Every second person suffers from varicose veins. Some do not suspect that they are sick. And others, and this is the majority, postpone visiting the doctor until the last moment, preferring to treat themselves with the help of various gels and creams, advertising that promises "healthy veins forever. "Meanwhile, many do not knowthat today medicine has made great progress in the treatment of this disease and can offer some minimally invasive and painless methods.
Varicose veins
There is an opinion that the diagnosis of "varicose veins on the lower leg" is many people "who are over 40 years old. "In fact, no one is immune from this disease. The main cause of varicose veins on the lower legs is the accumulation of blood in the veins during prolonged static load, when a person is in one position for a long time - standing or sitting. The modern world is structured in such a way that most in-demand professions require this from us: all office workers sit in front of the computer all day, and the same salesperson, hairdresser, teacher or, for example, surgeon have to spend the working day "on the feetthem. "
Risk groups also include:
- pregnant women (lower varicose veins in women are discontinuous and after childbirth the condition returns to normal);
- people whose work involves heavy physical work and heavy lifting;
- people interested in strength training;
- everyone who is overweight.
Phlebologists have this joke: "Anyone will live to see his varicose veins, unless, of course, he dies of something else! " cynically? But there is some truth in every joke. 90% of the world's population today suffers from this disease.
What are the symptoms of varicose veins on the lower legs that should alert the patient and signal that it is time to see a doctor? Not everything is so simple here. As a rule, this disease develops gradually and many do not realize that there is something wrong with their veins, attributing everything to fatigue or age-related changes. Let's take, for example, the famous "spider veins" - damage to the small vessels (reticular) of the venous system.
Modern phlebology does not separately consider reticular varicose veins of the lower leg. On the other hand, it is a cosmetic defect that occurs in women due to hormonal imbalance, which does not necessarily lead to varicose veins. The main signs of varicose veins in the lower legs include: swelling, a feeling of heaviness in the legs at the end of the working day, and sometimes cramps.
Today, ultrasound of the lower leg veins is the most informative method for diagnosing varicose veins. When should you do it? If at the end of the working day you feel as if your legs are "filled with lead" and swell significantly. In this way, the gold standard is now considered a situation where the phlebologist himself performs an ultrasound examination to determine the severity of the disease and decide on further treatment tactics for the patient.
Stage of varicose veins on the lower leg
According to the international classification according to CEAP, which is used in phlebology, the development of varicose veins from the veins in the lower part of the leg is divided into 6 stages.
- Level zero.Other than the discomfort in the legs at the end of the day, there was no visible change.
- First stage.A single network of small veins is visible through the skin.
- Second stage.The expansion of the saphenous vein is clearly visible through the skin of the leg.
- Third stage.The feeling of heaviness in the legs is accompanied by swelling, and "bumps" of veins appear on the surface of the skin.
- Fourth stage.In the area above the deep vein expansion, the skin begins to itch continuously and over time turns dark brown.
- Fifth stage.An indicator of an advanced state of the disease: a trophic ulcer appears in the place where the damaged vein is scratched, which takes a long time to heal.
- Sixth level.Trophic ulcers no longer heal, ooze, and are constantly infected.
Depending on the level of varicose veins on the lower leg, the doctor chooses one or another treatment tactic.
Surgery for varicose veins on the lower leg
It should be clearly understood that the treatment of varicose veins on the lower leg does not always involve surgical intervention. Often on the Internet, patients look for an answer to the question: "How to treat reticular varicose veins on the lower leg? "Despite the fact that in Western terminology such a diagnosis does not exist at all, this is exactly the case when surgery can be performed without surgery.
In the early stages of varicose veins, it is enough to adjust your lifestyle and take drugs from the rutoside class, which strengthen the vascular walls. Only a doctor can prescribe the dosage and duration of use.
Radical methods for treating varicose veins on the lower legs include: phlebectomy, laser surgery, as well as various mechanochemical methods*. Let's take a closer look at them.
- Standard phlebectomy
It is a surgical removal of damaged vein fragments under general or spinal anesthesia. There are several types of 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 vein. In any case, modern phlebology considers this method of treatment as an extreme measure, used when, for various reasons, it is impossible to use others.
- Endovenous laser coagulation
Belongs to the category of modern thermo-ablative treatment methods. Electric current is applied to the affected veins, causing the formation of blood clots, which over time are replaced by connective tissue, and the problem veins simply disappear. The advantage of this method is that it is painless. Surgery is performed under local anesthesia; after finishing, the patient wakes up and actually goes home.
- Radiofrequency ablation
This is another laser treatment method for varicose veins on the lower legs. 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 altered vein is exposed to radiofrequency radiation. Surgery is also performed using local anesthesia and has a short recovery period.
- Echosclerotherapy
This mechanochemical method is today considered more innovative than laser treatment, because it does not use physical substances, but chemical agents. Sclerosant is injected into the lumen of the vein - a special medicinal substance that "sticks" 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 basic compulsory medical insurance program.
* Please note that the decision to choose one or another treatment method is made by the doctor, depending on the individual indications and contraindications of the particular patient.
Ointment and gel for varicose veins
Are any medications used to treat varicose veins on the lower legs? They applied, but with two serious reservations. First, since drug therapy in this case is aimed at relieving the symptoms and not the cause, it is only prescribed if there are signs of venous insufficiency, which we have discussed above. Secondly, they are only prescribed by the attending physician.
For all types of gels, creams and ointments for varicose veins on the lower legs, their effectiveness is largely ignored for the simple reason that the active ingredients reach the vein walls in minimal concentration. The relief experienced by many patients after applying the drug to problem areas on their feet can be explained by the placebo effect. If you use any external product, then you should take into account this important nuance: it is safe to use it only if there are no open skin lesions, i. e. at stage 1-3 of the disease.
Massage and physical activity for varicose veins
A comprehensive treatment program for varicose veins includes massage therapy and exercise. Do I need to say that both the first and the second must be agreed with the attending physician? Light massage for varicose veins on the lower legs is aimed at improving blood circulation and is performed by a specialist only if there is no trophic ulcer.
Gymnastics for varicose veins on the lower legs prevents the formation of edema, promotes the outflow of lymph. Exercises you can do at home include:
- Riding a bike.
Lying on your back, imitate pedaling a bicycle.
- Walk alternately.
Walk first on your toes and then on your heels.
- "Scissors".
While lying on your back, make a cross swing with the legs straightened at the knees.
About yoga and stretching for varicose veins on the lower legs, everything is individual. The ability to perform these exercises depends on factors such as the stage of the disease, the presence of concomitant pathology and the competence of the fitness instructor.
The dangers of being overweight with varicose veins
Nutrition for lower leg varicose veins is a special topic. The main desire of the doctor comes down to one thing: it is necessary to control the body weight. Excess body weight not only "hits" the joints and is harmful to the functioning of the cardiovascular system, but also serves as a factor that provokes the development of varicose veins, because any internal pressure leads to dilation of the veins.
There is no special diet for varicose veins on the lower legs, but it is advised to exclude spicy and salty foods from the daily menu, and replace tea and coffee with herbal tea. The diet should be rich in fiber, fresh vegetables and fruits, which contain a lot of vitamin C. And it is better to say goodbye to bad habits such as drinking alcohol and nicotine if you want to prolong the health of your blood vessels for a long time. time.
Due to varicose veins
The consequences of neglected varicose veins are always very serious. First, trophic ulcers in the varicose veins of the lower leg are part of the disease in the final stage. Besides the fact that they look very unsightly, they are also itchy and painful.
Secondly, all patients diagnosed with varicose veins are at risk of developing thrombophlebitis in the lower legs - an inflammatory disease of the veins, in which blood clots form in their lumen. To prevent their appearance, acetylsalicylic acid is also prescribed, but for varicose veins on the lower legs this is already a double-edged sword. For patients taking anti-clotting drugs, doctors can no longer offer laser surgery as a treatment: while taking acetylsalicylic acid and similar drugs, ablation, the purpose of which is to cause the formation of blood clots, will simply be useless.
When they asked me: "Doctor, is it possible to live with varicose veins and not do anything about it? ", I honestly answered: "You can live. But you are unlikely to like such a life! "First, trophic changesin the veins leads to ulcers, which will surely become infected and leak. Second, varicose veins in the superficial veins can cause deep vein thrombosis in the lower legs, which is a risk of pulmonary embolism and, in some cases, death.
Is prevention possible?
It is easier to prevent any disease than to waste time and money on its treatment. Unfortunately, varicose veins are a chronic disease. There are no special preventive measures that can be 100% guaranteed to protect us from the possibility of getting sick once and for all. Moreover, even using radical treatment methods, the probability of relapse, according to statistics, is 30%.
Does this mean you should give up everything and not limit yourself to anything? Of course not. To avoid varicose veins on the lower legs, doctors strongly recommend to follow a healthy lifestyle: watch your weight, move more, engage in non-strength sports (for example, go to the swimming pool).
A good prevention of varicose veins on the lower legs is the usual use of elastic compression: the phlebologist will help you choose class 1 or 2 for stockings or tights individually, depending on the severity of the disease.