins. With 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. In these conditions, all the factors that increase blood clotting (pregnancy, overheating, trauma, sprains, hypothermia and scratching, acute respiratory infections) can cause the formation of a blood clot in the varicose vein and its inflammation. Thrombophlebitis occurs in 25% of patients with varicose veins of the lower extremities. The cause of thrombophlebitis is 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 edema, darkening of the skin, the appearance of trophic ulcers and varicose dermatitis.
Varicose trophic ulcer
A trophic ulcer is a sign of an extreme degree of chronic venous insufficiency. This is a long-term non-healing wound that occurs with a serious violation of the 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 doesn't get treatment sooner or later gets a trophic ulcer. It can develop with both varicose veins and secondary varicose veins. Without the elimination of pathological venous discharges, a varicose trophic ulcer does not heal or recurs constantly. Trophic ulcers with varicose veins occur in most patients and cause severe suffering. Modern minimally invasive methods allow you to reliably get rid of varicose trophic ulcers without incisions and pain.
Venous thrombosis and thromboembolism
Pulmonary embolism is a serious complication of venous thrombosis. Varicose veins are a major risk factor for thrombophlebitis and deep vein thrombosis. Thromboembolism leads to the development of severe heart and respiratory failure, with a mortality rate of more than 50%.
Prevention of varicose veins of the lower limbs
Any modern person should understand what varicose veins in the legs are, how to treat them and prevent their occurrence. With a hereditary predisposition, factors contributing to varicose veins should be avoided. The use of venotonic drugs, the use of compression stockings during exercise, 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 of the 1st compression class at work, therapeutic exercises, outdoor activities, daily walks for at least 1 hour in medical socks, foot massage and swimming. Refusal to use oral contraceptives with complicated inheritance of varicose veins. It is better to adhere to these simple rules than to cure varicose veins on the legs.
Avoid producing factors during heavy physical work. For this, compression stockings are necessary, especially with a predisposition to varicose veins. Medical knitwear is indicated for all pregnant women, and in cases of predisposition to varicose veins and thrombophlebitis special compression stockings are worn for childbirth. It is recommended that all pregnant women see a phlebologist and perform an ultrasound of the veins in the last weeks of pregnancy. This will help reduce the risk of problems with the venous system.
How to treat varicose veins in the legs
Over the past 10 years, "barbaric" methods of treating varicose veins are becoming a thing of the past, thanks to the emergence of more gentle and effective methods that are successfully used in clinics.
Venous sclerotherapy for varicose veins
Sclerotherapy is the introduction into the lumen of a varicose vein of a drug that causes the walls to "stick" together with the disappearance of the veins. Numerous chemicals are used for sclerotherapy, there have been attempts to deal with ozone. At one time, the aspect of foam sclerotherapy revolutionized phlebology. For the first time, an effective method of treating varicose veins without major surgical interventions appeared. Currently, foam sclerotherapy is used to remove medium diameter varicose veins after laser obliteration of pathological venous discharges. Sclerotherapy is indispensable in the treatment of varicose veins and reticular varices, where it has no real competitors.
Treatment of varicose veins with a laser
Laser treatment for varicose veins of the lower limbs (EVLT) is the most modern, radical and economical method of treatment that allows both to treat varicose veins of the legs and to eliminate the causes of trophic ulcers. The significance 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 a 1470nm laser and radial light guide, which have been introduced into medical practice by phlebologists. The postoperative period after this technique is completely painless, and the result is superior to other treatment options: the radicality of the laser intervention is at least 98%.
Surgery to remove varicose veins
Surgical treatment of varicose veins with the removal of major venous trunks is a thing of the past. The risk of complications of stem vein removal forced phlebologists to seek other approaches, which led to the development of laser techniques and other methods of thermal vein obliteration. However, the modification of the classic phlebectomy into microflebectomy according to Müller and Varadi allowed for a wonderful combination of laser treatment and removal of large varicose veins through punctures without incisions or sutures. The Varadi technique saved patients from the painful sclerotherapy of large varicose veins. The miniflebectomy allows both to treat the varicose veins of the legs and to remove the varicose veins visible in any part of the body.
Obliteration of varicose veins with radiofrequency
Radio frequency obliteration (RFO) of varicose veins in 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. In terms of painlessness, the method corresponds to laser coagulation with laser at a wavelength of 1470 nm, it is easy to perform and there is little postoperative pain. However, RFO is much inferior to 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 an active treatment method for varicose veins.
All types of modern massage are used, especially in the pathology of the lymphatic and venous system. Among the exclusive methods is the technology of lymphatic drainage massage with bandage, which very effectively relieves chronic venous insufficiency.
In chronic venous insufficiency, massage is used to eliminate venous hypertension in varicose veins and post-thrombotic syndrome. The combination of this massage with the bandage allows you to effectively eliminate all clinical manifestations of the disease.
Bathing with varicose veins, thrombophlebitis or post-thrombotic disease is very dangerous. Any thermal stress can cause the formation of blood clots in the deep veins with all the ensuing consequences.
Unfortunately, it is impossible to get a complete cure for varicose veins without getting rid of venous discharges 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 prevalence of varicose veins and chronic venous insufficiency sometimes gives rise to the desire to speculate on this issue. Consider the modern methods of treatment and deception.
Medicines for varicose veins
The goal of drug therapy for venous disease is to reduce symptoms and prevent complications, but these goals are not easy to achieve. Today, the abundance of usable means has given rise to another problem: which one to choose? Unfortunately, most of the proposed drugs have a rather low efficacy, despite the theoretically justified use opportunity. 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. An ideal drug for the treatment of venous insufficiency should affect as many pathogenetic links as possible in chronic venous insufficiency, while having a minimal number of side effects and high absorption by the body. A fairly large number of venotonic agents are represented in 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 ingredient.
You should not expect the disappearance of varicose veins from these drugs, however there can be lightness in the legs, a decrease in edema and the disappearance of night cramps.
Creams and gels for varicose veins
Despite the high efficiency 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 oppose the use of these agents, since their rubbing promotes venous outflow, like a light massage, and has a calming effect on the skin. With advanced forms of venous insufficiency, these creams and ointments can cause dermatitis and allergies, and therefore are very harmful. Some drugs are used in the development of acute thrombophlebitis and help to calm the inflammatory process, but varicose veins do not disappear from them. Thanks to the right advertising, shamanic products with leeches have gained great popularity among the people, but they have no attitude towards medicines, and not even leeches, and there is no point in expecting them.
Medicines for blood clots in varicose veins
A frequent complication of varicose veins is thrombophlebitis, especially during pregnancy and the postpartum period. A proven drug for preventing blood clots is a low molecular weight sulfur-containing acid glycosaminoglycan. To prevent thrombophlebitis after the treatment of varicose veins, tablets are used in clinics. They are taken 7 days after laser or radiofrequency surgery.
Compression stockings for varicose veins
Compression stockings are undoubtedly one of the most effective means of curing venous edema and reducing the degree of chronic venous insufficiency. Invented more than 100 years ago, having gained immense popularity in the 20th century and even more so in the 21st century, compression stockings and stockings have become an integral part of a phlebologist's treatment. This is due to the effects it has:
- improvement of venous and lymphatic outflow from the lower limbs,
- improvement of 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 stockings
So, if you have varicose veins and plan to treat them, you will undoubtedly use compression stockings for a period of several days or several months (individually) during treatment. If your feet are swollen towards the end of the day after work and you suffer from heavy legs syndrome, you can also use compression stockings during the day to avoid these symptoms in the evening. If you have complications of untreated varicose veins - trophic ulcers or thrombophlebitis - you will, of course, 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 use to improve the return of venous blood from the legs, which is undoubtedly not easy for veins compromised by diseases and against the law of universal gravitation. Compression knitwear can be safely called one of humanity's genius inventions, but in order for it to work for you, several conditions must be met:
- Compression knitwear is selected individually (according to standards). The main requirement is the respect of the anatomical profile of the limb and, therefore, the creation of the correct pressure gradient.
- Knitwear is selected individually by a doctor (phlebologist). Medical products are marked in mm Hg and are divided into compression classes 1, 2, 3, 4. Each compression class corresponds to a certain pressure. At different stages of varicose veins or chronic venous insufficiency, the appropriate compression class is used. That is why 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 knitwear, not slimming. Only proven brands with RAL certificate.
When do you need knitwear for varicose veins?
- correction of "heavy legs" syndrome: reduction in severity, edema, improvement in quality of life;
- during treatment with a phlebologist: after surgery or for a period prescribed by a specialist;
- slow down the progression of varicose veins;
- for the treatment of complications of varicose veins (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 the conditions for any type of radical treatment of varicose veins. Modern medical knitwear has a high therapeutic effect and excellent aesthetic properties.
Elastic bandages |
Therapeutic mesh |
|---|---|
The creation of the necessary pressure is determined by the technique and the bandaging skills of the doctor or patient |
Treatment profile and pressure level specified during production according to the compression class |
The need for medical participation in the imposition of a bandage or patient education |
The participation of the doctor is limited to the choice of the compression class and the type of product |
Difficulty in providing compression and fixation on the thigh |
Provides effective compression and fixation on the thigh |
Used for non-standard limb shape |
With a non-standard shape of the limb, customization is possible |
Daily washing causes the bandages to wear out quickly |
Daily washing is necessary to maintain the compression properties |
It needs to be replaced after several washes |
Guaranteed preservation of compression properties for 6 months |
Possible violations of the water and heat balance of the skin |
The porous bond provides the normal temperature and water balance of the skin |
Low aesthetic properties, offer practicality and comfort |
High aesthetic properties, practicality and comfort in use |
Exercises and sports for varicose veins
Power sports for varicose veins and athletics are possible after the elimination of varicose syndrome or in compression stockings of 2-3 compression classes. Modern treatment is able to restore legs with varicose veins to normal, removing all restrictions.
We bring to your attention a complex of therapeutic and preventive exercises developed by leading experts. Its regular implementation will help reduce the manifestations of venous insufficiency in the lower limbs, slow the progression of the disease and reduce the risk of life-threatening complications.
- Discharge of the leg veins. Breathing deeply and evenly, lie down with your eyes closed, relax. At the same time, place some pillows under your feet so that they are raised at an angle of 15-20 °
- Exercise by bike. Lying on your back and breathing evenly, imagine you are pedaling on a bicycle.
- The exercise consists of several parts, it is performed slowly and smoothly. Lying on your back with your legs stretched out, take a deep breath. Exhaling, bend the right leg, bringing the knee to the chest. While inhaling, straighten the leg vertically upwards. As you exhale, lower it. Repeat this exercise alternately for each leg.
- Lying on your back, arms along your body, lift your legs vertically. Rotate both feet at the same time inward, then outward.
- Alternatively, bend and straighten your feet at the ankle joint forward and backward.
- Alternatively, bend and straighten your toes.
- Stand in one position: legs together, arms along the torso. After taking a deep breath, slowly rise to your toes, exhaling, return to the starting position.
- Walk in place without lifting your socks off the floor.
- Vertical scissors. Lying on your back, your arms along the body, breathing evenly, alternately cross your legs, alternating them.
- Lying on his back, he bends his knees without lifting his feet off the floor. Put your hands on your hips. Breathing in slowly, he raises his head and torso. At the same time, his hands slide to his knees. Exhaling slowly, he returns to the starting position.
- Lying on your back, arms along the body, legs at an angle of 15-20 °, hold a small pillow between your feet. Breathing in slowly, bend at the waist, tearing your buttocks off the mattress. Exhaling slowly, return to the starting position.
- Lying on your back, arms along your body, bend your knees, keeping your feet on the ground. Exhaling slowly, draw in the stomach. Breathing in slowly, inflate the stomach.
- Lying on your back, legs raised at an angle of 15-20 °. Bend your right leg, bringing the knee to your chest. At the same time, firmly squeeze the foot with your hands. Slowly straighten your leg. The hands, tightly gripping the leg, slide along the calf to the level of the knee. Slowly lower the leg, hands slide to the thigh. The exercise is repeated for the other leg.
- Stand, feet together, arms along the body, inhaling slowly, bring your shoulders back, exhaling slowly, relax your shoulders and tilt your head forward.
- Contrast shower on the legs. Hard alternating jets of hot and cold water. 5-10 minutes for each leg.