Modern healthcare faces many different challenges, but despite rapid medical advances, there are diseases that continue to affect millions of people. Varicose disease of the lower extremities ICD 10 - I83 is precisely a problem that practically cannot be solved over time.
Prevalence in numbers
The disease has spread to various developed countries, such as the United States, France, Belgium, Germany, etc. The number of patients with this diagnosis represents almost a quarter of the population of each country.
Half of the patients are over 55 years old, but the other part are able-bodied workers, very often employed in the manufacturing sector. As any VD disease progresses, complications form, patients lose their jobs due to disability, then the problem becomes not only medical, but also economic and social. The appearance of varicose veins may be related to the age of the patient. In people over the age of 70, varicose veins of the lower extremities are more common than in people before retirement age.
In four out of one hundred patients over the age of 80, varicose veins take on a form aggravated by concomitant pathologies, in the form of trophic ulcers, various dermatitis or eczema. Also at this age, other diseases of the cardiovascular and bronchopulmonary systems occur, thus excluding the possibility of surgical intervention.
Important!At the first symptoms of the disease it is better to consult a doctor; the younger the patient's age, the lower the risks if surgical treatment is necessary.
Origins of the disease
Despite the fact that the disease progresses gradually, there are still etiological factors for the development of varicose veins.
So, what are the causes of varicose veins:
- inheritance;
- endocrinological reasons;
- mechanical factor;
- infection;
- intoxication;
- nonspecific inflammatory process;
- Factors contributing to venous hypertension.
Complaints and symptoms
Oddly enough, at the very beginning of the disease, visible disorders appear, which are often ignored. Confusing defects of small vessels with a minor external disorder that "will go away by itself", patients provoke the development of the disease.
Further symptoms develop progressively:
- feeling of tiredness/heaviness in the legs;
- swelling in the foot area;
- night cramps;
- numbness, tingling, "pins and needles" sensation;
- pain in the area of varicose veins.
Diagnosis of varicose veins is an important condition at any stage of the disease
The disease at any stage requires a diagnosis; it is the diagnosis that suggests which treatment option is most acceptable to the patient. Clinical and instrumental diagnostic methods are used in tandem. Depending on the course of the disease, you can use all methods or only part of them.
Clinical examination methods: examination and conversation
Clinical methods are used not only for varicose veins, but also for any other diseases:
- Taking the story. The medical history includes all the basic facts of your life (age, heredity, bad habits, type of main job).
- Definition of complaints. Complaints may indicate how much the varicose veins have progressed at the time of the exam. The duration of the disease becomes an important condition. When did the first symptoms of leg disease appear?
- Inspection.During the examination, the doctor should 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 extent of damage, the temperature at the location of the varicose veins, as well as the tension and elasticity of the vessel.
A phlebologist is the first doctor who should see 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, the foci of varicose lesions, the length of the damaged vessel, the insufficiency of venous valves, the speed of blood flow, etc. are determined.
This:
- 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 venous wall.
- Doppler ultrasound.The study determines the speed of blood flow, thereby identifying pathologies of the valves in the vessel.
- 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 X-ray contrast, with the introduction of a contrast agent into the lumen of the vessel. A CT image, unlike an x-ray, is three-dimensional.
- magnetic resonance imaging.The method is justified and informative and is performed without the administration of contrast or other drugs. However, this method remains expensive, so it is very rarely used.
Note!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 many factors:
| External events |
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| Cause of the disease |
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| Anatomical position of the veins |
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| Mechanism of the disease |
|
The most common reason for contacting specialists is grade 2 varicose veins of the lower extremities, when external manifestations of the disease become significant. Perhaps, if the disease did not manifest itself externally, the detection of varicose veins would occur in the later stages.
Note!The concept of "internal varicose veins of the lower extremities" is used only colloquially, meaning varicose veins of the deep veins, which can be diagnosed only by instrumental methods.
To treat or not to treat, that is the question
The gradual progression of the disease sooner or later pushes patients to think that treatment is necessary. Often the doctor's task is to convince the patient to start treatment in the initial stages of the disease. The direction of treatment can be different and depends on many factors (age, symptoms, degree of the disease, etc. ).
Therefore, treatment can be aimed at:
- improve quality of life; cosmetic surgeries.
- prevent complications; impact on microcirculation.
- elimination of symptoms; haemodynamically significant treatment.
One way or another, treatment is always chosen by a specialist (phlebologist, vascular surgeon). In the treatment of varicose veins, complexity is important, so one cannot limit oneself to just surgery or just therapeutic and preventive physical training. It is important to follow all your doctor's instructions.
Lifestyle advice
Varicose veins force patients to abandon the factors that provoke complications. Sometimes such a measure is necessary, since untreated varicose veins significantly affect the quality of life.
Do-it-yourself treatment is a futile exercise, however, you should pay attention to your lifestyle so that varicose veins do not progress so quickly.
What should be done for varicose veins:
- Women must give up high-heeled shoes;
- Abandon bad habits, especially smoking;
- Move, if you have to sit or stand for a long time, then try changing your position;
- Avoid tight/tight clothing and shoes;
- Avoid exposure to high temperatures (tanning, hot wax, baths, saunas);
- Check your weight;
- Do not lift heavy objects;
- Take a contrast shower;
- Walk, run, swim more often;
- Keep your legs elevated whenever possible (sleep, rest).
Compression therapy
Regardless of the etiology, patients with varicose veins should wear medical hosiery or apply elastic bandages.
- The use of knitwear is more convenient; socks or knee-highs, made of special material, most often do not cause discomfort. The compression level of medical hosiery must be recommended by a doctor. The only disadvantage of compression garments is the price.
Note!Brands of medical hosiery manufacturers can be different, so you need to choose carefully. Make sure the elastic on your knee socks or socks is not too tight.
- Alternatively, patients often prefer to use elastic bandages with short, medium or long elasticity. The choice of distensibility also depends on the stage of the disease and should be advised by a doctor. The first few uses may be a little difficult as you will have to check the tension level of the bandage yourself.
Compression therapy is used daily, wearing underwear or bandages significantly relieves the load on the legs during the day.
Physical education and sport as treatment
Varicose veins require movement, so therapeutic and preventive physical education is an important component. Of course, it is better not to perform the exercises blindly, but to choose a set of exercises with a specialist. Some medical institutions offer group physical therapy classes.
Most often, physical therapy exercises do not require special training and are available regardless of age; for clarity, a set of physical therapy exercises:
- Tighten and relax the thigh muscles (10 times);
- Inhale, lifting the abdominal wall, exhaling, draw in the stomach (4 times);
- Bend and straighten your legs at the ankle (10 times);
- Inhaling, raise your arms to your sides, exhaling, lower them (4 times);
- Bend and straighten your toes (15 times);
- Raise your arms as you inhale and lower them as you exhale.
Even from this small set of exercises it is clear that anyone can perform them, regardless of age. It's important to take your time and do everything at a slow pace, without holding or speeding up your breath.
Athletes can also perform this series of exercises before the main workout. It is especially important if the patient participates in any sport not recommended for varicose veins.
Sports are also appropriate as an alternative to physical therapy for varicose veins of the lower extremities, but it is necessary to consult a doctor and a personal trainer. Some exercises will have to be excluded from training.
Athletes are sometimes simply forced to leave their professional careers, especially in jumping, powerlifting and heavyweight boxing. Those who love swimming, running and walking, in turn, can continue to do so.
Medicines, subject to doctor's prescription
The objectives of pharmacology in the treatment of varicose veins are different, namely:
- improvement of venous tone;
- correction of microcirculation;
- improvement of lymphatic drainage;
- prevention of thrombotic complications;
- suppression of the development of complications.
That is why all medications must be prescribed by a doctor. It is in this sense that there is a guarantee of an effective resolution of the disease.
Treatment with drugs is used at different stages: during the preparation of the patient for an upcoming operation, in the postoperative period, as well as in case of obvious contraindications to surgical intervention. Drugs can be systemic or local and used both in tandem and separately.
Phlebosclerosing treatment
Phlebosclerosis also refers to drug treatment methods, however its use is often unjustified, since the positive effect does not apply to all patients. In most cases the method is used for correction in an aesthetic sense.
It should be noted that the use of this method is fraught with relapses and complications, so the procedure is performed by surgeons who have undergone 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 successfully used to relieve 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, since any physiotherapy has a number of indications and contraindications.
All physiotherapeutic procedures are not applied continuously, but in cycles of 10-20 days. In most cases, physiotherapy delays the progression of the disease, but it is not the main method of treatment and certainly cannot be used as monotherapy.
Surgical treatment
Despite numerous therapeutic methods, 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 with the availability of modern minimally invasive methods. The Brunner approach, Müller dissection, and mini-phlebectomy with Varadi hooks facilitate the management of patients with varicose veins and often last within a day.
Of course, there are also contraindications to surgery; the main group consists of patients over 75 years of age who present trophic tissue disorders, microcirculation and/or lymphatic drainage disorders or excessive lesions of the venous vessels. There are special instructions for performing operations on such patients. Sometimes it is necessary to abandon the operation altogether, sometimes doctors continue to operate through a combined phlebectomy.
Pharmacological treatment
The treatment regimen for varicose veins is determined by the doctor. For this, conservative methods and surgical methods are used, it all depends on the stage of development of the disease and the presence of complications.
The simultaneous use of drugs and ointments allows you to alleviate the symptoms of the pathology and achieve good results in treatment. Currently on the shelves of pharmacies there is a vast selection of drugs, effective in combating the pathology in its early stages of development.
Drug treatment for varicose veins in the legs is effective.
Important!Only a doctor can prescribe drugs, dosage and methods of use.
Sclerotherapy
Sclerotherapy is one of the best methods for treating varicose veins today. Specially administered drugs allow you to destroy the stagnation of the vein inside. After a while, it will begin to stick together and dissolve, and blood circulation will be transferred to healthy veins.
The treatment is carried out in a cycle that includes up to six sessions for each painful leg. You can notice a positive result no earlier than two weeks. 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 properly performed procedure offers a high chance of recovery.
Ecosclerotherapy is the same as sclerotherapy, the difference lies in the use of an ultrasound scanner. This method is preferable because you can monitor the movement of the syringe and the medicine will be distributed evenly.
Foam sclerotherapy is another type of sclerotherapy. Medicines are administered in the form of microfoam, so the procedure achieves better results. The fact is that the medicine is much closer to the walls of the veins and does not mix with blood.
Surgical methods of treatment
Surgical treatment of varicose veins is used only if conservative methods do not achieve the desired result. Patients are given local anesthesia and can go home after a couple of hours.
There are practically no hematomas and there is no intoxication characteristic of general anesthesia. The result obtained lasts for several years.
Phlebectomy is a type of operation performed as part of local surgery. Two small punctures are made to remove the affected vein. Sometimes this method can replace sclerotherapy. After just a couple of weeks the patient will be able to return to his usual lifestyle.
Laser treatment is the most gentle 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 boils the plasma, the diseased vein closes and does not participate in blood circulation. The price of such an intervention is high, therefore it is not affordable for everyone.
Darsonevaluation
With the help of the D'arsonval apparatus it is possible to normalize blood circulation and 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 circulation of blood, allows tissues to receive adequate nutrition and the amount of oxygen in them increases. Veins narrow or expand; gymnastics can increase their elasticity.
The device moves from bottom to top. The lymph and blood drain from the ankle to the thigh and the 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
Advise!Varicose veins can also be treated effectively using 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 and clean the affected areas several times a day.
Artemisia
Collect fresh herbs and chop them in a mortar. Separate a spoonful of herbs and mix it with the same amount of sour cream. Apply the resulting mixture to the 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 then repeat the course of treatment again.
Kalanchoe
Wash the Kalanchoe leaves, place them on a paper towel and let them dry. Chop the leaves and place them in a glass jar. Pour alcohol over and let it brew for seven days, stirring occasionally. Strain the tincture and lubricate the sore 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 rub undiluted apple cider vinegar on the sore areas twice a day. After a month, the veins will start to get smaller.
Cream
Grind part of the garlic, add two parts of butter. In its pure form, place the resulting cream on the sore spots, cover with parchment paper on top and apply a bandage. Leave the compress overnight, wash 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 tablespoon three times a day.
Tomatoes
Cut a fresh tomato into slices, apply to the problem area and wrap with a bandage. Keep the compress on for four hours, then remove it and wash your feet. The duration of the treatment course is two weeks, then a ten-day break is taken and is 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 the development of varicose veins, you need to pay more attention to your health.
First of all, you need to abandon bad habits and follow the advice 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 and increase their elasticity. Vitamin C has exactly the same property.
Copper
Elastin synthesis is aided by copper-rich foods. Seafood is included here. To maintain body weight you need to give up sugary foods.
To prevent varicose veins, you need to follow the following rules:
- It is not recommended to strain your legs too much during the day. People who work in a standing position must spend several minutes every hour in a sitting position. Ideal: assume a horizontal position, raise your legs above your head and maintain the position for twenty minutes.
- If you work in a sitting position, you need to get up for a few minutes once an hour and spend this time standing. Therefore, the speed of blood movement through the veins will increase. Periodically rotate your feet in different directions.
- It is not recommended to lift heavy objects.
- Massage your feet every day using a jet of cool water.
- Do not abuse visits to saunas and baths.
Effective methods for treating varicose veins can achieve good results. Patients quickly return to a full life.
How complicated is the disease?
Complications of varicose veins are always unpredictable, although they develop gradually. Without medical supervision and therapeutic treatment, the risk of developing complications becomes many times greater.
- Trophic ulcers with ascending and descending varicose veins.They are most often found in the lower third of the leg inside, however, they can also be observed outside, although this manifestation occurs quite rarely. The deeper the trophic ulcer, the greater the risk of bleeding.
- Thrombophlebitis.It can occur with any type of varicose veins; the onset of this complication directly depends on the coagulative properties of the blood. This complication can be prevented by using laboratory monitoring.
- Eczema.It occurs due to a violation of tissue trophism. Eczema and trophic ulcers can occur both together and separately.
- Bleeding from varicose veins of the lower extremities.This type of complication can appear against the background of deep trophic ulcers, as described above; such 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, because 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 scrupulously the patient follows them. Varicose veins are a chronic disease, so even after surgery, treatment often does not end.
What the doctor recommends must be done and followed, be it a magnet for varicose veins of the lower extremities, medications or physical therapy. It is a complex treatment that gives a positive result and you should not ignore even one, the most insignificant point.