Varicose veins of the lower extremities are a chronic systemic pathology that develops against the background of dysfunction of the valves that control blood flow.
This leads to the accumulation of an excessive volume of fluids in the vessels, which gradually stretch, losing elasticity and strength.Varicose veins are characterized by the formation of voluminous nodes under the skin of the legs, but this is not the only symptom of the disease.Patients complain of pain and heaviness in the legs, burning and itching, dryness and irritation of the skin.In advanced cases, non-healing purulent ulcers are formed on the skin, which are very difficult to cure because of the irreversible necrotic processes that progress in them.In order for the treatment of varicose veins in the legs to be effective and help prevent recurrence, it is necessary to first find out its causes.
Causes of varicose veins in the legs
The tendency to develop such a severe vascular disease is often hereditary and in most cases this pathology is inherited by women.Therefore, if there are cases of varicose veins in your family, girls and women will be at risk.
Other common causes of the disease:
- Poor nutrition.If the diet is dominated by fatty and heavy foods rich in animal fats, the risk of developing varicose veins of the lower extremities increases significantly.
- Heavy physical activity.Some types of work, for example, a cook, a waiter, a surgeon, an office worker, a hairdresser, create conditions for a gradual increase in pressure in the veins.With regular stress, blood vessels and valves are deformed;due to the continuous high pressure, the walls of the veins become thinner, become fragile and varicose veins develop.
- Wearing uncomfortable high-heeled shoes.Such shoes reduce the amplitude of muscle contraction and compress blood vessels, which in turn contributes to impaired blood flow and the development of varicose veins.
- Sedentary lifestyle.In the absence of at least a minimal load on the muscles, blood begins to stagnate in the venous bed, since the walls of the veins do not contract on their own.Gradually, the vessels are stretched, the function of the valves is broken, and thickening and varicose veins are formed.
- Excess weight.The more excess weight a person has, the greater the load on the lower limbs and, accordingly, the blood vessels.In addition, obese people move very little and mostly eat poorly, doubling the chances of getting varicose veins in the legs.
- Pregnancy.As the fetus grows, the volume of blood in the future mother's body increases, which creates additional stress on the veins.In addition, the growing uterus and fetus compress the pelvic vessels, which prevents normal venous outflow.During pregnancy, the hormone progesterone is produced in excess, which relaxes the walls of blood vessels, promoting the development of varicose veins.In most cases, varicose veins during pregnancy are reversible, so after giving birth, a woman can completely get rid of the problem.
- Age.As the body ages, the walls of the veins, as well as the valves, cease to perform their functions completely, becoming weaker.Elasticity and strength are lost, causing the vessels to stretch.
The mechanism of development of varicose veins of the lower extremities
Varicose veins of the lower extremities develop according to a complex mechanism:
- In the initial stage, in the presence of a hereditary predisposition and the provocation of exogenous and endogenous factors, a slowing of venous blood flow occurs.A long-term stagnation process causes the development of inflammatory processes in the vein walls and valves.
- When the valves are incompetent and the walls of the venous vessels are weak, blood begins to flow through the veins in both directions.This leads to an increase in intravenous pressure, which in turn leads to excessive stretching and deformation of the walls of blood vessels.
- Further stagnation of blood and the progress of the inflammatory process contribute to the spread of pathology, the development of ischemia and the formation of trophic ulcers.
Gradually, the function of the affected veins is impaired.Varicose veins cause stagnation of blood in blood vessels, which leads to local toxic lesions, as well as an increase in pressure.In advanced stages, the vessels are no longer able to withstand the excess pressure, resulting in ruptures, which lead to massive hemorrhages.
Symptoms
The disease is insidious in that in the earliest stages it is practically asymptomatic.The first sign that indicates the development of varicose veins is fatigue in the legs, which is often ignored by patients and does not become a reason to seek advice from a specialist.However, as the pathology progresses, leg fatigue is felt more often, especially appearing in the evening, after a day's work.Other symptoms of vascular disease:
- Pain, feeling of squeezing.Such signs begin to appear in the second stage, when the pathological process begins to progress.The pain appears mainly in the evening after a day's work, and disappears in the morning.If a person ignores the discomfort and there is no treatment, the pain syndrome becomes chronic and bothers him constantly.
- Varicose veins and vascular network.At first, the affected veins are stronger than usual, but later they begin to swell, swell, forming knots.The vascular network is most often located in the thigh and leg.
- Cramps.A characteristic sign of varicose veins, the cause of which is blood stagnation in the veins.Stagnant processes lead to increased pressure in the vessels, as a result of which the muscles begin to contract spontaneously.
In addition, vascular disease is accompanied by pronounced external changes.With the development of ischemia, patients complain of constant itching.Excessive stretching and thinning of the veins leads to the formation of hematomas and bruises.In advanced stages, when atrophic processes develop, the following external symptoms appear:
- red spots on the skin;
- peeling;
- the formation of dark pigmented spots;
- hair loss.
If the patient develops trophic ulcers, accompanied by blackening of the extremities, this indicates the progress of irreversible necrotic processes.
Complications of varicose veins of the legs
If there is no treatment for varicose veins of the lower extremities, serious complications develop as the disease develops, such as
- Venous thrombosis.With this complication, pathological processes affect the deep veins.Pathology is associated with blockage of a vessel with a blood clot - a thrombus.The main cause of venous thrombosis is the slowing of blood flow in the lower extremities.
- Pulmonary embolism.A condition when a blood clot detached from the wall of a vessel, along with the blood flow, enters the pulmonary artery, blocking its lumen.If the blood clot is large, death occurs immediately.Smaller clots do not lead to death, but cause complex breathing and circulatory disorders.
- Thrombophlebitis.It is characterized by inflammation of the superficial vessel walls, accompanied by the formation of a blood clot.The disease is manifested by hyperemia, swelling along the inflamed and blocked vein, pain with varying degrees of intensity.Acute thrombophlebitis is accompanied by fever and chills, which complement the above symptoms.
- Trophic ulcer.An inevitable complication of untreated varicose veins of the lower extremities, which develops in the absence of timely treatment.Violation of tissue nutrition and the progress of the inflammatory process contribute to the compression of the subcutaneous tissue, thinning, darkening of the skin, followed by the formation of a non-healing trophic ulcer.
- Varicose eczema.It appears as local skin rash, peeling and unbearable itching.If there is no treatment, the complication spreads quickly and leads to a worsening of the patient's condition.
- Bleeding from varicose veins.A dangerous complication that develops against the background of rupture of varicose veins.
Bleeding can occur due to mechanical damage, as the walls of the affected veins are very fragile and thin.Therefore, even light friction can cause severe venous bleeding.
Diagnosis of varicose veins of the lower extremities
If you have symptoms that indicate the development of varicose veins of the lower extremities, you should make an appointment with a phlebologist who will diagnose, treat and prevent such vascular pathology.
The doctor will be able to make a preliminary diagnosis during the initial examination, during which a dense vascular network, swollen veins protruding above the surface of the skin and venous nodes in the limb are detected.To confirm the diagnosis, a referral is given for additional examination, including the following procedures:
- Doppler ultrasound;
- duplex ultrasound angioscan;
- radionuclide and radiopaque phleboscintigraphy;
- phlebomanometry;
- plethysmography;
- photoplethysmography.
Treatment of varicose veins of the legs
If the disease is diagnosed in the earliest stages, when there are no serious complications, conservative therapy is prescribed, the main goals of which are:
- elimination of stagnant processes;
- normalization of pressure in the veins;
- restoration of blood circulation;
- elimination of pathological symptoms.
For these purposes, drugs of the following groups are used:
- Venotonics and phlebotonics.It helps improve the health of blood vessels, normalize blood circulation and improve lymph flow.
- Anticoagulants.It is used to reduce blood viscosity and prevent blood clotting.
- Nonsteroidal anti-inflammatory drugs.They have a pronounced anti-inflammatory effect and relieve pain.
- Antiplatelet agents.It reduces the risk of thrombosis and improves tissue trophism.
If drug treatment is ineffective and the disease progresses, the doctor discusses surgical treatment options with the patient.Surgical methods for treating varicose veins include:
- Sclerotherapy.The introduction into the lumen of the affected vein of a sclerosing medication, which glues the vessel, as a result of which it resolves itself, 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 on the vessel, as a result of which it resolves itself.
- Phlebectomy.A surgical intervention during which the surgeon removes the deformed areas of the blood vessels, performing all the necessary manipulations through microscopic punctures in the skin.
Contraindications
For varicose veins in the legs, any action that contributes to the development of stagnation in the vessels of the lower extremities is contraindicated:
- long standing in static positions;
- heavy physical activity, lifting heavy weights;
- sitting with legs together or crossed;
- wearing tight and uncomfortable shoes.
It is also necessary to get rid of bad habits such as smoking and alcohol abuse.Tobacco smoke and alcohol negatively affect the health of the whole body, making the veins fragile, thin and inelastic, which soon leads to the development of varicose veins and other cardiovascular diseases.
The cost of treating varicose veins of the lower extremities
The cost of treatment for varicose veins in the legs is influenced by the following factors:
- the stage at which the disease was diagnosed;
- related complications;
- individually chosen method of therapy - conservative or surgical;
- the need for additional therapeutic techniques, such as physiotherapy.