At least half of adults have some kind of problem with varicose veins. This common condition is a family problem for many people. Women are at least twice as likely to develop varicose veins as men. Among both sexes, it affects 25% to 60% of adults, depending on age.
Varicose veins do not always appear as convex bluish veins, nor do they sometimes appear as a thin vascular network that runs just below the surface of the skin. It almost always affects the legs and feet. Visible swollen and tortuous veins - sometimes surrounded by patches of congested capillaries, resembling cobwebs or spider veins - are superficial varicose veins. Although they are often painful and disfiguring, they are mostly harmless. As inflammation develops, such veins become hard to the touch and can interfere with blood circulation to the extent that ankle swelling, itching, and pain develop in the affected limb.
In addition to the surface network of veins, the legs have an internal, or deep, venous network. In rare cases, varicose veins also affect the deep veins of the legs. These deep varicose veins are usually not visible, but they can cause swelling or pain throughout the leg and – most dangerously – can be a site for blood clots to form.
To help circulate oxygenated blood from the lungs to all parts of the body, arteries have a thick muscular lining. For the reverse flow of blood through the venous system, the surrounding muscles are used, the muscle layer on the vein wall is thin and weak, but the veins are equipped with internal valves that allow blood to pass in only one direction - towards the heart, valves are needed to prevent the reverse flow of blood.
In varicose veins, the valves don't work properly, causing blood to pool in the vein and making it harder for the muscles to push the blood "up". Instead of flowing from one valve to another, blood continues to pool in the vein, increasing venous pressure and further damaging the valves, causing a bulging and tortuous vein. Because superficial veins have less muscle support than deep veins, they are more prone to varicose veins.
What contributes to varicose veins?
Any condition that involves excessive strain and pressure on the legs or abdomen can lead to varicose veins. The most common factors that cause intra-abdominal pressure are pregnancy, obesity and work that requires standing for long periods of time or lifting heavy loads. Chronic constipation, prostate adenoma that requires straining during bowel movements and urination, and, in rare cases, tumors can also cause varicose veins. A sedentary lifestyle contributes to the appearance of varicose veins, because muscles that are not working do not pump blood well.
The likelihood of varicose veins increases with age as the muscles and veins weaken. Previous leg trauma can damage the venous valves and contribute to the development of varicose veins. Genetics also play a role, so if other family members have varicose veins, you are more likely to have them too. Contrary to popular belief, sitting cross-legged does not cause varicose veins, although it can worsen the existing condition.
Can you prevent varicose veins?
Although genetics play a role in the risk of developing varicose veins, there are things you can do to prevent them:
- Exercise regularly because maintaining good physical shape is the best way to keep leg muscles toned, improve blood circulation and control your weight. Swimming and aqua aerobics are considered to have the greatest preventive effect among all types of fitness;
- Support for a healthy weight; if you are overweight or even obese, then losing weight will reduce the risk of developing varicose veins, because a normal weight prevents excess pressure on the leg veins;
- Avoiding tight clothing. Tight clothing can reduce blood flow to the thighs, groin and legs;
- Avoid wearing high-heeled shoes frequently and for long periods of time, as they can impede blood circulation. Shoes with completely flat soles are also undesirable, it is better to choose shoes with a low and stable heel or an elastic elastic sole, because they are better for blood circulation and improve calf muscle tone.
- Movement! Prolonged sitting or standing should be avoided to stimulate blood circulation. If your daily routine requires you to be on your feet a lot, consider wearing a day support jersey. Stretch your legs and exercise as often as possible to improve circulation and reduce venous pressure.
- The fight against smoking. Research shows that smoking can contribute to the development of varicose veins.
- During pregnancy, you should sleep on your left side, not on your back. This will reduce the pressure of the uterus on the veins in the pelvic area and even improve the blood supply to the fetus;
- If you have risk factors for varicose veins, ask your doctor to choose compression stockings for you - these can be special socks, stockings or tights.
Spider veins and varicose veins
As we age, many of us find lumpy, bluish stars under our skin or swollen ligaments that spread down our thighs and calves. These deformed blood vessels occur in 60% of adults after the age of 50.
What are spider veins?
Spider veins are small, tortuous blood vessels that are visible through the skin. They can be red, purple or blue in color and most often appear on the legs or face.
What are varicose veins?
These are larger blood vessels that, due to changes in the vein wall, have lost their elasticity, swelled and acquired a tortuous flow. Such veins appear bluish and raised above the surface of the skin. Varicose veins can appear anywhere, but most often develop on the legs, thighs and feet.
What causes spider veins and varicose veins?
Healthy veins collect blood from the capillary network and transport it from the periphery to the heart through a system of one-way valves. These valves direct blood flow in the desired direction from the superficial veins to the deeper veins and to the heart. The vessels are surrounded by muscles that contract and help pump blood to the heart. Normally, healthy venous valves prevent backflow of blood. However, problems with valves, muscles, or blood pressure can cause blood to pool inside a vein. When blood accumulates in a vein, the pressure increases and the vein wall weakens. As a result, the vein becomes bulging and tortuous. As a result, depending on the caliber of the blood vessel and the degree of swelling, a network of spider veins or varicose veins is formed.
Who is at risk of varicose veins?
Spider veins or varicose veins can occur in any person, but women are twice as likely to suffer from this problem as men. This problem is also known to those whose jobs require them to be constantly on their feet, including nurses, hairdressers, lecturers and teachers. Other factors that trigger the development of varicose veins include aging, obesity, pregnancy, leg injury or surgery, and a family history of varicose veins.
What are the symptoms of varicose veins?
Often, spider veins and/or varicose veins are not just an unpleasant cosmetic defect. Varicose veins are a disease that can cause unpleasant symptoms and dangerous complications, especially pain or cramps in the legs, a feeling of heaviness, throbbing or tingling. Severely inflamed veins become hard to the touch and reduce circulation, leading to itching and swollen ankles. Also, over time, trophic changes develop in the skin and subcutaneous tissue, such as thickening, pigmentation and ulceration.
Complications of varicose veins
Although veins and varicose veins spoil the appearance of the legs and cause unpleasant symptoms, they rarely pose a serious threat to health. However, in some cases, complications may develop that require a visit to the doctor and even hospitalization.
The most common complications of varicose veins are trophic ulcers on the background of long-term venous insufficiency, such ulcers are most often formed in the ankle area and heal very poorly. Another frequent and more dangerous complication of varicose veins is thrombophlebitis - thickening and inflammation of the vein wall, which can again lead to venous thrombosis - a dangerous complication that requires hospitalization and intensive treatment. If thrombosis has developed in the deep vein system, there is a risk of blood clot migration, the so-called. thromboembolism, and as a consequence of thrombophlebitis, the development of chronic postthrombophlebitis disease can occur, which significantly affects the quality of the patient. life and performance.
Diagnosis of varicose veins of the lower extremities
It is easy to diagnose spider veins and varicose veins of superficial veins - a visual examination is enough. However, the primary diagnostic complex always includes an ultrasound examination of the deep vein system, because superficial varicose veins may indicate insufficiency of the valves of the deep veins of the lower extremities, which requires a serious approach to treatment. During the examination, the doctor always pays attention to the swelling of the ankle joints, the symmetry of the swelling, if any, compaction of the vein wall and subcutaneous tissue, changes in skin color, pigmentation, pain, and the presence of trophic ulcers.
Most cases of spider veins and varicose veins, unless accompanied by venous insufficiency, do not require surgical treatment, but can be removed for cosmetic purposes. If varicose veins are accompanied by complaints such as heaviness in the legs, pain, fatigue or muscle cramps, swelling of the ankles, then there are recommendations for treatment that will alleviate the symptoms and slow down the progression of the disease.
Treatment of varicose veins
Therapeutic approaches to varicose veins can be conservative and surgical. The choice of therapy method can be made by a phlebologist based on examination and examination. The purpose of the examination for varicose veins is to determine the stage of the disease and the risk of developing possible complications. Such an examination, which includes a detailed examination, ultrasound examination of the veins of the lower extremities, and in some cases laboratory tests.
Who treats varicose veins?
A phlebologist treats diseases of the veins of the lower extremities. A phlebologist is a doctor of surgical specialty, which is based on training first in general surgery and then in cardiovascular surgery. Phlebology is a branch of vascular surgery that deals with the study and treatment of diseases and malformations of the venous system. A phlebological surgeon must be skilled in a wide range of techniques used in the treatment of venous diseases.
Conservative treatment of varicose veins
Conservative treatment of varicose veins is aimed at slowing down its development and preventing complications. It usually consists of recommendations for lifestyle changes (weight loss, proper physical activity, removal of static loads that contribute to the progression of the disease), selection of compression stockings, prescribing drugs that tone the walls of venous vessels and prescribing a course of physiotherapy.
Compression jersey - support socks, socks and tights
The easiest way to prevent the progression of varicose veins is to wear support stockings. Also called compression socks, they improve blood circulation and relieve pain and discomfort in the legs. They can be found in pharmacies and specialized medical equipment stores. Such socks are especially necessary during pregnancy and during long flights.
Lifestyle change it can also help prevent the rapid development of varicose veins. First of all, you need to normalize your weight and introduce physical activity into your life, such as walking or swimming; exclude frequent wearing of high heels, static loads and a sedentary lifestyle.
Drug treatment - there are many drugs, both in the form of gels and creams, and in the form of tablets, which have a venotonic effect and affect the speed of progression of varicose veins, slowing down its development. However, their action can only be effective in combination with other preventive measures.
Physiotherapy - for varicose veins, both in the early stage and in advanced forms of the disease, pressotherapy is most often used - a course of physiotherapy using compression - repeated compression of the veins with specialized circular pads, the pressure that spreads from the feet to the hips, improves blood flow, stimulates the vascular wall and normalizeswork of venous valves. This treatment is prescribed 2-4 times a year in courses of 10-12 procedures. It is also recommended after a session of sclero- and laser therapy for varicose veins. Such physiotherapy can be carried out independently or in combination with specialized electrical stimulation of the leg muscles, with the expectation of mutual reinforcement of the therapeutic effect.
Other situations in which physical therapy gives good results are trophic changes on the skin caused by advanced stages of varicose veins, in these cases laser therapy, magnetotherapy, phono- and electrophoresis can be prescribed (→ and other methods). that it is 100% contraindicated for physiotherapy for varicose veins is accompanying thrombosis or thrombophlebitis, therefore, before carrying out a course of physiotherapy procedures, you should undergo an ultrasound examination of the veins of the lower extremities.
Surgical and minimally invasive treatment of varicose veins and their complications
Patients, most of whom are women and girls, because varicose veins most often affect the fairer half of humanity, come to the phlebologist because of the external side of the disease - they are troubled by unsightly spots and bands on their legs. Treatment of varicose veins in this situation usually involves the removal of cosmetic defects. For this purpose, minimally invasive methods of treating varicose veins are used - sclerotherapy and endovenous laser coagulation (EVLC).
The term "minimally invasive" in relation to medical procedures means "low traumatic" and "gentle". Indeed, such a treatment is carried out on an outpatient basis, causes minimal pain, comparable to an ordinary injection, and allows excellent results to be achieved. This treatment consists of destroying the inner wall of the vein with a drug (sclerosant) or a laser, which leads to the blinding of the lumen of the vessel and the disappearance of the cosmetic defect.
In any case, the decision on the method of treatment is made by the doctor based on the examination and examination. In cases of complicated varicose veins, surgical treatment is applied, which is carried out in hospital conditions.