At least half of adults have a problem with enlarged veins. This common illness is a family 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 bluish convex strands; Sometimes varicose veins appear as a thin vascular mesh extending just below the surface of the skin. It almost always affects the legs and feet. Visible swollen and twisted veins – sometimes surrounded by patches of congested capillaries, resembling a spider web 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 interfere with blood flow to such an extent that they cause swelling of the ankles, itching and pain in the affected limb.
In addition to the superficial venous network, the legs have an internal or deep venous network. In rare cases, the deep veins of 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 dangerous, can be the site of blood clots.
To help circulate oxygenated blood from the lungs to all parts of the body, arteries have a thick muscular wall. For reverse blood flow through the venous system, the surrounding muscles are used, the muscle layer at 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 necessary to prevent reverse blood flow.
In the case of varicose veins, the valves do not function properly, causing blood to build up in the vein and making it difficult for the muscles to push upwards. Instead of flowing from one valve to the next, blood continues to pool in the vein, increasing venous pressure and further impairing the valves, causing the vein to bulge and twist. 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 involving excessive tension 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 jobs that require standing for long periods of time or lifting heavy objects. 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, because non-working muscles do not pump blood well.
The risk of varicose veins increases with age, as muscles and veins weaken. Previous trauma to the leg can damage the vein 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 an existing condition.
Can varicose veins be prevented?
Although genetics play a role in your risk of developing varicose veins, there are steps you can take to prevent them:
- Exercising regularly as staying physically fit 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 aqua 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, because a normal weight avoids excessive pressure on the veins of the legs;
- Avoid tight clothing. Tight clothing can restrict blood circulation in the thighs, groin and legs;
- Avoid frequent and prolonged wearing of high-heeled shoes, as they can restrict blood circulation. Shoes with completely flat soles are also not desirable; it is better to choose shoes with low, stable heels or elastic soles, as they are better for blood circulation and also improve the tone of the calf muscles.
- 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 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 and not your back. This will reduce the pressure of the uterus on the veins in the pelvic region and even improve blood supply to the fetus;
- If you have risk factors for developing varicose veins, ask your doctor about choosing compression stockings for you - these can be special socks, stockings or tights.
Spider veins and varicose veins
As we age, many of us find bumpy, bluish stars under our skin or swollen cords running down our thighs and calves. These deformed blood vessels occur in 60% of adults after age 50.
What are spider veins?
Spider veins are small, twisted blood vessels that show through the skin. They can be red, purple, or blue in color and most commonly appear on the legs or face.
What are varicose veins?
These are larger blood vessels that have lost their elasticity, swollen and acquired a tortuous course due to changes in the vein wall. These veins appear bluish and raised above the surface of the skin. Varicose veins can appear anywhere, but they most commonly 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 using a system of non-return valves. These valves direct blood flow in the desired direction, from superficial veins to deeper veins and toward the heart. The vessels are surrounded by muscles that contract and help pump blood to the heart. Normally, healthy venous valves prevent the backflow of blood. However, problems with the valves, muscles, or blood pressure can cause blood to build up in the vein. When blood builds up 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 for varicose veins?
Spider veins or varicose veins of large veins can appear in anyone, but women are twice as susceptible to this problem as men. This problem is also familiar to those whose jobs require them to be on their feet constantly, 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 accompany varicose veins?
Often, spider veins and/or varicose veins are not just an unpleasant cosmetic defect. Varicose veins are a condition that can cause unpleasant symptoms and dangerous complications, including leg pain or cramps, feelings of heaviness, throbbing or tingling. Severely inflamed veins become hard to the touch and reduce circulation, leading to itchy and swollen ankles. Additionally, over time, trophic changes develop in the skin and subcutaneous tissue, such as thickening, pigmentation and ulceration.
Complications of varicose veins
Even though spider veins and varicose veins spoil the appearance of the legs and cause uncomfortable symptoms, they rarely pose a serious threat to health. However, in some cases, complications may arise and require a visit to the doctor or even hospitalization.
The most common complications of varicose veins are trophic ulcers against the background of prolonged venous insufficiency; These ulcers most often form at the ankle and heal very poorly. The second frequent and most dangerous complication of varicose veins is thrombophlebitis - thickening and inflammation of the vein wall, which in turn can lead to venous thrombosis - a dangerous complication requiring hospitalization and intensive treatment. If thrombosis has developed in the deep venous system, then there is a risk of migration of the blood clot, 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 limbs
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 ultrasound of the deep venous system, since dilated superficial 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, symmetry of 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 treatment recommendations that will reduce 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 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 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 limbs. 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 which deals with the study and treatment of diseases and malformations of the venous system. A phlebotomist surgeon must master a wide range of techniques used in the treatment of venous diseases.
Conservative treatment of varicose veins
Conservative treatment of varicose veins aims to slow down their development and prevent complications. These generally include recommendations for lifestyle changes (weight loss, good physical activity, elimination of static loads that contribute to the progression of the disease), the choice of compression stockings, the prescription of toning medications. for the walls of venous vessels and the prescription of a course of physiotherapy.
Compression jersey – socks, stockings and support tights
The easiest way to prevent the progression of varicose veins is to wear compression stockings. Also called compression stockings, they improve blood circulation and relieve leg pain and discomfort. They are found in pharmacies and specialty medical supply stores. Such stockings are especially necessary during pregnancy and during long flights.
Lifestyle change 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, thereby slowing down their development. However, their 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 compression physiotherapy - sequential compression of the veins with specialized circular pads, the pressure of which spreadsfrom the feet to the hips, improving blood circulation, stimulating the vascular wall and normalizing the functioning of the venous valves. This treatment is prescribed 2 to 4 times a year in courses of 10 to 12 procedures. It is also recommended to perform it after sessions of sclerotherapy and laser therapy for varicose veins. Such physiotherapy can be carried out independently or in combination with specialized electrical stimulation of the leg muscles, hoping to mutually enhance the therapeutic effect.
Other situations in which physiotherapy gives good results are trophic changes in the skin caused by advanced stages of varicose veins; in these cases, laser therapy, magnetic therapy, phono and electrophoresis (→ and other methods) can be prescribed. that it is 100% contraindicated for physiotherapy of varicose veins in case of concomitant thrombosis or thrombophlebitis, therefore, before carrying out a series of physiotherapeutic procedures, you mustundergo an ultrasound scan 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 beautiful half of humanity, come to a phlebologist because of the external side of the disease - they are bothered by spots and cordsunsightly on the legs. Treatment of varicose veins in this situation most often 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 "minimal traumatic" and "gentle". Indeed, such treatment is carried out on an outpatient basis, causes minimal pain, comparable to a regular injection, and allows excellent results to be obtained. This treatment consists of destroying the internal wall of the vein using a drug (sclerosant) or a laser, which results in the lumen of the vessel sticking together and the cosmetic defect disappearing.
In each case, the decision on the method of treatment is made by the doctor on the basis of examination and examination. In case of complicated varicose veins, surgical treatment is used, which is carried out in a hospital setting.