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 just such a problem that practically cannot be solved over time.
Prevalence in numbers
The disease has spread in various 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 any country.
Half of all patients are over 55 years of age, but the rest are able-bodied workers, most often employed in manufacturing. As each VD disease progresses, complications arise, patients lose work due to disability, so the problem becomes not only medical, but also economic and social. The appearance of varicose veins can be related to the age of the patient. In people over 70, varicose veins of the lower extremities are more common than in people before retirement age.
In four out of a hundred patients over 80 years of age, varicose veins take on 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 system appear, 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.
The origin 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;
- drunkenness;
- nonspecific inflammatory process;
- Factors contributing to venous hypertension.
Complaints and symptoms
Strangely enough, from the beginning of the disease, visible disorders appear, which are often ignored. By mistaking small vessel defects for a small 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 leg area;
- night 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 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:
- Taking history. The anamnesis includes all the basic facts about his life (age, heredity, bad habits, type of main work).
- Definition of complaints. Complaints can show how far the varicose veins have progressed by the time of examination. The duration of the illness becomes an important condition. When did the first symptoms of foot 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 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 vessel.
A phlebologist is the first doctor who should visit your feet.
Instrumental methods of examination are a prerequisite
To prescribe the treatment, an examination will not be enough. Varicose veins of the lower extremities require mandatory instrumental diagnosis. During the 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 vein wall.Doppler ultrasound. The study determines the speed of blood flow, thus identifying the pathologies of the valves in the vessels.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.MRI. The method is justified and informative and is performed without the administration of contrast or other medications. However, this method remains expensive, so it is used extremely rarely.
Note!In patients allergic to iodine, contrast agents cannot be administered, in which case MRI may be necessary.
Diagnosis by classification
Like other diseases, varicose veins are divided into classes, taking into account many factors:
| External manifestations |
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| The cause of the disease |
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| Anatomical location of veins |
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| The mechanism of the disease |
|
The most common reason for contacting specialists is varicose veins of the 2nd degree of the lower extremities, when the external manifestations of the disease become significant. Perhaps, if the disease was not manifested externally, then the discovery of varicose veins would occur in the later stages.
Note!The concept of "internal varicose veins of the lower extremities" is used only colloquially, which means varicose veins of 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 initial stages of the disease. The direction of the treatment can be different and depends on many factors (age, symptoms, degree of the disease, etc. ).
Thus, treatment can be aimed at:
- improving the quality of life; aesthetic surgical interventions.
- prevention of complications; impact on microcirculation.
- elimination of symptoms; hemodynamically important 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, so you can't limit yourself to only surgical interventions, or only therapeutic and preventive physical training. It is important to follow all the doctor's instructions.
Lifestyle tips
Varicose veins force patients to abandon factors that provoke complications. Sometimes such a measure is necessary, since untreated varicose veins greatly affect the quality of life.
Self-treatment is a useless exercise, however, you should pay attention to your lifestyle so that varicose veins do not progress so quickly.
What to do about varicose veins:
- Women should give up high-heeled shoes;
- Give up bad habits, especially smoking;
- Move, if you have to sit or stand for a long time, then try to change your position;
- Avoid tight/tight clothing and shoes;
- Avoid exposure to high temperatures (sunbaths, 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 etiology, patients with varicose veins should wear medical hosiery or apply elastic bandages.
- The use of knitted clothing is more convenient; socks or knee socks, made of special material, most often do not cause discomfort. The compression level of medical stockings should be recommended by a doctor. The only disadvantage of compression garments is their price.
Note!The brands of manufacturers of medical knitwear can be different, so you need to choose carefully. Make sure the elastic on your socks or knee socks is not too tight.
- As an alternative, patients often prefer to use elastic bandages with short, medium or long stretch. The choice of stretch 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 will have to check 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 facilities offer group exercise therapy classes.
Most often, exercise therapy exercises do not require special training and are available regardless of age; for clarity, a set of exercise therapy exercises:
- Tighten and relax the thigh muscles (10 times);
- Inhale, lifting the abdominal wall, exhaling, pulling in the stomach (4 times);
- Bend and straighten the legs at the ankles (10 times);
- Inhaling, raise your arms up to the sides, while exhaling, lower them (4 times);
- Bend and straighten the toes (15 times);
- Raise your arms up as you inhale and lower as you exhale.
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 or speeding up your breathing.
Athletes can also perform this set of exercises before the main workout. It is especially important if the patient is involved in any sports that are not recommended for varicose veins.
Sports, as an alternative to exercise therapy for varicose veins of the lower extremities, are also suitable, but you should consult a doctor and personal trainer. Some exercises will have to be excluded from the training.
Athletes are sometimes simply forced to leave their professional careers, especially in jumping, powerlifting and heavyweight boxing. Those who like to swim, run and walk, on the other hand, can continue to do so.
Medicines, after the doctor's prescription
The objectives of pharmacology in the treatment of varicose veins are different, namely:
- improvement of vein tone;
- correction of microcirculation;
- improvement of lymphatic drainage;
- prevention of thrombotic complications;
- suppressing the development of complications.
This is why all medications must be prescribed by a doctor. It is in this direction that there is a guarantee for the successful resolution of the disease.
Drug treatment is used at different stages: during the preparation of the patient for a future operation, in the postoperative period, as well as in cases of obvious contraindications to the operation. Medicines can be systemic or local and are used both together and separately.
Phlebosclerosis treatment
Phlebosclerosis also refers to pharmacological treatment methods, however, its 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 relapses and complications, so the procedure is performed by surgeons who have undergone special training.
Physiotherapy in the treatment of varicose veins
Physiotherapy 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'arsonval, electrophoresis, barotherapy, magnetic therapy for varicose veins of the lower extremities are used only under the supervision of a doctor, since each physiotherapy has a number of indications and contraindications.
All physiotherapy procedures are not applied continuously, but in courses of 10-20 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 important. Vascular surgeons perform successful operations on many patients.
Traumatic venectomies became a thing of the past as modern minimally invasive methods became available. The Brunner approach, Müller dissection, and mini-phlebectomy with Varadi hooks facilitate the management of patients with varicose veins and are often completed within a 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 lesions of venous vessels. There are special instructions for performing operations on such patients. Sometimes you have to abandon surgery altogether, and sometimes doctors continue to operate through a combined phlebectomy.
Drug treatment
The treatment regimen for varicose veins is determined by the doctor. Conservative methods and surgical methods are used for this, it all depends on the stage of development of the disease, as well as the presence of complications.
The simultaneous use of medicines and ointments allows you to relieve the symptoms of the pathology and achieve good results in the treatment. Currently, there is a large selection of drugs on the shelves of pharmacies, they are effective in combating the pathology in the early stages of development.
Drug treatment for varicose veins in the legs is effective.
Important!Only a doctor can prescribe medications, dosage and course of their 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 some time, it will begin to stick together and dissolve, and blood flow will be transferred to healthy veins.
The treatment is carried out in a course, which includes up to six sessions for each injured 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 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 preferable 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 administered in the form of microfoam, so the procedure allows you to achieve better results. The thing is that the drug is much closer to the walls of the veins and does not mix with the 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 after a few hours they can go home.
There is practically no hematoma and no intoxication characteristic of general anesthesia. The obtained result lasts for several years.
Phlebectomy is a type of surgery that is 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 his usual lifestyle.
Laser treatment is the mildest method of treatment 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 equipment. 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 available to everyone.
Darsonvalization
With the help of the D'arsonval apparatus, it is possible to normalize the blood circulation, as well as to eliminate the blockage in the diseased veins. The increased tone gradually decreases, the tone of the veins increases. Patients are relieved of pain and itching.
Full circulation of lymph, as well as full blood circulation, allows the tissues to receive proper nutrition and the amount of oxygen in them increases. Veins narrow or widen; gymnastics can increase their elasticity.
The device moves from bottom to top. Lymph and blood flow from the ankle to the thigh and the blockage stops. To achieve the desired result, you must undergo a full course of treatment, which includes at least twenty procedures.
Home remedies
Advice!Varicose veins can also be treated effectively using home remedies.
The most common methods are the use of medicinal plants. You can buy them at the pharmacy or take them yourself during the summer.
White acacia
Based on the flowers of the plant, an alcohol solution is prepared. Soak a cotton swab in it and wipe the affected areas several times a day.
Sagebrush
Gather fresh herbs and grind them in a mortar. Separate a spoonful of herbs and mix 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. Cut the leaves and place them in a glass jar. Pour alcohol on top and let it brew for seven days, stirring occasionally. Strain the tincture and apply it to the injured veins for several months in a row.
Apple cider vinegar
Dissolve two spoons of vinegar in a glass of water and drink it twice a day. It is recommended to rub undiluted apple cider vinegar on the affected areas twice a day. After a month, the veins will start to get smaller.
Cream
Grind one part of garlic, add two parts of butter. In its pure form, put the resulting cream on the sore spots, cover with parchment paper on top and put a bandage. Leave the compress overnight, rinse off in the morning and wrap your feet with an elastic bandage. Repeat the procedures throughout the month.
Garlic
To consolidate the results of the treatment, garlic can be taken internally. Mix 250 grams of chopped garlic and 350 grams of honey, let it brew 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 and wash your feet. The duration of the treatment course is two weeks, then there is a ten-day break and it is repeated.
Preventing
It is much easier to prevent a disease than to fight it later, so prevention is necessary. If you have a hereditary predisposition to the development of 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
The vitamin is found in many foods: lettuce, vegetable oil, legumes. It is necessary to strengthen the walls of the veins, as well as to increase their elasticity. Vitamin C has exactly the same property.
COPPER
Elastin synthesis is aided by foods rich in copper. This includes seafood. To maintain body weight, you must give up sugary foods.
To prevent varicose veins, you should follow the following rules:
- It is not recommended to strain your legs too much during the day. People who work in a standing position should spend several minutes per hour in a sitting position. Ideal: take a horizontal position, raise your legs above your head and hold them for twenty minutes.
- If you work in a sitting position, you should get up for a few minutes once an hour and spend this time standing. Thus, the speed of blood movement through the veins will increase. Periodically rotate your legs in different directions.
- Lifting heavy objects is not recommended.
- Massage your feet daily using a stream of cold water.
- Do not overdo it with visits to saunas and baths.
Effective methods of 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. Most often they are located on the lower third of the leg from the inside, however, they can also be observed on the outside, although this manifestation occurs quite rarely. The deeper the trophic ulcer, the higher the risk of bleeding.Thrombophlebitis. It can happen with any type of varicose veins; the appearance of such a complication directly depends on the coagulation properties of the blood. This complication can be prevented by using laboratory monitoring.Eczema. It occurs due to the violation of tissue trophism. Eczema and trophic ulcers can appear 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 shall be external. Internal (subcutaneous) bleeding is observed with the prolonged flow 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 progress 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, the treatment often does not end.
You must do and follow what the doctor advises, be it magnets for varicose veins of the lower extremities, medications or exercise therapy. It is a complex treatment that gives a positive result and you should not overlook even one point, the most insignificant.