Varicose veins in the lower extremities are a chronic systemic pathology that develops in the background of malfunctions of blood flow control valves.This leads to the accumulation of excessive amounts of liquid in the vessels, which gradually elongate, losing their elasticity and strength. Varicose veins are characterized by the formation of bulky nodules under the skin of the legs, but this is not the only symptom of the disease. Patients complain of leg pain and heaviness, burning and itching, dryness, skin irritation. In advanced cases, non-healing purulent ulcers develop on the skin, which are very difficult to cure due to the irreversible necrotic processes that progress in them. In order for the treatment of varicose veins in the legs to be effective and to help prevent relapse, it is first and foremost necessary to find out the causes.
The cause of varicose veins in the legs
The tendency to develop such severe vascular diseases is often hereditary, and in most cases this pathology is inherited by women. Therefore, if there have been varicose veins in the family, girls and women will be at risk.
Other common causes of the disease:
- Improper nutrition. If the diet is dominated by fatty, heavy foods saturated with animal fats, the risk of varicose veins in the lower extremities increases significantly.
- Heavy physical activity. Certain types of work, such as chef, waiter, surgeon, office worker, hairdresser, create the conditions for a gradual increase in venous pressure. With regular loads, the vessels and valves are deformed, and due to the constantly high pressure, the vessel walls become thinner, brittle, and varicose veins form.
- Wearing uncomfortable high heels. Such footwear reduces the amplitude of muscle contraction, constricts blood vessels, which in turn contributes to harmful blood flow and varicose veins.
- Passive lifestyle. In the absence of at least minimal muscle load, the blood begins to stagnate in the venous bed because the walls of the blood vessels do not contract on their own. Gradually, the blood vessels lengthen, the valves stop working, varicose veins and nodules form.
- Overweight. The more a person is overweight, the greater the load on the lower limbs and, accordingly, on the blood vessels. In addition, obese people exercise very little and mostly eat poorly, doubling the chances of varicose veins getting into their legs.
- Pregnancy. As the fetus grows, the volume of blood in the expectant mother’s body increases, which puts additional stress on the veins. In addition, the growing uterus and fetus compress the vessels in the small pelvis, which prevents normal venous outflow. During pregnancy, the hormone progesterone is produced in excess, which relaxes the walls of the blood vessels, contributing to the formation of varicose veins. In most cases, varicose veins during pregnancy are reversible, so a woman can get rid of the problem completely after giving birth.
- Disease. As the body ages, the walls of the veins as well as the valves cease to perform their functions fully, becoming weak. Flexibility and strength are lost, causing the blood vessels to strain.
Mechanism of lower limb varicose veins
The varicose veins of the lower extremities develop according to a complex mechanism:
- In the initial stage, in the presence of hereditary tendency and to provoke exogenous and endogenous factors, the flow of venous blood slows down. The long stagnant process causes the formation of inflammatory processes on the walls and valves of the vein.
- With the failure of the valve and the weakness of the walls of the venous vessels, blood begins to flow in both directions through the veins. This leads to an increase in intravenous pressure, which in turn leads to strain and deformation of the vessel wall.
- Further stagnation of the blood and progression of the inflammatory process contribute to the spread of pathology, the development of ischemia, and the development of trophic ulcers.
The function of the affected veins is gradually impaired. Varicose veins cause blood to stagnate in the blood vessels, leading to local toxic lesions as well as an increase in pressure. In advanced stages, the vessels are no longer able to withstand the excessive pressure that causes cracks to appear, leading to profuse bleeding.
The disease is insidious in that it is almost asymptomatic in the earliest stages. The first sign of the development of varicose veins - fatigue in the legs, patients often ignore and do not become educated with the help of a specialist. However, as the pathology progresses, leg fatigue is felt more often, especially in the evening, after a hard day. Other symptoms of vascular diseases:
- Feeling pain, tightness. Such signs appear from the second stage onwards, when the pathological process began to progress. The pain bothers you most in the evening after a hard day and disappears in the morning. If a person ignores the discomfort and there is no treatment, the pain syndrome becomes chronic and they are constantly worried.
- Swollen veins and vasculature. At first, the affected blood vessels are stronger than usual, but later they bulge, bulge, form lumps. The vascular network is more often localized on the thighs and legs.
- Cramps. It is a characteristic sign of varicose veins caused by stagnation of blood in the veins. Stagnant processes lead to an increase in vascular pressure, as a result of which the muscles begin to contract spontaneously.
In addition, vascular diseases are accompanied by marked external changes. With the development of ischemia, patients complain of constant itching. Excessive stretching and thinning of the veins leads to bruising and bruising. At an advanced stage, when atrophic processes develop, such external symptoms appear:
- red spots on the skin;
- formation of dark pigmented spots;
- the disappearance of the hair.
If a patient develops trophic ulcers, along with blackening of the limbs, this indicates the progress of irreversible necrotic processes.
Complications of leg varicose veins
If there is no treatment for lower limb varicose veins as the disease progresses, serious complications develop, such as:
- Venous thrombosis. In such a complication, the abnormal processes affect the deep veins. The pathology is accompanied by blockage of the blood vessel with a blood clot - a thrombus. The main cause of venous thrombosis is a slowdown in blood flow to the lower extremities.
- Pulmonary embolism. A condition in which a blood clot detached from the blood vessel wall enters the pulmonary artery along with the blood flow, blocking its lumen. If the blood clot is large, death occurs immediately. Smaller blood clots do not lead to death, but cause complex respiratory and circulatory disorders.
- Thrombophlebitis. It is characterized by inflammation of the surface vessel wall, accompanied by the formation of a blood clot. The disease is hyperemia, swelling along an inflamed and clogged vein, pain of varying intensity. Acute thrombophlebitis is associated with fever, chills, which supplement the above symptoms.
- Trophic ulcers. An unavoidable complication of untreated varicose veins in the lower extremities, which develops in the absence of timely treatment. Disruption of tissue nutrition and the progress of the inflammatory process contribute to the compaction of subcutaneous tissue, the thinning and darkening of the skin, and the development of an incurable trophic ulcer.
- Varicose veins. Local redness, peeling and unbearable itching of the skin are manifested. If left untreated, the complication spreads rapidly and leads to a deterioration in the patient’s condition.
- Bleeding in varicose veins. It is a dangerous complication that develops in the background of the rupture of the varicose veins.
Bleeding can occur due to mechanical damage as the walls of the affected veins are very fragile and thinned. Therefore, even mild friction can cause copious venous bleeding.
Diagnosis of varicose veins in the lower extremities
In the presence of symptoms suggestive of vascular disease of the lower extremities, a consultation should be made with a phlebologist who will diagnose, treat, and prevent such vascular pathology.
During the initial examination, the doctor will be able to make a preliminary diagnosis, in which a dense network of blood vessels, swollen veins protrude above the surface of the skin, and venous nodules are located on the limbs. To confirm the diagnosis, a reference is given for a further examination, which includes the following procedures:
- ultrasound dopplerography;
- ultrasound duplex angioscanning;
- radionuclides and radiopaque phleboscintigraphy;
Treatment of varicose veins in the legs
If the disease is diagnosed at the earliest stage when there are no serious complications, conservative therapy is prescribed, the main goals of which are:
- eliminates stagnant processes;
- normalizes venous pressure;
- restore blood circulation;
- eliminate the abnormal symptoms.
For these purposes, medicines belonging to the following groups are used:
- Venotonics and phlebotonics. They help to repair blood vessels, normalize blood circulation and improve lymph outflow.
- Anticoagulants. They are used to reduce the viscosity of the blood and prevent blood clots from forming.
- Non-steroidal anti-inflammatory drug. They have a pronounced anti-inflammatory effect, relieving pain.
- Antiplatelet agents. Reduce the risk of thrombosis, improve tissue trophism.
If medical treatment is ineffective and the disease progresses, the doctor will discuss surgical treatment options with the patient. Surgical methods for treating varicose veins include:
- Sclerotherapy. The introduction of a sclerosing preparation into the lumen of the affected vein, which adheres to the vessel, results in its self-absorption, being replaced by connective tissue.
- Laser coagulation. It is indicated in cases where the diameter of the affected veins does not exceed 10 mm. The laser beams create a sclerosing effect in the vessel, as a result of which it dissolves on its own.
- Phlebectomy. A surgical procedure in which the surgeon excises the deformed areas of the vessels, performing all necessary manipulations through microscopic punctures of the skin.
Varicose veins in the legs, any activity that contributes to the development of stagnant processes in the vessels of the lower limbs is contraindicated:
- prolonged stay in a static position;
- heavy physical activity, lifting a lot of weight;
- sitting bent or crossed legs;
- wearing tight, uncomfortable shoes.
You also need to get rid of bad habits like smoking, drinking alcohol. Tobacco smoke and alcohol negatively affect the health of the whole body, making the veins fragile, thinned, inflexible, which soon leads to varicose veins and other cardiovascular diseases.
Costs of treating varicose veins in the lower extremities
The following factors affect the treatment of varicose veins in the legs:
- the stage of diagnosing the disease;
- accompanying complications;
- individually selected therapeutic method - conservative or surgical;
- the need for additional therapeutic techniques such as physiotherapy.