Varicose veins treatment

Varicose veins (varicose veins) are a very common vascular disease, known to people since ancient times.It is mentioned in the papyri of Ancient Egypt;a mummy was even excavated with manifestations of varicose veins in the legs.They find information about pathology in Hippocrates, Galen, and Avicenna.Modern doctors also often encounter varicose veins in patients and look for effective treatment methods.

The term “varices” is of Latin origin, the word “varix” is translated as “expansion”.That is why the disease came to be called “Varicose veins”.With this disease, peripheral veins increase in volume, become long, tortuous, deformed and knotted.Blood stagnates in the lower parts of the leg because the valves begin to malfunction and the walls weaken.Most often, vascular damage is observed in the legs, as there is a greater load on the vessels, it is necessary to pump large volumes of blood and overcome the force of gravity.

Varicose veins are diagnosed in approximately 17–25% of people.Among young people, both boys and girls are equally affected.In mature and elderly women, this pathology occurs 2 to 3 times more frequently than in men of the same age.This is due to the constant hormonal changes in the female body that occur throughout life.

How are the veins in the legs arranged?

The legs have two groups of venous vessels: superficial and deep or deep.The first are located in the subcutaneous tissue, that is, on the surface of the leg.The latter are located deeper, in the thickness of the muscles, close to the arteries and tendons.Deep and superficial vessels are connected by perforating or perforating veins.Its wall is made up of collagen and elastin fibers, with weak and few smooth muscles.

The venous wall has a three-layer structure:

• At the top is the adventitia, which is made up of loose connective fibers, smooth muscle cells elongated along the walls, surrounded by small capillaries and nerves responsible for the trophism of the vessel.
• In the middle is the media, made up of circular smooth muscle fibers.
• The intimate is located inside.The basis of the intima is the endothelium;between its cells there are longitudinal fibers of smooth muscles.  The inner shell is folded, the thickenings are opposite each other and resemble swallows' nests or patch bags.They are called valves and are responsible for the correct direction of blood flow.

Venous valves direct blood from peripheral parts to the heart, as well as from superficial to deep veins.They prevent reverse flow and increase venous pressure.In addition to the valves, smooth muscles, tendons and leg muscles participate in maintaining normal tone.When any of the layers (usually the middle and inner layers) are damaged, the veins lose tone and expand, and varicose veins occur.

There are several superficial veins:

1. The great saphenous vein is located on the inside of the leg;its walls are equipped with several valves;blood from the anterior femoral surface is collected in this vein through a series of smaller vessels.
2. The small saphenous vein is located on the outside of the leg, equipped with valves, and collects blood from the veins in the front and back of the leg.

Communication between large and small veins occurs through connecting vessels.

The deep veins are the posterior and anterior tibial veins, the popliteal vein and the femoral vein.  They develop varicose veins in advanced stages, when the disease has not been treated for a long time.

Why do varicose veins appear and who is at risk of getting sick?

It's hard to say why people have varicose veins at this point.Only a number of risk factors have been identified, due to which the valves weaken and reduce the elasticity and tone of the walls of superficial and perforating veins.

Here are the factors that lead to the development of the disease:

• Heredity.The structure of blood vessel walls is genetically determined;with some changes in genes, they weaken and the valves do not close well.As a result, with the slightest increase in pressure in the veins, a reverse outflow of blood occurs, the vessels overflow and expand.
• Hormonal changes in women's bodies.  This situation is typical for pregnant women or the second half of the cycle, when the amount of progesterone increases and the level of estrogen decreases.As a result, blood rheology changes (coagulability increases), vascular tone decreases, elastin and collagen fibers are destroyed and the risk of blood clots increases.
• Obesity.Overweight people move little, which reduces blood flow throughout the body.Excess subcutaneous fat in the abdomen leads to increased pressure in the abdominal cavity and compression of the main veins.This leads to stagnation of blood in the vessels of the legs and subsequently to varicose veins.
• Diabetes mellitus.Sugar, the level of which increases in this disease, damages the vascular endothelium, which increases the risk of blood clots.
• Alcoholism.When drinking large doses of alcohol, dehydration occurs, the blood thickens, clots form, clogging small blood vessels and causing congestion.
• Static occupational loads, such as lifting heavy loads, working standing or sitting.In such a situation, muscle tone drops, blood flows from the lower extremities to the heart, stagnation occurs and the veins in the legs dilate because of this.  
• Congenital blood clotting pathologies.Hypercoagulation, in which many factors responsible for the formation of blood clots are produced, causes thrombosis and prevents blood circulation through the vessels.
• Wrong diet.A diet deficient in a number of vitamins (C, E, PP) and plant fiber leads to disturbances in the structure of the endothelium and other structural elements of the vascular walls.
• Tight underwear.When wearing tight underwear, some veins become compressed, which causes obstruction of blood flow in the lower half of the body.
• Frequent constipation.People who suffer from this problem have to constantly strain, this increases the pressure inside the abdomen, making it difficult for blood to flow.
• High heels.Excessive effort of the calf muscles and insufficient contraction cause blood to stagnate in the veins.
• Hot climate.In summer, during the heat, the body becomes dehydrated.If you do not compensate for the problem by drinking enough fluid, the risk of blood clots in the vessels will increase.
• Heart and kidney pathologies.These can be congenital or acquired heart defects, kidney failure.
• Exceeding doses of medications that affect clotting.In this case, the blood vessels may become clogged with blood clots.
• Operation.The risk of thrombosis in this case increases due to blood loss and compression of the veins during the intervention.

How can varicose veins be complicated?

• Thrombosis due to blood stagnation.
• Vascular thromboembolism as a result of detachment of blood clots.
• Thrombophlebitis or inflammation of the venous wall.
• PE (pulmonary embolism).In this case, blood flow in the pulmonary circulation is severely disturbed, which leads to death.Small blood clots can lodge in the small pulmonary arteries and cause a heart attack or pulmonary edema.  
• Trophic ulcers, eczema on the skin of the legs due to tissue malnutrition.With poor blood circulation, little oxygen and nutrients enter the tissues, which impairs regeneration or causes massive cellular necrosis.
• Edema syndrome.As a result of impaired blood flow and stagnation, fluid leaks through the walls of blood vessels into the intercellular space.The swelling has a soft, elastic consistency and most often appears close to the affected vein, regardless of the time of day.  
• Dermatitis.The inflammatory process in the skin develops due to impaired blood flow and tissue nutrition. 
• Hyperpigmentation, cyanosis of affected areas of the skin.
• Consolidation of subcutaneous fat due to swelling and hemorrhage.

How to diagnose varicose veins

• Through functional tests (tourniquet application), the condition of the valves is studied.They are named in honor of the authors - Troyanov-Trendelenburg, Pratt, Sheinis, Delbe-Perthes, etc.. For the Troyanov-Trendelenburg test, it is necessary to place the patient horizontally and then offer to raise the leg 450. In this position, the doctor strokes the limb from the foot up to empty the superficial veins.The next step is to apply a tourniquet to the upper half of the thigh, after which the patient gets up from the stretcher.Healthy leg veins should fill after 15 seconds.  
• Duplex ultrasound of veins (ultrasound angiocannulation) provides more information and allows you to visualize the vessels and the blood flow through them.
• Dopplerography is a method for evaluating blood circulation through vessels.
• Phlebography or radiographic examination with contrast, which helps in studying the internal structure of the vessel.
• Phleboscintigraphy is a technique that uses radioactive substances with subsequent study in a special device for their distribution.

To study the superficial veins, they are examined and palpated.The first three methods are used as additional examinations.The last two methods are necessary to study the condition of deep or deep veins.

Varicose veins treatment

Conservative treatment options

• Drug therapy does not cure varicose veins, but with the help of medications, valve function, vascular trophism, blood circulation partially improve and the risk of thrombosis is reduced.Venotonics are used for this purpose.They can be prescribed for any type of varicose veins.Ointments with non-steroidal anti-inflammatory drugs are indicated for thrombophlebitis.Also in this situation, anticoagulants are used, which effectively resolve blood clots.The treatment must be chosen by the doctor, after a thorough diagnosis and taking into account the patient's characteristics.
• Phytotherapy and additional techniques have auxiliary value.It is advisable to wear compression stockings, do gymnastics, skiing, cycling and swimming.The “bicycle” exercise in a supine position, flexing and extending the feet, gives good results;improves blood flow to the extremities.You can do the exercises if there are no complications.  It is also recommended to take a contrast shower in the morning (first water the leg with warm water, and then gradually reduce the temperature to cold).  Cold baths with decoctions of oak bark, horse chestnut, chamomile, St. John's wort, rubbing the skin with tincture of white acacia flowers, Kalanchoe leaves and apple cider vinegar help.Leeches help eliminate thrombophlebitis.
• Mode.You need to get out of bed slowly, 5-10 minutes.Your legs should be raised 10-15⁰ at night;To do this, place a cushion under your heels.You need to walk calmly, it is undesirable to cross your legs when sitting and not overwork.All patients are advised to wear compression stockings.
• You need to eat well, include coarse fiber and foods rich in vitamins in your menu.  Citrus fruits, tomatoes, rose hips, black currants, nuts, legumes, liver, onions, eggs and seafood will be useful.It is important not to drink alcohol, not smoke and drink plenty of water throughout the day.For persistent constipation, it is recommended to drink a laxative.

Surgical treatment

Phlebectomy or complete vein removal

The indication for such a radical operation is varicose veins, which involve a large number of veins.At the same time, complications arise - difficult-to-treat trophic ulcers, thrombophlebitis, persistent swelling in the legs, general symptoms (fatigue, dizziness, fainting).

The operation is contraindicated in case of ischemic heart disease, severe infections, in very elderly patients, in the second half of pregnancy, in case of local inflammation of the legs (erysipelas, pustular rashes, eczema).

Only surgery can radically rid the patient of varicose veins and restore valve function.If the situation is very serious, untreated and neglected, this method of treatment remains the only one.The disadvantages of the intervention are the need to apply anesthesia and keep the patient hospitalized for several days under observation, post-operative trauma with scars.

Laser therapy (endovascular microthermocoagulation)

Treatment of varicose veins with a laser is used if the pathology is combined with diseases of the cardiovascular system (CHI, hypertension), changes in peripheral vessels (phlebitis, thrombophlebitis), diseases of the respiratory system (asthma, chronic bronchitis, pleurisy), pathologies of the gastrointestinal tract (cholecystitis, ulcers, peritonitis), nervous system (chronic injuries, meningitis, encephalitis and their consequences), genitourinary system (inflammation of the kidneys, prostate, pathology of the uterus withappendages), with skin diseases (furunculosis, dermatitis, psoriasis, etc.).

Contraindications to the use of laser are oncology, decompensated pathology of the kidneys, liver, heart, cerebral sclerosis, pregnancy.

The main advantages of laser therapy are its effectiveness in eliminating the dilation of superficial veins, speed (manipulation duration is 15 to 20 minutes), no need to go to the hospital and low trauma.
Among the disadvantages, it is worth highlighting the low accessibility of the technique;Not all clinics have the appropriate equipment.Treatment is expensive and of little use for deep and severely affected veins.If the laser is used incorrectly, you can get thermal burns, and sometimes depigmentation occurs at the sites of exposure.

Radiofrequency coagulation (ablation)

The operation is indicated for extensive lesions of the saphenous veins, trophic ulcers resulting from long-standing and untreated varicose veins.

Radiofrequency coagulation is contraindicated in acute thrombophlebitis, limited patient mobility, pregnancy and mental disorders.

The main advantages of the method are its painlessness, absence of injuries and the need for hospital admission.Patients can return to normal activities the next day.

The disadvantage is the high cost of the intervention.

Sclerotherapy

Indicated for varicose veins of small and large superficial veins (in large vessels it is performed under duplex Doppler ultrasound control) in the initial phase and without complications.

Pregnant and lactating women, drug allergies, deep vein thrombosis, infectious and inflammatory skin lesions on the legs are not treated with this method.

The main advantages are low price, quick recovery, no need for hospitalization.The procedure leaves no marks and does not cause injuries.

The disadvantage is the risk of the sclerosing drug entering a deep vein, the reduction in effectiveness when it comes into contact with the blood and the possibility of use only in the initial stages.

Is it possible to cure varicose veins at home?

At home, it is allowed to use auxiliary methods in the treatment of varicose veins, which alleviate the symptoms.They use pharmacy or self-prepared ointments, herbal baths and lotions, compresses, drink decoctions and infusions to improve blood flow and relieve swelling.Below are some recipes.

Chestnut tincture

Take about 200 g of ripe, peeled chestnuts.Pass through a meat grinder or grind in a blender.Fill everything with a liter of vodka, put it in a dark corner and leave it for a few weeks.To make the product smell pleasant, add a few drops of peppermint oil.At night, lubricate your legs with the tincture to get rid of heaviness and itching, strengthen blood vessels and prevent their fragility.It is also recommended to make a compress with the tincture.If you don't have chestnuts, replace them with nutmeg, the recipe remains the same.Tincture with musk nuts can not only be used to rub sore feet;it is recommended to drink 20 drops a day.After the bottle is used up, a new tincture is made.But there should be a break of 2 weeks between taking the next portion.

Calendula-based ointment

An infusion is made from calendula flowers - pour a tablespoon of boiling water, put on fire, cook for a few minutes, leave for 3 hours in a thermos.Strain the infusion and add some type of fat;lanolin, petroleum jelly and badger fat are suitable.For the smell, it is recommended to add a drop of aromatic oil (rose, bergamot, citrus, sage, lavender, etc.).Rub the ointment morning and night, with gentle movements from the lower leg to the knee, until completely absorbed.Thyme, hop cones and nettle are also added to the calendula infusion.

Chamomile oil

Medicinal chamomile flowers are placed in a half-liter glass jar of a dark shade so that the container is filled to the top.Pour half a liter of any type of vegetable oil, for example, olive, corn, hemp.  Leave for a month, shaking or stirring occasionally.After that, the oil infusion is filtered.For scent, add a few drops of tea tree, mint, lavender and grapefruit scented oil.Apply chamomile oil to the foot early in the morning and at the end of the night, giving it a light massage.You can also make night compresses with the infusion.

Wormwood-based compress

Take a pack of kefir or fermented baked milk, 3 tablespoons of dry wormwood.The grass is crushed and mixed with kefir (ryazhenka).When the grass is wet, place it on cheesecloth along with thick liquid.After that, a compress is applied to the leg, covered with wax paper on top (cellophane film is not used), and everything is fixed with several layers of bandage.  Keep your legs elevated and remove the compress after half an hour.It is recommended to do the procedure twice a day.Instead of wormwood, you can take hops, chamomile flowers, string, clover, oak or birch leaves, St. John's wort, horsetail, tricolor violet flowers, yarrow.Combinations of different plants give a good effect.To improve the effect of the compress after the procedure, it is recommended to lie down for a while with your legs raised.All of the herbs listed can be infused and used to make foot baths.The water for this bath should be warm, the procedure lasts about 25 minutes.Relieves fatigue, swelling, reduces itching and pain in the skin.

Traditional recipes for internal use

Various herbal infusions improve blood flow in the veins well.The following herbs are used:

• Clover
• in succession
• Leaves and fruits of blueberries, viburnum, strawberries, raspberries
• Coltsfoot
• Calendula
• Japanese Sophora
• Melissa
• Schisandra
• hawthorn

The grass is dried, then crushed and turned into a mixture of different types of plants.Then take 3 tablespoons, pour a liter of boiling water, leave overnight in a thermos and drink 1/3 glass before meals.

Varicose veins are well treated with bee pollen and honey.Pollen should be consumed internally.Honey can also be consumed, but it still makes good compresses.It is recommended to add infusions of various herbs to honey.

Treatment of varicose veins in pregnant women

Carrying a baby is accompanied by a hormonal storm in the female body and overload, which often provokes varicose veins.Treatment during this period is carried out conservatively, using creams, ointments and local gels.

The most effective ointments have a decongestant effect and eliminate heaviness in the limbs. Apply in a thin layer, moving from bottom to top, with gentle massaging movements.The frequency of manipulations is 1 to 3 times a day.

Folk remedies also help.It is recommended to prepare baths with herbal decoctions (from chamomile, thyme, hop cones, calendula, wormwood, coltsfoot, oak bark, birch leaves, etc.).

You can combat swelling by applying cabbage leaves or grated raw potatoes to your feet.It is necessary to cover the compress with waxed or plain thick paper, not cellophane, so that the skin can breathe.The procedure is done before bed and the lotion is left overnight.

Doctors also prescribe internal medicines for pregnant women.There are venotonics that do not negatively affect the development of the fetus and the health of the mother.Most often, they are based on plant extracts.

After taking medications, the venous tone increases, the walls become elastic, they do not stretch so much, the lymph flow improves, the liquid part of the blood stops leaking into the intercellular space and the swelling disappears.You cannot take these medications without a prescription.

Traditional methods of treating varicose veins

There are many popular recipes for infusions, decoctions, lotions and compresses.Several remedies are advised to be taken, even internally.Below are several options for treating varicose veins using traditional methods.

Archill

Take a container with a volume of one and a half liters, pour lilac flowers and leaves into it.Then everything is filled with vodka or medical alcohol so that the liquid completely covers the grass (to the edge of the container).Infuse for a week, shaking occasionally, then filter and rub the tincture into your feet every day.Rub the skin with gentle massaging movements, from fingers to knees.

With the help of tincture they fight inflammation, swelling, cramps and pain in the legs.

Garlic ointment

Garlic cloves from a whole head are peeled, ground in a meat grinder or pressed through a garlic press.After that, you need to take butter (unsalted) and mix it with crushed garlic in a 1:2 ratio (2 parts butter and 1 part garlic).Apply this mixture to the affected leg, cover with baking paper, bandage it, the compress can be kept overnight.

The compress eliminates pain and burning sensations, has antiseptic properties, softens the skin and helps wound healing.

Honey with garlic

You need to take a head of garlic and 250 ml of honey (preferably linden or buckwheat).Both ingredients are mixed well and left for a week.Drink a tablespoon three times a day, before meals.
The product relieves swelling and fatigue, pain and varicose veins become less noticeable.

Potato juice

Raw potatoes are crushed on a grater or in a blender and the pulp is applied to the wounds.Keep the compress for about half an hour;If you wish, you can leave it on all night.To increase efficiency, drink half a glass of potato juice at the same time.The product relieves swelling and discomfort in the legs, eliminates heaviness, reduces fatigue and inflammation.

What is the effect of wearing compression garments for varicose veins?

Compression garments do not cure varicose veins.But using it slows down the disease, alleviates many of the symptoms it causes and improves well-being.

After putting on compression stockings, the lumen of the saphenous veins narrows, blood and lymph flow better and do not stagnate in the limbs.At the same time, swelling is relieved, convulsive contractions of the calves disappear, the legs become less tired and there is no feeling of heaviness.

The main types of compression garments prescribed for varicose veins are leggings, stockings, stockings, and long tights.It is recommended to use the products every day;You need to put them on in the morning, before getting out of bed, always lying down.

There are different degrees of compression of the meshes, they are chosen according to the stage of the varicose veins.Only the right underwear will have the appropriate therapeutic effect.It is best to have it prescribed by a doctor, but low compression stockings or tights for prevention are easy to purchase on your own.

Before purchasing, you need to determine exactly which compression class you need.Find out about the labeling characteristics of the chosen company’s products.Reputable companies always use the word “compression” to define the class and define it in mmHg.If “DEN” is written on the packaging, then this product has nothing to do with medical underwear.