Modern healthcare faces many different challenges, but despite rapid advances in medicine, there are diseases that continue to affect millions of people. Varicose disease of the lower extremities ICD 10 - I83 is a problem that practically cannot be resolved over time.
Prevalence in numbers
The disease has spread to several developed countries such as the USA, France, Belgium, Germany, etc. The 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 other part are able-bodied workers, most often employed in industry. As any RV disease progresses, complications arise, patients lose their jobs due to disability, so the problem becomes not only medical, but also economic and social. The occurrence of varicose veins may be correlated with the patient's age. In people over 70 years of age, varicose veins of the lower extremities are more common than in people before retirement age.
In four out of every hundred patients over 80 years of age, varicose veins take on a form aggravated by concomitant pathologies, in the form of trophic ulcers, various dermatitis or eczema. Other diseases of the cardiovascular and bronchopulmonary systems also occur at this age, thus excluding the possibility of surgical intervention.
Important!At the first symptoms of the disease, it is best to consult a doctor, the younger the patient, the lower the risks if surgical treatment is necessary.
Origins of the disease
Although the disease progresses gradually, 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;
- nonspecific inflammatory process;
- Factors contributing to venous hypertension.
Complaints and symptoms
Interestingly, visible disorders appear at the beginning of the disease, which are often ignored. Mistaking defects of small vessels for a minor external disorder that "will go away on its own", patients provoke the development of the disease.
Other symptoms develop progressively:
- feeling of tiredness/heaviness in the legs;
- swelling in the foot area;
- nocturnal cramps;
- numbness, tingling, "pins and needles" sensation;
- pain in the area of varicose veins.
The diagnosis of varicose veins is an important condition at any stage of the disease.
The disease at any stage requires diagnosis; It is the diagnosis that suggests which treatment option is most acceptable to the patient. Clinical and instrumental diagnostic methods are used together. Depending on the course of the disease, all methods or only part of them can be used.
Clinical examination methods - examination and conversation
Clinical methods are used not only for varicose veins, but also for any other disease:
- Making history. The anamnesis includes all the basic data about your life (age, heredity, bad habits, type of main job).
- Definition of complaints. Complaints may indicate how far varicose veins have progressed at the time of examination. The duration of the disease becomes an important condition. When did the first symptoms of leg disease appear?
- Inspection.During the examination, the doctor must pay attention not only to the blood vessels, but also to the condition of the skin, to exclude the presence of complications and concomitant 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 vessel.
The phlebologist is the first doctor who should examine your feet.
Instrumental examination methods are a prerequisite
To prescribe treatment, one examination will not be enough. Varicose veins of the lower extremities require mandatory instrumental diagnosis. During instrumental research methods, foci of varicose lesions, the length of the damaged vessel, the insufficiency of venous valves, the speed of blood flow, etc. are determined.
That:
- 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 reveals pathologies of the vein wall.
- Doppler ultrasound.The study determines the speed of blood flow, thus identifying pathologies of the vessel valves.
- X-ray contrast venography. A more complex type of diagnosis using X-rays. The procedure is rarely used due to the possible occurrence of complications.
- Computed tomographic venography. It is performed in the same way as radiographic contrast, with the introduction of a contrast agent into the lumen of the vessel. A CT image, unlike an X-ray, is three-dimensional.
- MRI.The method is justified and informative, being performed without administration of contrast or other medications. However, this method remains expensive, so it is used very rarely.
Observation!In patients with iodine allergy, contrast agents cannot be administered, in which case MRI may be necessary.
Diagnosis according to classification
Like other diseases, varicose veins are divided into classes, taking into account several factors:
| External manifestations |
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| Cause of the disease |
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| Anatomical location of veins |
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| Disease mechanism |
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The most common reason for contacting specialists is grade 2 varicose veins of the lower extremities, when the external manifestations of the disease become significant. Perhaps, if the disease did not manifest itself externally, the detection of varicose veins would occur at later stages.
Observation!The concept of "internal varicose veins of the lower extremities" is used only colloquially, meaning varicose veins of the deep veins, which can only be diagnosed by instrumental methods.
To treat or not to treat, that 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 may aim to:
- improving quality of life; cosmetic surgical interventions.
- prevention of complications; impact on microcirculation.
- elimination of symptoms; hemodynamically significant treatment.
One way or another, the treatment is always chosen by a specialist (phlebologist, vascular surgeon). In the treatment of varicose veins, complexity is important, which is why it cannot be limited to just surgical intervention, or just therapeutic and preventive physical training. It is important to follow all of your doctor's instructions.
Lifestyle Tips
Varicose veins force patients to abandon factors that provoke complications. Sometimes such a measure is necessary, as untreated varicose veins greatly affect the quality of life.
Do-it-yourself treatment is a useless exercise, however, you must pay attention to your lifestyle so that varicose veins do not progress so quickly.
What needs to be done for varicose veins:
- Women need to ditch high-heeled shoes;
- Give up bad habits, especially smoking;
- Move, if you have to sit or stand for a long time, try changing positions;
- Avoid tight/tight clothes and shoes;
- Avoid exposure to high temperatures (sunbathing, hot wax, baths, saunas);
- Control your weight;
- Do not lift heavy objects;
- Take a contrast shower;
- Walk, run, swim more often;
- Keep your legs elevated whenever possible (sleeping, resting).
Compression Therapy
Regardless of the etiology, patients with varicose veins should wear medical mesh or apply elastic bandages.
- The use of knitwear is more convenient: stockings or knee-highs, made of special material, most often do not cause inconvenience. The compression level of medical socks should be recommended by a doctor. The only downside to compression garments is the price.
Observation!Brands of medical mesh manufacturers can be different, so you need to choose carefully. Make sure the elastic on your knee socks is not too tight.
- Alternatively, patients often prefer to use short, medium, or long stretch elastic bandages. The choice of distensibility also depends on the stage of the disease and should be recommended by a doctor. The first few uses can be a little difficult as you will need to control the tension level of the bandage yourself.
Compression therapy is used daily, wearing underwear or bandages greatly relieves the load on the legs throughout the day.
Physical education and sports as treatment
Varicose veins require movement, so therapeutic and preventive physical education 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 institutions offer group exercise therapy classes.
Most of the time, exercise therapy exercises do not require special training and are available regardless of age; for greater clarity, a set of exercise therapy exercises:
- Contract and relax your thigh muscles (10 times);
- Inhale, lifting the abdominal wall, exhale, draw in the stomach (4 times);
- Bend and straighten your legs at ankle height (10 times);
- Inhaling, raise your arms through the sides, as you exhale, lower them (4 times);
- Bend and straighten your toes (15 times);
- Raise your arms when you inhale and lower them when you exhale.
Even from this small set of exercises it is clear that anyone can practice them, regardless of age. It is important to take your time and do everything slowly, without holding or speeding up your breathing.
Athletes can also perform this set of exercises before their main workout. It is especially important if the patient practices any sport that is not recommended for varicose veins.
Sports, as an alternative to exercise therapy for varicose veins of the lower limbs, are also suitable, but it is necessary to consult a doctor and a personal trainer. Some exercises will have to be excluded from training.
Sometimes athletes are simply forced to abandon their professional careers, especially in jumping, weightlifting and heavyweight boxing. Those who like swimming, running and walking, in turn, can continue doing so.
Medicines, after being prescribed by a doctor
The objectives of pharmacology in the treatment of varicose veins are different, namely:
- improvement in vein tone;
- correction of microcirculation;
- improved lymphatic drainage;
- prevention of thrombotic complications;
- suppression of the development of complications.
This is why all medications must be prescribed by a doctor. It is in this sense that there is a guarantee of successful resolution of the disease.
Drug treatment is used at different stages: when preparing the patient for an upcoming operation, in the postoperative period, as well as in cases of obvious contraindications to surgery. Medications can be systemic or local and used together or separately.
Phlebosclerosis treatment
Phlebosclerosis also refers to pharmacological treatment methods, however, their use is often unjustified, since the positive effect does not apply to all patients. For the most part, the method is used for correction in an aesthetic sense.
It should be noted that the use of this method is fraught with recurrences and complications, which is why the procedure is performed by surgeons with special training.
Physiotherapy in the treatment of varicose veins
Physiotherapeutic methods are not the main ones in the treatment of varicose veins, but they are used successfully to alleviate the symptoms of the disease. D'incendiary, electrophoresis, barotherapy, magnetic therapy for varicose veins of the lower limbs are used only under the supervision of a doctor, as any physiotherapy has a number of indications and contraindications.
All physiotherapy procedures are not applied continuously, but in courses of 10 to 20 days. In most cases, physiotherapy provides a delay in the progression of the disease, but it is not the main method of treatment and certainly cannot be used as monotherapy.
Surgical treatment
Despite the many methods of therapy, surgery remains practically the most basic and significant. Vascular surgeons perform successful operations on many patients.
Traumatic venectomies have become a thing of the past as modern, minimally invasive methods have become available. The Brunner approach, Müller dissection, and miniphlebectomy with Varadi hooks facilitate the management of patients with varicose veins and generally last one day.
Of course, there are also contraindications to surgical intervention; the main group are patients over 75 years of age who present with tissue trophic disorders, microcirculation and/or lymphatic drainage disorders or excessive lesions of venous vessels. There are special instructions for carrying out operations on these patients. Sometimes you have to completely abandon the operation, and sometimes doctors even operate through a combined phlebectomy.
Drug treatment
The treatment regimen for varicose veins is determined by the doctor. Conservative and surgical methods are used for this, it all depends on the stage of evolution of the disease, as well as the presence of complications.
The simultaneous use of medications and ointments allows you to alleviate the symptoms of the pathology and obtain good treatment results. Currently, there is a wide variety of medicines on pharmacy shelves that are effective in combating pathology in its initial stages of development.
Drug treatment for varicose veins in the legs is effective.
Important!Only a doctor can prescribe medication, dosage and course of use.
Sclerotherapy
Sclerotherapy is one of the best methods of treating varicose veins today. Specially administered medicines make it possible to destroy the stagnation of the internal vein. After some time, it will start to stick together and dissolve, and blood circulation will be transferred to healthy veins.
Treatment is carried out in a course that includes up to six sessions for each sore leg. You can notice a positive result no earlier than two weeks later. However, patients should be prepared to experience pain and tingling.
Soon the unpleasant symptoms will disappear, the diseased veins will disappear. The dosage of the drug is selected taking into account the individual characteristics of the patient.
Complications and side effects are extremely rare. A correctly performed procedure offers great chances of recovery.
Ecosclerotherapy is the same as sclerotherapy, the difference is in the use of ultrasound. This method is preferable because the movement of the syringe can be monitored and the medicine will be distributed evenly.
Foam sclerotherapy is another type of sclerotherapy. The medicines are administered in the form of microfoam, which is why the procedure allows for better results. It turns out that the medicine stays much closer to the walls of the veins and does not mix with the blood.
Surgical treatment methods
Surgical treatment of varicose veins is used only if conservative methods do not achieve the desired result. Patients receive local anesthesia and after a few hours can go home.
There are practically no bruises and there is no intoxication characteristic of general anesthesia. The result obtained 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 their usual lifestyle.
Laser treatment is the gentlest treatment method and can only be carried out 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 vein closes and does not participate in blood circulation. The price of such an intervention is high, so it is not within everyone's reach.
Darsonvalization
With the help of the D'arsonval apparatus, it is possible to normalize blood circulation, as well as eliminate congestion in diseased veins. The increased tone gradually decreases, the tone of the veins increases. Patients get relief from pain and itching.
Full circulation of lymph, as well as full blood circulation, allows tissues to receive adequate nutrition and the amount of oxygen in them increases. Veins narrow or expand; gymnastics can increase your elasticity.
The device moves from bottom to top. Lymph and blood flow from the ankle to the thigh and congestion stops. To achieve the desired result, it is necessary to undergo a full course of treatment, which includes at least twenty procedures.
Home remedies
Advice!Varicose veins can also be treated effectively with home remedies.
The most common methods are the use of medicinal herbs. You can buy them at the pharmacy or pick them up yourself in the summer.
White acacia
An alcoholic tincture is prepared based on the flowers of the plant. Dip cotton swabs in it and clean the affected areas several times a day.
Artemisia
Collect fresh herbs and grind them in a mortar. Separate a spoonful of herbs and mix with the same amount of cream. Apply the resulting mixture to sore spots and apply a bandage on top. After two hours, remove the compress. Repeat the manipulations for five days, take a short break and repeat the treatment again.
Kalanchoe
Wash the Kalanchoe leaves, place on paper towel and let dry. Chop the leaves and place in a glass jar. Pour the alcohol over the top and let it ferment for seven days, stirring occasionally. Strain the tincture and lubricate painful veins for several months in a row.
Apple vinegar
Dissolve two tablespoons of vinegar in a glass of water and drink twice a day. It is recommended to rub undiluted apple cider vinegar into painful areas twice a day. After a month, the veins will begin to shrink.
Cream
Grind part of the garlic, add two parts of butter. In its pure form, place the resulting cream on the wounds, cover with parchment paper and apply a bandage. Leave the compress on all night, wash it off in the morning and wrap your legs with an elastic bandage. Repeat the procedures throughout the month.
Garlic
To consolidate the results of the treatment, you can take garlic internally. Mix 250 grams of chopped garlic and 350 grams of honey, let it brew for five days. Take one spoonful three times a day.
tomatoes
Cut a fresh tomato into slices, apply to the problem area and wrap with a bandage. Keep the compress for four hours, then remove and wash your feet. The duration of treatment is two weeks, then a ten-day break is taken and repeated.
Prevention
It is much easier to prevent a disease than to fight it later, which is why prevention is necessary. If you have a hereditary predisposition to developing varicose veins, you need to pay extra attention to your health.
First of all, you need to give up bad habits and follow the recommendations listed above. Your diet should include foods rich in vitamins.
Vitamin E
The vitamin is found in many foods: lettuce, vegetable oil, legumes. It is necessary to strengthen the walls of the veins, as well as increase their elasticity. Vitamin C has exactly the same property.
Copper
Elastin synthesis is aided by foods rich in copper. Seafood is included here. To maintain body weight, you need to give up sugary foods.
To prevent varicose veins, you must follow the following rules:
- It is not recommended to put too much pressure on your legs during the day. People who work standing need to spend several minutes per hour sitting. Ideal: stand in a horizontal position, raise your legs above your head and hold for twenty minutes.
- If you work sitting down, you need to get up for a few minutes once an hour and spend that time standing. Thus, the speed of blood movement in the veins will increase. Periodically rotate your feet in different directions.
- It is not recommended to lift heavy objects.
- Massage your feet daily with a stream of cold water.
- Do not abuse visits to saunas and baths.
Effective varicose vein treatment methods can achieve good results. Patients quickly return to a full life.
How is the disease complicated?
Complications from varicose veins are always unpredictable, although they develop gradually. Without medical monitoring and therapeutic treatment, the risk of developing complications becomes many times greater.
- Trophic ulcers with ascending and descending varicose veins.They are most frequently located in the lower third of the leg, on the inside, but they can also be seen on the outside, although this manifestation occurs very rarely. The deeper the trophic ulcer, the greater the risk of bleeding.
- Thrombophlebitis.It can occur with any type of varicose veins, the occurrence of this complication directly depends on the coagulatory properties of the blood. This complication can be avoided with laboratory monitoring.
- Eczema.It occurs due to a violation of tissue trophism. Eczema and trophic ulcers can occur together or separately.
- Bleeding from varicose veins of the lower extremities.This type of complication can arise in the context of deep trophic ulcers, as described above; this bleeding will be external. Internal (subcutaneous) bleeding is observed with prolonged course of varicose veins.
What is important to know about varicose veins
Varicose veins become a test for patients, as the more they ignore it, the more aggressive the disease will behave. 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 even after surgery, treatment often does not end.
What the doctor advises must be done and followed, whether it is a magnet for lower limb varicose veins, medication or exercise therapy. It is a complex treatment that gives positive results, and you should not ignore even one, the most insignificant point.