Every second person suffers from varicose veins. Some do not even suspect that they are sick. Others, and this is the majority, postpone a visit to the doctor until the last minute, preferring treatment with the help of various gels and creams that promise "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 the majority of people "over 40 years old". In fact, no one is immune to the disease. The main reason for varicose veins of the lower extremities is the accumulation of blood in the veins during long-term static loads, when a person is in one position for a long time - standing or sitting. The modern world is structured in such a way that the most demanding professions require us to do just that: all office workers sit at the computer all day, salespeople, hairdressers, teachers or, for example, the same surgeons are forced to spend their work. working day "on his feet".
The risk group also includes:
- pregnant women (varicose veins of the lower extremities are intermittent in women, and the condition normalizes after childbirth);
- people whose job is heavy physical labor and heavy lifting;
- persons interested in strength training;
- anyone who is overweight.
Phlebologists have a joke: "Every person will live to see varicose veins, unless he dies of something else, of course! "Cynically? But there is a 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 is it time to consult a doctor? Everything is not so simple here. As a rule, the disease develops gradually, and many people simply do not notice that there is something wrong with their veins, associating everything with fatigue or age-related changes. For example, take the notorious "spider veins" - damage to the small (reticular) vessels of the venous system.
Modern phlebology does not consider reticular varicose veins of the lower extremities separately. Rather, it is a cosmetic defect that occurs in women due to hormonal imbalance, and it does not necessarily cause varicose veins. The main symptoms of varicose veins of the lower extremities include: swelling, heaviness in the legs at the end of the working day, sometimes cramps.
Today, ultrasound of the veins of the lower extremities is the most informative method for diagnosing varicose veins. When should you do this? If you feel that your legs are "filled with lead" and noticeably swollen at the end of the working day. By the way, the gold standard is now considered a situation where a phlebologist himself performs an ultrasound examination to determine the severity of the disease and decide on the next treatment tactics for the patient.
Stages of varicose veins of the lower extremities
According to the CEAP international classification used in phlebology, varicose veins of the lower extremities are divided into 6 stages.
- Zero stage.At the end of the day, there are no visible changes, except for discomfort in the legs.
- The first stage.Single networks of small vessels are visible from the skin.
- The second stage.Dilation of the saphenous veins is clearly visible from the skin of the legs.
- The third stage.A feeling of heaviness in the legs is accompanied by swelling, and venous "bumps" appear above the surface of the skin.
- The fourth stage.In the areas above the expansion of the deep veins, the skin begins to itch constantly and turns dark brown over time.
- The fifth stage.An indicator of an advanced state of the disease: trophic ulcers appear where the damaged vessels are scratched, and their healing takes a long time.
- The sixth stage.Trophic ulcers no longer heal, leak and are constantly 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 extremities
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? " This is the case in which it can be performed without surgery, despite the fact that such a diagnosis does not generally exist in Western terminology.
In the initial stages of varicose veins, it is enough to adjust your lifestyle and take drugs from the rutoside class that strengthen the vessel walls. Only a doctor can determine their dosage and duration of use.
Radical methods of treating varicose veins of the lower extremities include: phlebectomy, laser surgery, as well as various mechanochemical methods*. Let's take a closer look at them.
- Standard phlebectomy
It is the surgical removal of the damaged part of the vessel under general or spinal anesthesia. There are several types of its implementation (according to Babcock, according to Varadi and others), the choice is determined by the doctor based on the severity of the lesion and the diameter of the damaged vessel. In any case, modern phlebology considers this method of treatment as an extreme measure used when it is impossible to use others for various reasons.
- Endovenous laser coagulation
It belongs to the category of modern thermoablative treatment methods. An electric current is applied to the affected vein, causing a blood clot to form, which over time is replaced by connective tissue, and the problematic vein simply disappears. The advantage of the method is that it is painless. The operation is performed under local anesthesia, after completion, the patient gets up and literally goes home.
- Radiofrequency ablation
This is another method of laser treatment of 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 changed vessel is exposed to radiofrequency radiation. The operation is also performed under local anesthesia and has a short recovery period.
- Exosclerotherapy
This mechanochemical method is considered more innovative than laser treatment today because it uses a chemical agent rather than a physical one. A sclerosant is injected into the lumen of the vein - a special medicinal substance that "sticks" it together. The procedure is painless for the patient and is performed on an outpatient basis. Most effective for superficial varicose veins. However, it is not included in the main mandatory health insurance program.
* Please note that the decision to choose this or that method of treatment is made by doctors depending on the individual indications and contraindications of a specific patient.
Ointments and gels for varicose veins
Are any drugs used to treat varicose veins of the lower extremities? They apply, but with two serious caveats. First, since drug treatment in this case aims to eliminate the symptoms, not the cause, it is prescribed only if there are signs of venous insufficiency, which we discussed above. Secondly, they are prescribed only by the attending physician.
As for all kinds of gels, creams and ointments for varicose veins of the lower extremities, their effectiveness is extremely insignificant for the simple reason that the active substance reaches the walls of the veins in minimal concentration. The relief that many patients feel after applying such drugs to problem areas of their legs can be explained by the placebo effect. If you use any external products, then you should consider this important nuance: it is safe to apply them only if there are no open skin lesions, i. e. in stages 1-3 of the disease.
Massage and physical activity for varicose veins
The complex treatment program for varicose veins includes massage and exercise therapy. Should I say that both the first and the second must be agreed with the attending physician? Light massage for varicose veins of the lower extremities is aimed at improving blood circulation and is performed by a specialist only in the absence of trophic ulcers.
Gymnastics for varicose veins of the lower extremities prevents the formation of edema, which promotes lymph flow. Exercises you can do yourself at home include:
- Cycle.
Lying on your back, imitate pedaling a bicycle.
- Alternative walk.
Walk on your toes first, then your heels.
- "Scissors".
While lying on your back, do cross swings with your legs straightened at the knees.
When it comes to 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 accompanying pathologies and the competence of the fitness instructor.
Danger of 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 "hits" the joints and is harmful to the functioning of the cardiovascular system, but also acts as an inciting factor for the development of varicose veins, because any internal pressure causes the veins to expand.
There is no special diet for varicose veins of the lower extremities, but it is recommended 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 vegetables and fruits, which contain a lot of vitamin C. If you want to prolong the health of your arteries for a long time, it is better to say goodbye to bad habits like drinking alcohol and nicotine. time.
Results of varicose veins
The consequences of neglected varicose veins are always extremely serious. First, trophic ulcers in the varicose veins of the lower extremities are an integral part of the disease in the last stage. Besides looking very unsightly, they itch and hurt.
Secondly, all patients diagnosed with varicose veins are at risk of thrombophlebitis of the lower extremities - an inflammatory disease of the veins, blood clots form in their lumen. Acetylsalicylic acid is also prescribed to prevent their appearance, but this is already a double-edged sword for varicose veins of the lower extremities. Doctors will no longer be able to offer laser surgery as a treatment for patients taking anti-coagulant drugs: when taking acetylsalicylic acid and similar drugs, ablation will simply be performed to cause the blood clot to form. useless.
When you ask me: "Doctor, is it possible to live with varicose veins and not do anything about them? ", I sincerely answer: "You can. But it is unlikely that you will not like such a life! "First, trophic changes in the veins lead to ulcers, which, will surely get infected and leak. Second, varicose veins of the superficial veins can cause thrombosis of the deep veins of the lower extremities, which is a risk of pulmonary embolism and, in some cases, death.
Is it preventable?
It is easier to prevent any disease than to spend time and money on its treatment. Unfortunately, varicose veins are a chronic disease. There are no specific 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, according to statistics, the probability of relapse is 30%.
Does this mean you should give up everything and limit yourself to nothing? Of course not. To prevent varicose veins of the lower extremities, doctors strongly recommend following a healthy lifestyle: monitor your weight, move more, engage in light sports (for example, go to the pool).
A good prevention of varicose veins of the lower extremities is the regular use of elastic compression: the phlebologist will help you choose 1 or 2 classes for socks or tights individually, depending on the severity of the disease.