At least half of adults have some type of problem with enlarged veins. This common condition is a familiar problem for many people. Women are at least twice as likely to develop varicose veins as men. In both sexes, it affects 25% to 60% of adults, depending on age.
Dilated veins do not always look like convex bluish threads, sometimes varicose veins appear as a fine vascular mesh that runs just below the surface of the skin; It almost always affects the legs and feet. Visible swollen, tortuous veins — sometimes surrounded by cobweb-like patches of congested capillaries or spider veins — are superficial varicose veins. Although they are often painful and disfiguring, they are most often harmless. When inflammation develops, these veins become dense to the touch and can impede blood circulation to such an extent that swelling in the ankles, itching and pain develop in the affected limb.
In addition to the superficial network of veins, the legs have an internal or deep venous network. In rare cases, the deep veins in the legs are also affected by varicose veins. 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 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 muscular layer near the venous wall is thin and weak, but the veins are equipped with internal valves that allow blood to pass in only one direction - towardsTo the heart, valves are necessary to prevent reverse flow of blood.
In varicose veins, the valves don't work properly, causing blood to pool in the vein and making it difficult for the muscles to push the blood "up. "Instead of flowing from one valve to another, blood continues to accumulate in the vein, increasing venous pressure and further damaging the valves, causing the vein to bulge and become tortuous. Because superficial veins have less muscular support than deep veins, they are more prone to varicose veins.
What contributes to the development of varicose veins?
Any condition that involves excessive strain and pressure on the legs or abdomen can cause varicose veins. The most common factors that cause intra-abdominal pressure are pregnancy, obesity and work that requires standing for long periods or lifting heavy weights. 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 development of varicose veins, as muscles that don't work don't pump blood well.
The likelihood of varicose veins increases with age as muscles and veins weaken. Previous trauma to the legs can damage venous valves and contribute to the development of varicose veins. Genetics also plays a role, so if other family members have varicose veins, you're more likely to have them too. Contrary to popular belief, sitting cross-legged does not cause varicose veins, although it can worsen an existing condition.
Can you prevent varicose veins?
Although genetics play a role in your risk of developing varicose veins, there are things you can do to prevent them:
- Exercise regularly because staying in good shape is the best way to keep your leg muscles toned, improve blood circulation and control your weight. It is believed that among all types of fitness, swimming and water aerobics have the greatest preventive effect;
- Healthy weight support; If you are overweight or even obese, losing weight will reduce the risk of developing varicose veins, as normal weight prevents excess pressure on the leg veins;
- Avoiding tight clothing. Tight clothing can restrict blood flow to the thighs, groin and legs;
- Avoid frequent and prolonged use of high-heeled shoes, as they can impede blood circulation. Shoes with completely flat soles are also undesirable; It is better to choose shoes with a low, stable heel or elastic elastic sole, as they are better for blood circulation and also improve the tone of the calf muscles.
- Movement! You should avoid sitting or standing for a long time to stimulate blood circulation. If your daily routine requires you to stand a lot, consider wearing a daily support shirt. Stretch your legs and exercise as often as possible to improve circulation and reduce venous pressure.
- 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 your back. This will reduce the pressure from the uterus on the veins in the pelvic region and even improve the blood supply to the fetus;
- If you have risk factors for developing varicose veins, ask your doctor to choose compression stockings for you - these can be stockings, stockings or special tights.
Spider veins and varicose veins
As we age, many of us find bluish, bumpy stars under our skin or swollen cords spreading across our thighs and calves. These deformed blood vessels occur in 60% of adults after age 50.
What are spider veins?
Spider veins are small, tortuous blood vessels that appear through the skin. They can be red, purple or blue and most often appear on the legs or face.
What are varicose veins?
These are larger blood vessels that have lost elasticity, swollen and acquired a tortuous course due to changes in the venous wall. These veins appear bluish and raised above the surface of the skin. Varicose veins can appear anywhere, but most commonly they 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 the valves, muscles, or blood pressure can cause blood to pool inside the vein. When blood builds up in a vein, pressure increases and the vein wall weakens. As a result, the vein becomes bulging and tortuous. As a result, depending on the size of the blood vessel and the degree of swelling, a network of spider veins or varicose veins is formed.
Who is at risk for varicose veins?
Spider veins or varicose veins of large veins can appear in anyone, but women are susceptible to this problem twice as much as men. This problem is also familiar 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 symptoms are accompanied by 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, including pain or cramps in the legs, a feeling of heaviness, throbbing or tingling. Severely inflamed veins become difficult to touch and reduce circulation, causing itchy and swollen ankles. Furthermore, over time, trophic changes develop in the skin and subcutaneous tissue, such as thickening, pigmentation and ulceration.
Complications of varicose veins
Although spider veins and varicose veins detract from the appearance of the legs and cause uncomfortable symptoms, they rarely pose a serious threat to health. However, in some cases, complications may arise that require medical consultation and even hospitalization.
The most common complications of varicose veins are trophic ulcers against the background of prolonged venous insufficiency. These ulcers usually form in the ankle area and heal very poorly; The second common and most dangerous complication of varicose veins is thrombophlebitis - thickening and inflammation of the venous wall, which in turn can lead to venous thrombosis - a dangerous complication that requires hospitalization and intensive treatment. If thrombosis develops in the deep venous system, there is a danger of blood clot migration, the so-called thromboembolism, and as a result of thrombophlebitis, chronic post-thrombophlebitis disease may develop, which significantly affects the patient's quality of life. life and performance.
Diagnosis of varicose veins of the lower extremities
It is easy to diagnose spider veins and varicose veins in superficial veins - a visual examination is enough. However, the primary diagnostic complex always includes ultrasound examination of the deep venous system, since superficial dilated 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 swelling of the ankles, the symmetry of the swelling, if present, the compaction of the venous 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, muscle fatigue or cramps, swelling in the ankles, there are treatment recommendations that will reduce symptoms and slow the progression of the disease.
Varicose veins treatment
Therapeutic approaches for varicose veins can be conservative and surgical. The choice of therapeutic method can be made by a phlebologist on the basis of examination and examination. The purpose of examining varicose veins is to determine the stage of the disease and the risk of developing possible complications. Such an examination, which includes a thorough 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 with a 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 phlebologist surgeon must be proficient in a wide range of techniques used in the treatment of venous diseases.
Conservative treatment of varicose veins
Conservative therapy for varicose veins aims to slow down their development and prevent complications. It usually consists of recommendations for lifestyle changes (weight loss, adequate physical activity, elimination of static loads that contribute to disease progression), selection of compression stockings, prescription of medications that tone the walls of venous vessels, and prescriptiona physiotherapy course.
Compression shirt – support stockings, stockings and tights
The easiest way to prevent varicose veins from progressing 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 specialty medical supply stores. These 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 medications, both in the form of gels and creams and in the form of tablets, which have a venotonic effect and affect the rate of progression of varicose veins, slowing down their development. However, its action can only be effective in combination with other preventive measures.
Physiotherapy – for varicose veins, both in the early stages and in advanced forms of the disease, pressotherapy is most often used - a course of physiotherapy with compression - sequential compression of the veins with specialized circular pads, the pressure of which spreads from the feet to the hips, improving flowblood, stimulating the vascular wall and normalizing the functioning of venous valves. This treatment is prescribed 2 to 4 times a year in courses of 10 to 12 procedures. It is also recommended that it be carried out after sclero and laser therapy sessions for varicose veins. This physiotherapy can be performed independently or in combination with specialized electrical stimulation of the leg muscles, with the hope of mutually enhancing the therapeutic effect.
Other situations in which physiotherapy gives good results are trophic changes in the skin caused by varicose veins in advanced stages. In such cases, laser therapy, magnetic therapy, phono and electrophoresis (→ and other methods) may be prescribed; which is 100% contraindicated to physiotherapy for varicose veins is concomitant thrombosis or thrombophlebitis, therefore, before carrying out a course of physiotherapy procedures, one must undergo an ultrasound examination of the veins of the lower extremities.
Surgical and minimally invasive treatment of varicose veins and their complications
Patients, mostly women and girls, because varicose veins most often affect the fair half of humanity, turn to a phlebologist because of the external side of the disease - they are bothered by unpleasant spots and cords on their legs. Treatment of varicose veins in this situation usually involves eliminating 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 "lowly traumatic" and "gentle. " In fact, this treatment is carried out on an outpatient basis, causes minimal pain, comparable to a normal injection, and allows excellent results to be obtained. This treatment consists of destroying the inner wall of the vein with a medication (sclerosing agent) or laser, which leads to the gluing of the vessel lumen and the disappearance of the cosmetic defect.
In each case, the decision on the method of treatment is made by the doctor on the basis of examination and examination. In cases of complicated varicose veins, surgical treatment is used, which is carried out in a hospital setting.