Modern healthcare faces many different challenges, but despite rapid advances in medicine, some diseases continue to affect millions of people. Varicose veins of the lower limbs ICD 10 - I83 are precisely a problem that cannot practically be solved over time.
Prevalence in figures
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 all patients are over 55, but the other portion are able-bodied workers, most often employed in the manufacturing sector. As the disease progresses, complications develop and patients lose their jobs due to disability. The problem therefore becomes not only medical, but also economic and social. The occurrence of varicose veins may be correlated with the age of the patient. In people over 70 years old, varicose veins of the lower limbs are more common than in people before retirement age.
In four out of a hundred patients over 80 years old, varicose veins take 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 best to consult a doctor; the younger the patient, 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 favoring the development of varicose veins.
So, what are the causes of varicose veins:
- heredity;
- endocrinological reasons;
- mechanical factor;
- infection;
- poisoning;
- nonspecific inflammatory process;
- factors contributing to venous hypertension.
Complaints and symptoms
Curiously, at the very beginning of the disease, visible problems appear, often ignored. By confusing small vessel abnormalities with a minor external disorder that will "go away on its own, " patients provoke the development of the disease.
Other symptoms develop gradually:
- feeling of fatigue/heaviness in the legs;
- swelling in the feet;
- night cramps;
- numbness, tingling, "pins and needles" feeling;
- pain in varicose veins.
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 in tandem. Depending on the course of the disease, all methods or only some of them may be used.
Methods of clinical examination - examination and conversation
Clinical methods are used not only for varicose veins, but also for any other diseases:
- History taking. The history includes all the basic facts about one's life (age, heredity, bad habits, type of main job).
- Definition of complaints. The complaints can indicate how far the varicose veins have progressed at the time of the examination. The duration of the illness 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, in order 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.
A phlebologist is the first doctor who should examine your feet.
Instrumental examination methods are a prerequisite
To prescribe treatment, a single 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. 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, thereby 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 tomography venography. It is carried out in the same way as radiological contrast, with the introduction of a contrast product into the lumen of the vessel. Unlike an x-ray, a CT image is three-dimensional.
- MRI.The method is justified and informative and is carried out without administration of contrast medium or other drugs. 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 an 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 illness |
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| Anatomical location of veins |
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| Disease mechanism |
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Grade 2 varicose veins of the lower extremities, when the external manifestations of the disease become significant, are the most common reason for seeking help from specialists. Perhaps, if the disease did not manifest itself externally, the detection of varicose veins would occur at later stages.
Note!The concept of "internal varicose veins of the lower extremities" is used only colloquially, denoting 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 believe that treatment is necessary. The doctor's task is often to convince the patient to start treatment in the early stages of the disease. The direction of treatment may be different and depends on many factors (age, symptoms, degree of disease, etc. ).
Thus, the treatment can aim to:
- improve quality of life; cosmetic surgical procedures.
- prevent complications; impact on microcirculation.
- elimination of symptoms; hemodynamically significant treatment.
One way or another, treatment is always chosen by a specialist (phlebologist, vascular surgeon). In the treatment of varicose veins, the complexity is significant, so we cannot limit ourselves to surgical intervention alone, nor to therapeutic and preventive physical training. It is important to follow all doctor's instructions.
Lifestyle Tips
Varicose veins force patients to abandon factors provoking complications. Sometimes such a measure is necessary, because untreated varicose veins greatly affect the quality of life.
Do-it-yourself treatment is a useless exercise, but you need to pay attention to your lifestyle so that varicose veins do not progress so quickly.
What to do in case of varicose veins:
- Women must give up high-heeled shoes;
- Give up bad habits, especially smoking;
- Move around, if you have to sit or stand for a long time, then try changing your position;
- Avoid tight/fitted clothing 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 as much as possible (sleeping, resting).
Compression therapy
Regardless of the etiology, patients suffering from varicose veins should wear medical knitwear or apply elastic bandages.
- The use of knitwear is the most practical: stockings or high socks, made of a special material, most often do not cause inconvenience. The compression level of medical stockings should be recommended by a doctor. The only downside to compression garments is their price.
Note!Brands of manufacturers of medical knitwear may be different, so you should choose carefully. Make sure the elastic on your socks or stockings is not too tight.
- As an alternative, patients often prefer to use elastic bandages with short, medium or long stretch. The choice of distensibility also depends on the stage of the disease and should be recommended by a doctor. The first few uses may be a little difficult because you will have to control the tension level of the bandage yourself.
Compression therapy is used daily, wearing underwear or bandages significantly relieves the load on the legs throughout the day.
Physical education and sport as treatment
Varicose veins require movement, which is why therapeutic and preventive physical education is an important element. 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 often, exercise therapy exercises do not require special training and are available regardless of age; for clarity, a set of exercise therapy exercises:
- Contract and relax the thigh muscles (10 times);
- Inhale by lifting the abdominal wall, while exhaling, pull in your stomach (4 times);
- Bend and straighten your legs at the ankle (10 times);
- While inhaling, raise your arms to the sides, while 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 series of exercises it is clear that everyone 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. This is particularly important if the patient practices a sport not recommended for varicose veins.
Sports, as an alternative to exercise therapy for varicose veins of the lower extremities, is also suitable, but you should consult a doctor and a personal trainer. Certain exercises will have to be excluded from training.
Athletes are sometimes simply forced to abandon their professional careers, particularly in show jumping, powerlifting and heavyweight boxing. Those who enjoy swimming, running and walking can, in turn, continue to do so.
Medicines, after being prescribed by a doctor
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.
This is why all medications must be prescribed by a doctor. It is with this in mind 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 in tandem or separately.
Phlebosclerosing treatment
Phlebosclerosis also refers to pharmacological treatment methods, but 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 the aesthetic sense.
It should be noted that the use of this method is fraught with relapses and complications, therefore the procedure is carried out 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 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 physiotherapy procedures are not applied continuously, but in courses of 10-20 days. In most cases, physiotherapy helps to delay the progression of the disease, but is not the main method of treatment and certainly cannot be used as monotherapy.
Surgical treatment
Despite the numerous therapeutic methods, surgery remains practically the most fundamental and important. Vascular surgeons successfully perform operations on many patients.
Traumatic venectomies have become a thing of the past thanks to the advent 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 surgical intervention: the main group is patients over 75 years old with tissue trophic disorders, microcirculation and/or lymphatic drainage disorders or excessive damage to thevenous vessels. There are special instructions for performing operations on these patients. Sometimes you have to abandon the operation altogether, and sometimes doctors still operate by combined phlebectomy.
Medical 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, as well as the presence of complications.
The simultaneous use of drugs and ointments allows you to relieve the symptoms of pathology and achieve good treatment results. Currently, there is a wide selection of drugs on pharmacy shelves, they are effective in combating pathology from its early stages of development.
Drug treatment of varicose veins of the legs is effective.
Important!Only a doctor can prescribe medications, their dosage and method of use.
Sclerotherapy
Sclerotherapy is one of the best methods of treating varicose veins today. Specially administered drugs allow you to destroy the stagnation of the vein inside. After a while, they will begin to stick together and dissolve, and blood circulation will be transferred to healthy veins.
Treatment is carried out in a course consisting of up to six sessions for each sore leg. You can see a positive result no earlier than two weeks. However, patients should be prepared to feel pain and tingling.
Soon the unpleasant symptoms will disappear, 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 gives a high chance of recovery.
Echosclerotherapy is the same as sclerotherapy, the difference is the use of an ultrasound machine. This method is preferable because the movement of the syringe can be monitored and the medication will be distributed evenly.
Foam sclerotherapy is another type of sclerotherapy. The medications are administered in the form of microfoam, so the procedure allows you to achieve better results. The fact is that the medicine 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 receive local anesthesia and after a few hours they can go home.
There are practically no hematomas and there is no intoxication characteristic of general anesthesia. The result obtained lasts 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 most gentle treatment method and can only be carried out by a qualified specialist. Using an ultrasound machine, 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 accessible to everyone.
Darsonvalisation
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 are relieved of pain and itching.
Full circulation of lymph, along with full blood circulation, allows tissues to receive adequate nutrition and the amount of oxygen in them increases. The veins narrow or dilate; gymnastics can increase their elasticity.
The device moves from bottom to top. Lymph and blood flow from the ankle to the thigh and the congestion stops. In order to achieve the desired result, you must undergo a comprehensive course of treatment consisting of 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 herbs. You can buy them at the pharmacy or collect them yourself in the summer.
White acacia
An alcoholic tincture is prepared based on the flowers of the plant. Dip cotton swabs in it and wipe the affected areas several times a day.
Mugwort
Collect fresh herbs and grind 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, then repeat the treatment.
Kalanchoe
Wash the Kalanchoe leaves, place them on a paper towel and let dry. Chop the leaves and place them in a glass jar. Pour alcohol over it and let it brew for seven days, stirring occasionally. Strain the tincture and lubricate the 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 onto painful areas twice a day. After a month, the veins will start to become 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 baking paper on top and apply a bandage. Leave the compress to act overnight, wash in the morning and wrap your legs with an elastic bandage. Repeat the procedures throughout the month.
Garlic
In order to consolidate the results of treatment, you can take garlic internally. Mix 250 grams of chopped garlic and 350 grams of honey, leave to infuse for five days. Take one scoop three times a day.
Tomatoes
Cut a fresh tomato into slices, apply it to the problem area and wrap it with a bandage. Keep the compress on for four hours, then remove it 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 the development of 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 and increase their elasticity. Vitamin C has exactly the same property.
Copper
Elastin synthesis is favored by foods rich in copper. Seafood is included here. In order to maintain your weight, you must 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 in a standing position should spend several minutes per hour in a seated position. Ideal: take a horizontal position, raise your legs above your head and hold for twenty minutes.
- If you work in a seated position, you should get up for a few minutes once an hour and spend this time standing. Thus, the speed of blood circulation in the veins will be increased. Periodically rotate your feet in different directions.
- It is not recommended to lift heavy objects.
- Massage your feet daily using a jet of cool water.
- Do not overuse visits to saunas and baths.
Effective methods of treating varicose veins can provide good results. Patients quickly return to a full life.
How does the disease get complicated?
Complications from varicose veins are always unpredictable, even if they develop gradually. Without medical supervision and therapeutic treatment, the risk of developing complications becomes several times greater.
- Trophic ulcers with ascending and descending varicose veins.They are most often localized on the lower third of the leg on the inside, however, they can also be observed on the outside, although this manifestation is quite rare. The deeper the trophic ulcer, the higher the risk of bleeding.
- Thrombophlebitis.This can occur with any type of varicose veins; the occurrence of such a complication directly depends on the coagulatory properties of the blood. This complication can be avoided through laboratory monitoring.
- Eczema.Occurs due to a violation of tissue trophism. Eczema and trophic ulcers can occur together or separately.
- Bleeding from varicose veins of the lower limbs.This type of complication can appear in the context of deep trophic ulcers, as described above; this bleeding will be external. Internal (subcutaneous) bleeding is observed in cases of prolonged development of varicose veins.
What is important to know about varicose veins
Varicose veins become a test for patients, because the more they ignore them, 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 stop.
What the doctor advises should be done and followed, whether it is a magnet for varicose veins of the lower extremities, medication or exercise therapy. This is a complex treatment that gives a positive result, and you should not ignore a single, even the most insignificant point.