Varicose veins of the lower extremities in modern medicine

Modern healthcare faces many different challenges, but despite rapid advances in medicine, there are diseases that continue to affect millions of people. Varicose veins of the lower extremities ICD 10 - I83 is just such a problem that practically cannot be solved over time.

Advantage in numbers

The disease is prevalent in various developed countries, such as USA, France, Belgium, Germany, etc. is widespread inThe number of patients with this diagnosis is almost a quarter of the population of each country.

Half of all patients are over 55 years of age, but the rest are working-age workers, mostly in manufacturing. As any VD disease progresses, complications arise, patients lose jobs due to disability, so the problem becomes not only medical, but also economic and social. The appearance of varicose veins can be associated with the age of the patient. People over the age of 70 have more varicose veins of the lower extremities than people who have not reached retirement age.

In four out of one hundred patients over 80 years of age, varicose veins take a form aggravated by accompanying pathologies in the form of trophic ulcers, various dermatitis or eczema. Also, at this age, other diseases of the cardiovascular and bronchopulmonary systems occur, thereby excluding the possibility of surgical intervention.

It is important!It is better to consult a doctor at the first signs of the disease, the younger the patient, the lower the risks if surgical treatment is required.

The origin of the disease

Despite the gradual progression of the disease, there are still etiological factors for the development of varicose veins.

So, what are the causes of varicose veins:

• heredity;
• endocrinological reasons;
• mechanical factor;
• infection;
• intoxication;
• non-specific inflammatory process;
• factors that cause venous hypertension.

Complaints and symptoms

Ironically, visible disorders appear at the very beginning of the disease, which are often ignored. Patients who mistake small vascular malformations for a small external disorder that will "go away on their own" lead to the development of the disease.

Additional symptoms develop gradually:

• feeling of fatigue/heaviness in the legs;
• swelling in the area of the legs;
• night cramps;
• numbness, tingling, "pins and needles" feeling;
• pain in the area of varicose veins.

Diagnosis of varicose veins is an important condition at any stage of the disease

At any stage, the disease requires a diagnosis, a diagnosis that suggests which treatment option is most appropriate for the patient. Clinical and instrumental diagnostic methods are used in tandem. Depending on the course of the disease, all methods or only a part of them can be used.

Methods of clinical examination - examination and conversation

Clinical methods are used not only for varicose veins, but also for any other disease:

1. Don't date. Anamnesis contains all the main facts about his life (age, heredity, bad habits, main type of work).
2. Definition of complaints. Complaints can indicate how far the varicose veins have progressed during the examination. The duration of the disease becomes an important condition. When did the first symptoms of foot disease appear?
3. Examination.During the examination, the doctor should pay attention not only to the blood vessels, but also to the condition of the skin, to rule out the presence of complications and accompanying pathologies. It is also important to determine the degree of damage, the temperature at the location of the varicose veins, as well as the tension and elasticity of the vein.

A phlebologist is the first doctor who should see your feet.

Instrumental examination methods are a prerequisite

One examination will not be enough to determine the treatment. Varicose veins of the lower extremities require mandatory instrumental diagnosis. During instrumental research methods, foci of varicose lesions, length of the damaged vein, insufficiency of venous valves, speed of blood flow, etc.

This:

1. Ultrasound.A standard B-mode study provides a complete picture of the anatomical structure and location of the vessel, as well as those adjacent to it. Ultrasound also detects pathologies of the vascular wall.
2. Doppler ultrasound.The study determines the speed of blood flow, thereby identifying the pathologies of the valves in the vein.
3. X-ray contrast venography. A more complex type of diagnosis using X-rays. The procedure is rarely used due to possible complications.
4. Computed tomography. It is carried out in the same way as X-ray contrast by introducing a contrast substance into the lumen of the vessel. A CT image is three-dimensional, unlike an X-ray.
5. MRI.The method is justified and informative and is performed without the use of contrast or other drugs. However, this method remains expensive, so it is rarely used.

Note!Contrast agents cannot be used in patients who are allergic to iodine, in which case an MRI may be necessary.

Diagnosis based on classification

Like other diseases, varicose veins are divided into classes, taking into account many factors:

External manifestations	telangiectasia; Varicose veins; edema; hyperpigmentation; ulcer in the healing stage; The ulcer is in an active stage.
The cause of the disease	congenital; unknown etiology; Acquired (injuries, etc. ).
Anatomical location of veins	Superficial; Deep; Individually perforating varicose veins are distinguished.
The mechanism of the disease	Throwing at nearby ships; Obstruction of venous blood flow.

The most common reason for contacting specialists is 2nd degree varicose veins of the lower extremities, when the external manifestations of the disease are significant. Perhaps, if the disease did not manifest itself externally, then the detection of varicose veins would occur in the later stages.

Note!The term "internal varicose veins of the lower extremities" is used only colloquially, that is, varicose veins of deep veins can only be diagnosed by instrumental methods.

To treat or not to treat is the question

The gradual progression of the disease sooner or later leads patients to the idea that treatment is necessary. Often, the doctor's task is to convince the patient to start treatment in the early stages of the disease. The direction of treatment can be different and depends on many factors (age, symptoms, degree of the disease, etc. ).

Thus, treatment can be focused on:

• improving the quality of life; aesthetic surgical interventions.
• prevention of complications; affects microcirculation.
• elimination of symptoms; hemodynamically significant treatment.

One way or another, treatment is always selected by a specialist (phlebologist, vascular surgeon). Complexity is important in the treatment of varicose veins, so you cannot limit yourself to only surgical intervention or only therapeutic and preventive physical training. It is important to follow all the doctor's instructions.

Lifestyle tips

Varicose veins force patients to give up factors that cause complications. Sometimes such a measure is necessary, because untreated varicose veins greatly affect the quality of life.

Self-treatment is a useless exercise, but you should pay attention to your lifestyle so that varicose veins do not progress so quickly.

What to do for varicose veins:

• Women should avoid high heels;
• Give up bad habits, especially smoking;
• Move, if you have to sit or stand for a long time, try to change your position;
• Avoid tight/tight clothing and shoes;
• Avoid exposure to high temperatures (sunbaths, hot wax, baths, saunas);
• Manage your weight;
• Do not lift heavy objects;
• take a contrast shower;
• Walk, run, swim more often;
• Elevate your legs as much as possible (sleeping, resting).

Compression therapy

Regardless of the etiology, patients with varicose veins should wear medical stockings or apply elastic bandages.

1. It is most convenient to use knitwear; socks or knee socks, made of special material, often do not cause discomfort. The compression level of medical stockings should be recommended by a doctor. The only disadvantage of compression clothing is its price.

   Note!The brands of manufacturers of medical knitwear can be different, so you should choose carefully. Make sure the elastic in your knee socks or socks is not too tight.

2. Alternatively, patients often prefer to use short, medium or long stretch elastic bandages. The choice of extension also depends on the stage of the disease and should be recommended by the doctor. The first few uses can be a bit difficult, as you have to control the tension level of the bandage yourself.

Compression therapy is used daily, wearing underwear or bandages greatly eases the load on the legs during the day.

Physical education and sports as therapy

Varicose veins require movement, so therapeutic and preventive physical training is an important component. Of course, it is better not to perform exercises blindly, but to choose a set of exercises with a specialist. Some medical facilities offer group exercise therapy classes.

Often, exercise therapy exercises do not require special training and are available regardless of age; a series of exercise therapy exercises for clarity:

• Squeeze and relax thigh muscles (10 times);
• Breathe in, lift the abdominal wall, exhale, pull in the stomach (4 times);
• Bend and straighten your legs at the ankles (10 times);
• While inhaling, raise your arms up from the sides, lower while exhaling (4 times);
• Bend and straighten the toes (15 times);
• Raise your arms up while inhaling and lower while exhaling.

Even from this small set of exercises, it is clear that anyone can do them, regardless of age. It is important to take your time and do everything at a slow pace without holding your breath or speeding up.

Athletes can perform this set of exercises before the main training. It is especially important that the patient does not engage in any sports that are not recommended for varicose veins.

Exercise is also suitable as an alternative to exercise therapy for varicose veins of the lower extremities, but you should consult a doctor and personal trainer. Some exercises will have to be excluded from training.

Athletes are sometimes simply forced to leave their professional careers in jumping, powerlifting and heavyweight boxing. In turn, those who like to swim, run and walk can continue to do so.

Medicines, after being prescribed by a doctor

The goals of pharmacology in the treatment of varicose veins are different, namely:

• improvement of vascular tone;
• correction of microcirculation;
• improvement of lymphatic drainage;
• prevention of thrombotic complications;
• preventing the development of complications.

Therefore, all medicines should be prescribed by a doctor. It is in this vein that there is a guarantee of successful resolution of the disease.

Drug treatment is used at different stages: when preparing the patient for the upcoming operation, in the postoperative period, and also when there are obvious contraindications to the operation. Medicines can be systemic and local and are used both in tandem and separately.

Treatment of phlebosclerosis

Phlebosclerosis also refers to pharmacological treatment methods, but its use is often unjustified, since the positive effect does not apply to all patients. In most cases, the method is used for aesthetic correction.

It should be noted that the use of this method is fraught with relapses and complications, so the procedure is performed by specially trained surgeons.

Physiotherapy in the treatment of varicose veins

In the treatment of varicose veins, physiotherapeutic methods are not the main ones, they are successfully used to eliminate the symptoms of the disease. D'arsonval, electrophoresis, barotherapy, magnetic therapy for varicose veins of the lower extremities are used only under the supervision of a doctor, because any physiotherapy has a number of indications and contraindications.

All physiotherapy procedures are applied not continuously, but in 10-20 day courses. In most cases, physiotherapy slows down the progression of the disease, but it is not the main treatment method and certainly cannot be used as monotherapy.

Surgical treatment

Despite numerous therapeutic methods, surgery remains the most basic and important in practice. Vascular surgeons perform successful operations on many patients.

Traumatic venectomies became a thing of the past when modern minimally invasive techniques became available. Mini-phlebectomy with Brunner's approach, Muller's dissection, and Varadi hooks facilitates the treatment of patients with varicose veins and often takes one day.

Of course, there are also contraindications for surgical intervention, the main group being patients over 75 years of age who show tissue trophic disorders, microcirculation and/or lymphatic drainage disorders, or excessive damage to venous vessels. There are special instructions for operations in such patients. Sometimes you have to completely abandon the operation, and sometimes doctors still operate with a combined phlebectomy.

Drug treatment

The treatment regimen of varicose veins is determined by the doctor. For this, conservative methods and surgical methods are used, all depending on the stage of development of the disease, as well as the presence of complications.

The simultaneous use of drugs and ointments allows to eliminate the symptoms of pathology and achieve good results in treatment. Currently, there is a large selection of drugs on the shelves of pharmacies, they are effective in the fight against pathology in the early stages of development.

Medicinal treatment of varicose veins in the legs is effective.

It is important!Only a doctor can prescribe drugs, dosage and course of use.

Sclerotherapy

Sclerotherapy is one of the best methods of treating varicose veins today. Specially administered drugs allow to destroy the stagnation inside the vein. After some time, they will begin to stick together and dissolve, and blood circulation will be transferred to healthy vessels.

Treatment is carried out in a course of up to six sessions for each painful leg. You can see the positive result no later than two weeks. However, patients should be prepared to experience pain and tingling.

Soon unpleasant symptoms will disappear, diseased veins will disappear. The dose of the drug is selected taking into account the individual characteristics of the patient.

Complications and side effects are extremely rare. A properly performed procedure gives a high chance of recovery.

Echosclerotherapy is the same as sclerotherapy, the difference is in the use of an ultrasound scanner. This method is preferred because the movement of the syringe can be monitored and the medicine will be distributed evenly.

Foam sclerotherapy is another type of sclerotherapy. Medicines are applied in the form of microfoam, so the procedure allows for better results. The fact is that the drug is very close to the walls of the blood vessels and does not mix with the blood.

Surgical treatment methods

Surgical treatment of varicose veins is used only when conservative methods do not achieve the desired result. Patients are given local anesthesia and can go home after a few hours.

There are practically no hematomas and no intoxication typical of general anesthesia. The obtained result lasts for several years.

Phlebectomy is a type of operation performed under local surgery. Two small punctures are made to remove the affected vein. Sometimes this method can replace sclerotherapy. After just a few weeks, the patient will be able to return to a normal lifestyle.

Laser treatment is the gentlest treatment method and can only be performed by a qualified specialist. Using an ultrasound scanner, a light guide is inserted into the vein.

The procedure is controlled by special devices. The laser beam causes the plasma to boil, the diseased vessel is closed and does not participate in blood circulation. The cost of such an intervention is high, so it is not available to everyone.

Darsonvalization

With the help of the D'arsonval apparatus, it is possible to normalize blood circulation, as well as to remove blockages in diseased veins. The increased tone gradually decreases, the tone of the vessels increases. Patients are relieved of pain and itching.

Full circulation of lymph, as well as full blood circulation, allows tissues to be adequately nourished and the amount of oxygen in them increases. The veins either narrow or dilate; gymnastics can increase their flexibility.

The device moves from bottom to top. Lymph and blood flow from the ankle to the thigh and the congestion stops. To get the desired result, you need to go through a full course of treatment, which includes at least twenty procedures.

Home remedies

Advice!Varicose veins can also be effectively treated with home remedies.

The most common methods are the use of medicinal plants. You can buy them at the pharmacy or collect them yourself in the summer.

White acacia

An alcohol tincture is prepared based on the flowers of the plant. Soak cotton swabs in it and wipe the affected areas several times a day.

Sagebrush

Collect fresh herbs and crush them in a mortar. Separate a spoonful of herbs and mix with the same amount of sour cream. Apply the resulting mixture to painful places and apply a bandage on top. After two hours, remove the compress. Repeat the manipulations for five days, take a short break, and then repeat the course of treatment again.

Kalanchoe

Wash the Kalanchoe leaves, put them on a paper towel and leave them to dry. Chop the leaves and put them in a glass jar. Pour alcohol over it and infuse for seven days, stirring occasionally. Strain the tincture and lubricate the painful veins for several months in a row.

Apple cider vinegar

Dissolve two tablespoons of vinegar in a glass of water and drink it twice a day. It is recommended to apply undiluted apple cider vinegar to the painful areas twice a day. After a month, the veins will begin to shrink.

Cream

Chop one part of garlic, add two parts of butter. Put the cream in its pure form on painful places, cover it with parchment paper and apply a bandage. Leave the compress all night, wash off in the morning and wrap your feet with an elastic bandage. Repeat the procedures during the month.

garlic

You can take garlic internally to combine the results of the treatment. Mix 250 grams of chopped garlic and 350 grams of honey, infuse for five days. Take one spoon three times a day.

Tomato

Cut a fresh tomato into slices, apply it to the problem area and wrap it with a bandage. Keep the compress for four hours, then remove it and wash your feet. The duration of the treatment course is two weeks, then there is a ten-day break and it is repeated.

Prevention

It is easier to prevent the disease than to fight it later, so prevention is necessary. If you have a hereditary tendency to develop varicose veins, you should pay double attention to your health.

First of all, you should give up bad habits and follow the recommendations listed above. Your diet should include foods rich in vitamins.

Vitamin E

Vitamin is found in many foods: lettuce, vegetable oil, legumes. It is necessary to strengthen the walls of blood vessels and increase their elasticity. Vitamin C has exactly the same property.

Copper

Foods rich in copper help the synthesis of elastin. This includes seafood. You should avoid sugary foods to maintain your body weight.

To prevent varicose veins, you should follow the following rules:

1. It is not recommended to load your legs too much during the day. People who work in a standing position must spend several minutes per hour in a sitting position. Ideal: take a horizontal position, raise your legs above your head and hold for twenty minutes.
2. If you work in a sitting position, you should get up for a few minutes once an hour and spend that time standing. Thus, the speed of blood movement through the veins will be increased. Turn your legs in different directions from time to time.
3. Lifting heavy objects is not recommended.
4. Massage your feet with cool water every day.
5. Do not overuse sauna and bath visits.

Effective methods of treating varicose veins can achieve good results. Patients quickly return to full life.

How complex is the disease?

Complications of varicose veins are always unexpected, although they develop gradually. Without medical supervision and therapeutic treatment, the risk of developing complications increases many times.

1. Trophic ulcers with ascending and descending varicose veins.They are most often located on the inside in the lower third of the foot, but although this manifestation occurs very rarely, they can also be observed on the outside. The deeper the trophic ulcer, the higher the risk of bleeding.
2. Thrombophlebitis.It can happen with any type of varicose veins, the occurrence of such a complication directly depends on the coagulation properties of the blood. This complication can be avoided by using laboratory monitoring.
3. Eczema.It occurs due to a violation of tissue trophism. Eczema and trophic ulcers can occur together or separately.
4. Bleeding from varicose veins of the lower extremities.Such a complication can appear against the background of deep trophic ulcers, as described above, such bleeding will be external. With a long-term course of varicose veins, internal (subcutaneous) bleeding is observed.

What is important to know about varicose veins

Varicose veins become a test for patients, because if they ignore it, the disease will behave more aggressively. The course of varicose veins depends not only on the doctor's instructions, but also on how strictly the patient follows them. Varicose veins are a chronic disease, so treatment often does not end even after surgery.

Whether lower extremity varicose veins are a magnet for medication or exercise therapy, what your doctor recommends should be done and followed. It is a complex treatment that gives a positive result, and you should not overlook even the most insignificant point.